January 10, 2007

In This Issue

Search the website:

General Cushing's Info:
• Cushing's Syndrome Laboratorial Diagnosis

Adrenal:
Images of Adrenal Glands
ERK phosphorylation in the adrenal gland in response to chronic ACTH treatment

Pituitary:
Bilateral Inferior Petrosal Sinuses Sampling in the Routine Investigation of Cushing's Syndrome: A Comparison with MRI
A Novel Nuclear Receptor Cofactor Modulates Glucocorticoid-
Responsive Gene Expression

Corticotroph Tumor Progression after Adrenalectomy in Cushing’s Disease: A Reappraisal of Nelson’s Syndrome
Early Assessment of Hypothalamic-Pituitary-
Gonadal Function in Patients with Congenital Hypothyroidism of Central Origin

Pituitary: small gland with a big job
Eight on faculty receive DSPs, Named Chairs

Cortisol:
Adults Who Go to Bed Lonely Get Stress Hormone Boost Next Morning
Purge Protection
Post Traumatic Stress Disorder
Stress can affect overall well-being

General Health
Confusion between types of steroids

Newest site features: bios, Helpful Doctors
US Postage Stamps for Cushing's Awareness
Order Cushing's Awareness Silicone Bands for yourself, a family member or donate to a Cushing's patient at NIH
Upcoming Meetings: Washington, DC and Toronto ENDO 2007.


Also on the website:

Pictures from Past Meetings:
April 8, 2007, Petitions on the message boards to have April 8 be declared as Cushing's Awareness Day again this year. This date was chosen because it was Dr. Harvey Cushing's Birthday. More info here »

Pictures from the Pittsburgh, PA Christmas Dinner, December 13, 2006
Click here »

Pictures from the April 5-8, 2006 CUSH Cushing's Awareness Day Medical Forum, held in Oklahoma City, OK
Click here »

Upcoming Meetings:
MAGIC Foundation (Growth Hormone) 3rd Adult Educational Convention, February 9 to 11, 2007, Las Vegas, NV More info here or call 708.383.0808 for details.»
June 2-5, 2007, ENDO 2007, Toronto, Canada, Metro Toronto Center.

Recent Donations:

click for fullsize graph

In honor of:
   Dr. Jennifer Pecina
Other donors
To make a donation
Donations cover...

News:
The message boards now number over 5,500 participants.
Search Tool. Use this tool to search this site, PubMed, NIH Clinical Trials or any other website. More sites to be added soon.
CUSH Cuisine! $10.00 each, including shipping.
More info »
Guest Transcripts »

Latest Media:

Helpful Books (pituitary):
Art Russell shares the powerful story of his struggle with Cushing's Disease.
October 18, 2006 Obese from Secret Disease (ABC News) (Jaimie on the boards) Read this article »
Jun 17, 2006 Student hopes to rebound from brain surgery Rare disease caused teen to double weight in a year Read this article »
May 21, 2006 Rare disease treated at OHSU (sowens on the boards) Read this article »
May 15, 2006 Patients Fighting Cushings Disease (Rooon on the boards)
Read this article »
MedScape News

Newest Site Features:
Read the Current Newsletter »
Packing Suggestions For Surgery
Talk to Your Doctor
New Diabetes Drug Successfully Used to Treat Pituitary Tumors
New Approaches to Managing Tumors of the Pituitary Gland Offer Patients Hope.
Corticosteroid Converter.
More info on Adrenal Crisis.
Helpful Hints for dealing with Cushing's Symptoms. The first ones are here.
Add your Helpful Hints
US Cushing's Postage Stamps to promote Cushing's Awareness. See a sample here.
Cushing's Bracelets to promote Cushing's Awareness. Order the bands here.
Reviews of this site

Testing:
Midnight Salivary Cortisol Versus Urinary Free and Midnight Serum Cortisol

