Kenneth Kee - A Simple Guide to Cushings Syndrome: Treatment and Related Diseases

A Simple Guide To Cushing 's Syndrome, Treatment And Related Diseases By Dr Kenneth Kee M.B., B.S. ( Singapore) Ph.D (Healthcare Administration) Copyright Kenneth Kee 2014 Published by Kenneth Kee at amazon.com
Dedication This book is dedicated To my wife Dorothy And my children Carolyn, Grace And Kelvin This book describes the Cushing Syndrome, Treatment and Adrenal Diseases such as Adrenal Fatigue, Adrenal Crisis, Adrenal tumors, Addisons disease which are seen in some of my patients in my Family Clinic. This eBook is licensed for your personal enjoyment only. This eBook may not be re-sold or given away to other people. If you would like to share this book with another person, please purchase an additional copy for each reader. If youre reading this book and did not purchase it, or it was not purchased for your use only, then please return to Amazon.com and purchase your own copy.

Thank you for respecting the hard work of this author.
TABLE OF CONTENT

Chapter 5 Addison Disease Chapter 6 Adrenal Fatigue Chapter 7 Adrenal Crisis Epilogue
Introduction Cushing Syndrome is due to the presence of excess corticosteroids This is produced in the adrenal glands as mineral and glucocorticoids Corticosteroids are also present as pharmaceutical medications They are used in allergies and immunosuppressants in many conditions Cushing Syndrome patients have round flat plethoric red face (moon face) Their skin is thin and often bruises very easily When there is a scratch and a localized injury (bump) Truncal obesity occurs with pad of fat between shoulders (buffalo hump) There is weakness of the muscles of the upper and lower limbs Osteoporosis can lead to back pain and a leg limp Excessive adrenal androgen secretions lead to acne and hirsutism Stunting of growth may occur as in hypothyroidism Treatment is by reducing all forms of iatrogenic corticosteroids There may be use of anti-adrenal drug such as aminogluthemide Bilateral adrenalectomy may reduce the adrenal hormone production P ituitary tumor or primary tumor in lungs is removed by operation -An original poem by Kenneth Kee Interesting Tips about the Cushing Syndrome A Healthy Lifestyle 1. Take a well Balanced Diet 2. Treatment of Cushing Syndrome: a. Cushing syndrome caused by corticosteroid use: Slowly decrease the drug dose (if possible) under medical supervision. b. b.

Cushing syndrome caused by a pituitary or a tumor that releases ACTH (Cushing's disease): Surgery to remove the tumor Radiation after removal of a pituitary tumor (in some cases) You may need hydrocortisone (cortisol) replacement therapy after surgery, and possibly continued throughout your life c. Cushing syndrome due to an adrenal tumor or other tumors: Surgery to remove the tumor If the tumor cannot be removed, medications to help block the release of cortisol i. Anti-adrenal drug such as aminogluthemide ii. Bilateral adrenalectomy iii. Surgery to remove primary neoplasm in lungs or pancreas 3. Keep bones and body strong Bone marrow produces our blood Eat foods rich in calcium like yogurt, cheese, milk, and dark green vegetables.

Eat foods rich in Vitamin D, like eggs, fatty fish, cereal, and fortified milk. Eat food rich in Vitamins B and C such as green vegetables and fruits Zinc and other minerals are important to the body 4. Get enough rest and Sleep Avoid stress and tension 5. Exercise and stay active. It is best to do weight-bearing exercise such as walking, jogging, stair climbing, dancing, or lifting weights for 2 hours a week. One way to do this is to be active 30 minutes a day at least 5 days a week.

Begin slowly especially if a person has not been active. 6. Do not drink more than 2 alcohol drinks a day for a man or 1 alcohol drink a day for a woman. Alcohol use also increases the chance of falling and breaking a bone. Alcohol can affect the neurons and brain cells. 7. 7.

Stop or do not begin smoking. It also interferes with blood supply and healing. Cigarettes contain more than forty types of hazardous and possibly cancer causing chemicals which can harm the smokers and those around them
Chapter 1 Cushings Syndrome What is Cushing Syndrome? Cushing Syndrome is a disease that is caused by the exposure of the body to excessive quantities of glucocorticoids steroids. Cushing syndrome is a disorder that occurs when your body is exposed to high levels of the hormone cortisol. It may also occur if you take too much cortisol or other steroid hormones. People of all ages are affected but more are seen in females between 30 to 50 years of age.

What are the causes of Cushing Syndrome? The causes are believed to be: Some people develop Cushing syndrome because their bodies produce too much cortisol, a hormone normally made in the adrenal gland. 1. Cushing Disease - when the pituitary gland makes too much of the hormone ACTH. ACTH then signals the adrenal glands to produce cortisol. Tumor of the pituitary gland may cause this condition. A pituitary basophile or chromphobe adenoma may be present.

There is excessive production of adrenocorticotrophin hormone (ACTH) by the pituitary gland causes bilateral adrenal (gland above kidney) hyperplasia (overgrowth of gland tissue). The enlarged adrenal gland will produce excessive corticosteroids. 2. Adrenal tumors that may be benign or malignant can produce excessive corticosteroids Tumor elsewhere in the body that produces cortisol 3. Ectopic ACTH syndrome Production of ACTH by a tumor such as cancer of the lung leads to adrenal hyperplasia Tumors elsewhere in the body that produce ACTH (such as the pancreas, lung, and thyroid) 4. Iatrogenic -patients receiving excessive doses of corticosteroids may present as Cushing syndrome Cushing syndrome may be caused by taking too much corticosteroid medications such as prednisone and prednisolone.

These drugs are used to treat conditions such as asthma and rheumatoid arthritis. What are the symptoms of Cushing Syndrome? Symptoms of Cushing Syndrome: 1. Obesity predominally truncal often with pad of fat between shoulders (buffalo hump) Upper body obesity (above the waist) and thin arms and legs 2. Round flat plethoric red face (moon face) 3. Skin changes that are often seen: Acne or skin infections Purple marks (1/2 inch or more wide) called striae on the skin of the abdomen, thighs, and breasts Skin is thin and bruises easily 4. Muscle and bone changes include: Backache, which occurs with routine activities Bone pain or tenderness Collection of fat between the shoulders (buffalo hump) Rib and spine fractures (caused by thinning of the bones) and Osteoporosis Weak muscles - Proximal myopathy leads to difficulty in getting out of chairs and walking upstairs 5.

Women with Cushing syndrome often have: Hirsutism - Excess hair growth on the face, neck, chest, abdomen, and thighs Menstrual cycle that becomes irregular or stops 6. Men may have: a. Decreased or no desire for sex b. Impotence 7. Slow growth rate in children - there may stunting of growth 8. Hypertension and glycosuria (glucose in urine) are common 9.

Other symptoms that may occur with this disease: a. Mental changes, such as depression, anxiety, or changes in behavior b. Fatigue c. Headache d. Increased thirst and urination How is the Diagnosis of Cushing Syndrome made? Diagnosis of Cushing Syndrome: 1. The typical moon face and buffalo hump can suggest the diagnosis of Cushing Syndrome 2.

Blood sugar and white blood cell counts may be high. 3. Potassium level may be low. Laboratory tests that may be done to diagnose Cushing syndrome and identify the cause are: 1. Serum cortisol levels 2. Salivary cortisol levels 3.

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