Videos and Webcasts:
Video: Transnasal Pituitary Surgery
Webcasts from NIH Pituitary Symposium and Endo 2004.
Videos on several topics of interest to Cushing's Patients:
Jaimie and others from the message boards on TV
Transsphenoidal Pituitary Surgery
Laparoscopic Bilateral Adrenalectomy (BLA)
Transsphenoidal Pituitary Surgery
A Young Woman's Battle with a Hidden Enemy: Cushing's Disease
Top Five Webcast feature updates twice daily and highlights the most popular webcasts viewed each day.
New pages and updates

Doctors and Hospitals:
The US Helpful Hospitals list has been updated

Helpful Doctors:

New Doctors added to
Erie, PA
Astoria, OR
Portland, OR
Boston, MA
Toronto, Ontario, Canada
Norwalk, CT
Pennsylvania
Lucknow, India
Moorooka, Queensland, Australia
Budapest, Hungary
Washington, DC

Doctors updated:
Dr William Ludlam is moving to Seattle, WA from Portland, OR.
More info here
Dr. James Neifing, Portland, OR

Newest Bios:
Add or Update your bio here
Newest bios,
listed by type of Cushing's
Mary Jo
Michel-lee
Denise's Father
Teraleann
Tracy
Kathy
JeanD
Carol
Nicole B
Brook
Peggy
Stasia

Updated Bios:
JoAnn (In Memory)
Kirby
Michelle
MaryO
Lisa G

In Memory
Sue Ann Koziol (SuziQ),
CUSH Founding President

Sue was a very special friend to Cushies world-wide. We will remember her always.

To light a candle or post a tribute for Sue, please click here »

To read more about Sue's journey, please click here »




Happy New Year to all!

May the New year be filled with peace and contentment for all. I hope that you find what you seek...and that this year brings warmth, love, good health and may your Cushing's symptoms be a thing of the past.

Welcome to the Cushing's Help and Support Newsletters!

If it appears that the entire newsletter is not here, or you prefer to read the HTML version of this newsletter on the Internet, it is available here: http://www.cushingsonline.com/newsletters/1-10-2007.htm.

Read archived past newsletters here: http://www.cushingsonline.com/newsletters/newsletters.htm

To make sure you continue to receive Cushing's e-mail in your inbox (and that it is not sent to bulk or junk folders), please add CushingsSupport@aol.com to your address book.

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Cushing's Awareness Day! April 8, 2007


What Can *YOU* Do to help?

Sign Amber's Petition. www.ipetitions.com/petition/CushingsDiseaseAwareness

Amber writes:
Thought I would explain what this petition can do....

First of all, it adds power and substance to our efforts to have a Nationally recognized day if we have an extensive, following.

Second, this petition and all the signatures can be printed and sent to a Senator, politician, or medical professional that may be will to take on the cause.

Third, this petition and its list of signatures are IDEAL for releasing to the press and media for coverage and will assist GREATLY in getting the word out there.

It is so simple. The petition has a place to add your name and a comment if you want. PLEASE take a moment to sign and formward it on to all the people in your address book, your friends and family.

We all get forwarded messages all the time, but this one is dear to our hearts and can make a differnce! WHATS STOPPING YOU!?

PLEASE SUPPORT OUT EFFORTS TO RAISE AWARENESS! YOUR HELP IS NEEDED AND IT IS SO EASY!

CherylF, CUSH Vice President suggests:
I contacted Senator Inhofe's (OK) office recently, and he is happy to reintroduce the Cushings Awareness Day Resolution for April 8, 2007.

Please contact your US Senator's office and ask them to support this Resolution. I'm not sure when Senator Inhofe will try and contact other senators but if you send a letter soon, and call your senator to let him know your letter is coming, and that Senator Inhofe is going to reintroduce the Resolution, it will truly help.

Last year the Resolution was introduced, but to my understanding, only one senator-another from Oklahoma was the only one to contact Senator Inhofe's (Okla) office to co-sponsor the Resolution.

If you send a letter requesting it, you might also request that a reply be sent back to you . Please try to send the letter in the next two weeks if possible.

Last year we had a small Conference in OKC celebrating the passing of the Resolution, and there is some information on that conference on the CUSH website (CUSH.org) , and I believe on this one as well. We won't be having a specific conference in OKC, but ask that you bring awareness in your own states, communities as you can. Last year a TV station in OKC aired a small segment about the conference & Cushings Awareness Day, as did one in Nebraska- with Autumn as the contact person.

As the OK CUSH rep as well, I might have something for those around the OK area, a small get together if anyone is interested...more like a dinner or luncheon so we can visit each other. You can always contact me for more info if you'd like...together we can make a difference!

cheryl1957ann@sbcglobal.net
Thank you in advance, Cheryl Farrar- CUSH Vice President

Contact your Senator Print out a sample letter to send to your congress person or senator or download it in Word format.

More information here

Follow Jayne's Lead. She writes:

Of course, I'll be supporting the day and writing letters and emails and making phone calls. I hope to find us a celebrity ribbon wearer. Something else I am working on is national TV recognition with the major networks and National publications. You can email them as well on their "contact us" info. Contact the hosts of the show and the producers to mention April 8th and Cushing's Awareness.

I am going to find out information on getting money (grant) to publish magazine adds/articles for the April editions, if not this year then for next year. I know they are probably being printed, but I just thought of this idea. My local paper will run a small 2x3 ad for starting at $300. I want the whole page! I thought about having a yard sale to raise money to put in an ad, but doubt that I'd make enough. Oh Well!

Something else I thought about is getting a chain pharmacy to post cushings info for that week prior to the 8th. Medical school journal/papers can also be contacted. I know I must have emails over 100 doctors last year on the 7th (once I know that it had passed). I'll be setting up a booth at the women's Forum again this year. I hope to set up at some health expo's and at the local Hospital or at least make/pass out flyers.

US Cushing's Postage Stamps to promote Cushing's Awareness. See a sample here.

• Wear Cushing's Bracelets or T-Shirts to promote Cushing's Awareness. Order the bands here.. Cushing's Awareness T-Shirts and other products are available here: Cushie GiftStore.

Post your ideas and what you have done here: http://cushings.invisionzone.com/index.php?showtopic=19173

Last year:

For Immediate Release:                                                                   

                    April 6, 2006                                                                                                          

INHOFE DESIGNATES ‘NATIONAL
CUSHING’S SYNDROME AWARENESS DAY

More info here »


April 8, 2006, the Cushing's Understanding, Support & Help Organization (CUSH) petitioned in the USA to have April 8 be declared as Cushing's Awareness Day. This date was chosen because it was Dr. Harvey Cushing's Birthday. More info here »


The Cushing's Awareness Day Proclamation, from http://thomas.loc.gov/cgi-bin/query/z?c109:S.RES.423:

Designating April 8, 2006, as `National Cushing's Syndrome Awareness Day'. (Agreed to by Senate)

More info here »

CUSH Cookbooks are here!

The CUSH Cookbooks are only $10.00 each including shipping and handling.

Any profits will go to help bring awareness for Cushings. Thank you!

The cookbooks have about 169 recipes, so it isn't a huge cookbook, but one that includes contributions from many Cushing's message board members.

To purchase a cookbook send a check to:
CUSH
PO Box 1843
Florence, AL.
35631-1843

please indicate on your check "Cookbook" or include a note with payment.

You can also purchase cookbooks through Paypal. Please indicate that the payment is for "cookbook."

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Be sure that your correct mailing address is included with payment along with a contact phone number in case we have questions concerning your order.

If anyone has any questions concerning cookbook payments please contact CUSH Treasurer Cathy Gifford at CUSHOrg@aol.com


Coming Soon!
Cushing's Podcasts coming soon! What would you like to hear in a Cushing's Podcast?

Bios, possibly told by the person whose story it is?

Cushing's news?

Interviews with patients?

Interviews with doctors?

Would you be willing to interview your doctor/surgeon?

Listener comments?

Other ideas?

Submit your opinions and see what others have said on the Message Boards.

New Pages on the Website:
Packing Suggestions For Surgery

http://cushings.invisionzone.com/index.php?showtopic=19233 elsewhere on the boards and MaryO's personal experience.

  • MRI Films (originals plus a CD)
  • updated medical records. Anyone who goes for surgery needs to have a back-up set of records with them. Some doctors like a list all of labs on a spreadsheet with dates, results, ect. on them to make it easier for them to go through. However, Most doctors want to see the actual test results. Have both forms, if possible.
  • nightgowns
  • robe, slippers
  • extra pillow, if needed
  • microfleece blanket
  • book or magazines Adrenal people: you may have trouble resting things like books on your stomach post-op so magazines or paperbacks are a better choice than hard cover
  • Sudoku / crossword puzzles
  • shampoo, conditioner
  • comb, brush
  • toothbrush, toothpaste, deoderant
  • lip balm
  • lotion
  • Puffs Plus with lotion
  • underwear
  • maxi pad/tampons
  • cool max sports injury gel pack
  • medications Note: Check with your doctor - the hospital may not allow you to take meds from outside.
  • Crisis letter
  • medic alert bracelet
  • an iPod/charger or some CD's and small player pants with a loose elastic waist are good, or a long, loose dress.
  • cell phone and charger Note: Check with the hospital. Many do not allow the use of cellphones.
  • list of cell phone numbers of people to call from the hospital
  • change of clothes to wear home. Adrenal people: pants with a loose elastic waist are good, or a long, loose dress.
  • digital recorder so that you can record any instructions if need be after surgery
  • huge, cuddly teddy bear
  • mints for dry mouth
  • Buy a COOL GEL SPORTS INJURY PACK (Walmart or Walgreens) and wrap it around your head and back of your neck when you have a head-ache or are feeling bad. The cool settles your tummy, relieves the pain and swelling in the tissue around the head and neck that is irritated from surgery.
  • Take advantage of the moisture-ventilator that they give you in ICU and be sure to request or demand that they let you keep it after you get to your room. It releived the dry pain that my nose had and made the whole thing WAY less painful than others have said it was for them. ALSO...if you buy one of those $30 cool water humidifiers from Walmart/Target for you upon your return home...you will LOVE the moisture it gives you and it will make your nose feel MUCH better, MUCH faster!
Optional, if used:
  • nightguard for teeth
  • cpap and oracle mask
  • Growth hormone and supplies
  • camera
  • deck of cards

Updated Pages on the Website:

Testimonials http://www.cushings-help.com/testimonials.htm
I am very thankful that you chose to make this site as for I believe whole heartedly that everyone needs to make informed decisions about their doctors based on both sides, the good and the bad. This is private and keeps you protected! I am truely greatful to you!


Thank you so much for all of your help. You have done such an awsome job with these boards. I can not tell you how much of an inpact they have made on my life! For that alone I THANK YOU! The amount of info here is amazing. When I started doing searches online for Cushing's I kept finding the same articles over and over again, just placed on different sites and it was all just the definition of. So it was great to find a place with real stories, more information on what to expect, testing, etc.
By the way, thank you so much. Thank you for all that you do and thank you for this website. It truly has saved my life!
Mary O YOU are a present to all of us.
You very well may have SAVED my life - and remember what Schindler said, "To save one life, is to save all of mankind".

Heartfelt thanks for the site Mary, without it & YOU, I wouldn't even know about NIH. I wouldn't have hope, & my daughter wouldn't have a future.

Words just aren't enough Mary, look forward to meeting you.

Helpful links: http://www.cushings-help.com/links.htm
• Links added to Brook's and Nicole's MySpace pages

Helpful Hints for Dealing with Cushing's: http://www.cushings-help.com/helpful_hints.htm


News Items:

General Cushing's Info:

Barb (barbj222222 on the boards) posted this link to a fantastic (too long to post here!) article: http://www.medstudents.com.br/endoc/endoc7.htm
Cushing' Syndrome Laboratorial Diagnosis

Cushing’s Syndrome may be defined as a persistent and continuous state of endogenous cortisol overproduction, not being in accordance with ordinary circadian rhythm patterns (It was first fully clinically described by Harvey Cushing in 1912.). As a consequence, it leads to various symptoms and signs, namely:
Obesity (90%)*
Hypertension (85%)
Diminished Glucose Intolerance (80%)
Sexual and menstrual dysfunction (76%)
Hirsutism and acne (72%)
* The main Cushing’s obesity feature is centripetal, but generalized obesity can occur - often to children.

Apart from that, the finding of violet estriae, associated or not with the above characteristics, raises the suspicious of the syndrome. Also, it must be stressed out that the term "Cushing’s Disease" is a specific type of Cushing’s Syndrome whose ethiology is Pituitary Adenoma ACTH producer (generally it is due to microadenoma). The other types of Cushing Syndrome are classified according to the following...
http://www.medstudents.com.br/endoc/endoc7.htm


Adrenal:

Gina (da89165 on the boards) found this great site that shows images of different glands/organs. She writes: "This one really helped me to see 3 sets of adrenal glands....

1) atrophied from Addisons
2) normal
3) hyperplasia from cushings"

Images of adrenal glands

http://www-medlib.med.utah.edu/WebPath/ENDOHTML/ENDO003.html



The pair of adrenals in the center are normal. Those at the top come from a patient with adrenal atrophy (with either Addison's disease or long-term corticosteroid therapy). The adrenals at the bottom represent bilateral cortical hyperplasia. This could be due to a pituitary adenoma secreting ACTH (Cushing's disease), or Cushing's syndrome from ectopic ACTH production, or idiopathic adrenal hyperplasia.

Other images on the same site: Endocrine Pathology Index


Robin (staticnrg on the boards) found this:

ERK phosphorylation in the adrenal gland in response to chronic ACTH treatment

She writes:

For those of you who have high levels of ACTH, this article may explain some things that are going on:

Increased ERK phosphorylation in the adrenal gland in response to chronic ACTH treatment

Full article available temporarily.

Increased ERK phosphorylation in the adrenal gland in response to chronic ACTH treatment
Jorge G Ferreira1,3, Célia D Cruz2,3, Delminda Neves1,3 and Duarte Pignatelli1,3
1Laboratory of Molecular Cell Biology, Faculty of Medicine of Porto, Porto, Portugal
2Institute of Histology and Embryology, Faculty of Medicine of Porto, Porto, Portugal
3Instituto de Biologia Molecular e Celular (IBMC), Porto, Portugal

(Requests for offprints should be addressed to D Pignatelli)

(Current address of D pignatelli is at IPATIMUP, Porto, Portugal)

Abstract
ACTH released from the pituitary acts through activation of cAMP/PKA in adrenocortical cells stimulating steroidogenesis. Although ACTH was originally thought to have anti-proliferative effects on the adrenal, recently it has been described that it could also have proliferative effects acting via other signalling cascades. This is also relevant in humans given the increased levels of ACTH occurring together with adrenal cortex hyperplasia observed in Cushing's disease (CD) and possibly in other situations such as chronic stress. One of the signalling pathways regulating cell proliferation is the ERKs pathway. ERKs are members of the MAPK family of cascades. They are activated by extracellular stimuli such as growth factors and mitogens, become phosphorylated via MEK1/2 and regulate a diversity of cellular processes such as proliferation and differentiation. Until now no study addressed the effects of chronic ACTH administration on the activation of ERKs in vivo.

Objectives: Using rats submitted to different ACTH dosages as well as variable durations, we determined if ACTH induced ERKs activation and by establishing a parallelism with Proliferating Cell Nuclear Antigen (PCNA) expression we aimed to demonstrate a role of ACTH induced ERKs activation in cell proliferation. Blood was collected for hormonal analysis and the role of ACTH induced ERKS activation in the stimulation of steroidogenesis was also studied. We confirmed that ACTH increased adrenal weight and Corticosterone levels when compared with Control or Dexamethasone-treated animals. We also demonstrated that ACTH increases ERKs activation and PCNA expression in a time- and dose-dependent manner. When ERKs activation was blocked by the use of a specific MEK inhibitor (PD98059), there was a decrease in ACTH-induced Corticosterone release and PCNA expression. We conclude that chronic ACTH induces ERKs activation and that this plays an important role in the induction of cell proliferation as well as steroidogenesis.

Journal of Endocrinology

Pituitary:

• from http://ott.od.nih.gov/db/abstractdetails.asp?RefNo=1033

Description of Invention:
Nuclear receptors are ligand-activated transcription factors that regulate a wide range of biological processes and dysfunction of these receptors can lead to proliferative, reproductive and metabolic diseases, such as cancer, infertility, obesity and diabetes. Nuclear receptors are the second largest class of drug targets and the market for nuclear receptor targeted drugs is estimated to be almost 15% of the $400 billion global pharmaceutical market. Researchers at the National Institute of Diabetes and Digestive and Kidney Disease have isolated a novel protein termed STAMP (SRC-1 and TIF-2 Associated Modulatory Protein) that interacts with the biologically active domains of the coactivators TIF-2 and SRC-1 (J. Biol. Chem. (2002) 51,49256-66) and present data which support a role for STAMP as an important new factor in the glucocorticoid regulatory network. There remains a need for novel therapeutics that specifically block or enhance specific genes and an emerging therapeutic goal is the discovery of agents that modulate co-activators or co-repressors in a tissue specific manner.

The invention is a novel protein that plays a key role in modulating transcriptional properties of glucocorticoid receptor (GR)-steroid complexes during both gene induction and gene repression, and is likely to modulate the transcriptional properties of all the steroid receptors including androgen, mineralocorticoid and progesterone receptors. The inventors have shown that ectopically expressed STAMP protein both modulates the EC50 of glucocorticoid receptor-agonist complexes for induced genes and increases glucocorticoid receptor-repressive activity of suppressed genes in a manner that is inhibited by specific siRNAs under physiologically relevant conditions. The modulation of STAMP levels at the cell or organism level could possibly be used as a therapeutic able to modify inappropriate gene expression that occurs in certain diseases or as a result of long-term steroid treatment.

Available for licensing are claims directed to compositions which are capable of modulating the GR gene expression in a mammalian cell using DNA, siRNA or antibodies and to methods of shifting a steroid dose-response curve, where less of the steroid needs to be administered because the composition contains the STAMP polypeptide. The novel STAMP functional sequence can be used in a composition of matter claim or as a target that could be regulated by an antibody or perhaps other modulator that would vary the ability of STAMP to either induce or repress the activity of glucocorticoid receptors. Diseases that could be treated include: hypertension, diabetes, cardiovascular disease, osteoporosis, Cushing's Disease as well as any disease requiring chronic steroid treatment such as Rheumatoid Arthritis, Asthma, inflammatory and auto-immune diseases. The present invention provides a broad, flexible IP platform that should be of interest to companies which focus on nuclear receptors as drug target and lead discovery generators, as well as to companies which have the capability to develop STAMP's potential as a therapeutic.

Inventors:
S. Stoney Simons and Yuanzheng He (NIDDK)

Patent Status:
DHHS Reference No. E-056-2004/0 --
U.S. Provisional Application No. 60/548,039 filed 26 Feb 2004
PCT Application No. PCT/US2005/006393 filed 25 Feb 2005, which published as WO 2005/082935 on 09 Sep 2005

Licensing Status:
In addition to licensing, the technology is available for further development through collaborative research with the inventors via a Cooperative Research and Development Agreement (CRADA).

Portfolios:
Internal Medicine
Internal Medicine-Therapeutics-Cardiology-Other
Internal Medicine-Therapeutics
Internal Medicine-Other

For Additional Information Please Contact: Susan Carson D.Phil.
NIH Office of Technology Transfer
6011 Executive Blvd, Suite 325
Rockville, MD 20852-3804
Phone: (301) 435-5020
Email: carsonsu@mail.nih.gov
Fax: (301) 402-0220

Web Ref: 1033
Last Updated On: 1/05


• from http://jcem.endojournals.org/cgi/content/abstract/92/1/104

Journal of Clinical Endocrinology & Metabolism, doi:10.1210/jc.2006-0689
The Journal of Clinical Endocrinology & Metabolism Vol. 92, No. 1 104-109
Copyright © 2007 by The Endocrine Society

Early Assessment of Hypothalamic-Pituitary-Gonadal Function in Patients with Congenital Hypothyroidism of Central Origin

David A. van Tijn, Eelco J. Schroor, Henriette A. Delemarre-van de Waal, Jan J. M. de Vijlder and Thomas Vulsma

Department of Pediatric Endocrinology (D.A.v.T., J.J.M.d.V., T.V.), Emma Children’s Hospital, Academic Medical Center, University of Amsterdam, 1100 DE Amsterdam, The Netherlands; and Department of Pediatrics (E.J.S., H.A.D.v.d.W.), Subdivision Endocrinology, VU University Medical Center, 1007 MB Amsterdam, The Netherlands

Address all correspondence and requests for reprints to: David A. van Tijn, M.D., Department of Pediatric Endocrinology, Emma Children’s Hospital, G8-205, Academic Medical Center, University of Amsterdam, P.O. Box 22700, 1100 DE Amsterdam, The Netherlands. E-mail: tijn1@planet.nl .

Context: Early recognition of gonadotropic dysfunction couldenable well-timed growth and maturation and prevent damage togonads and external genitalia. The adaptation of the Dutch neonatalscreening program for congenital hypothyroidism in the mid 1990sresulted in enhanced detection of congenital hypothyroidismof central origin (CH-C), with high likelihood of multiple pituitaryhormone deficiency, including gonadotropin (Gn) deficiency.

Objective: We analyzed GnRH test results and baseline Gn andsex hormone measurements in 15 infants with CH-C to examinethese diagnostic tools for assessment of the integrity of thehypothalamus-pituitary-gonad axis in young infants.

Design: In a nationwide prospective study (1994–1996),patients were referred to our department if neonatal CH screeningresults were indicative of CH-C. When CH-C was confirmed, GnRHtests and baseline Gn and sex hormone measurements took placeat the age of 3 months, when euthyroid status had been accomplishedby T4 supplementation, and if necessary, cortisol supplementationwas installed.

Setting: The study took place at the Department of PediatricEndocrinology, Emma Children’s Hospital, Academic MedicalCenter, University of Amsterdam (referral center).

Patients: The study included 15 neonates (five girls and 10boys) with CH-C, detected by neonatal screening, in whom investigationof the hypothalamus-pituitary-gonad axis could be performedat 3 months of age.

Main Outcome Measures: Results of GnRH tests and baseline Gnand sex hormone measurements were assessed.

Results: GnRH tests at 3 months of age showed a pattern indicativeof endogenous GnRH stimulation in nine infants and a bluntedresponse in six. Baseline Gn and sex hormone concentrationsexcept estradiol (P = 0.053) were significantly different betweenresponders and nonresponders.

Conclusions: The GnRH test and baseline measurements of Gn andsex hormone serum concentrations at 3 months of age are promisingoptions in the assessment of hypothalamic-pituitary-gonadalfunction in infants with CH-C of both sexes.



Robin (staticnrg on the boards) posted this from http://www.ajronline.org/cgi/content/abstract/187/2/562

DOI:10.2214/AJR.05.0557
AJR 2006; 187:562-570
© American Roentgen Ray Society
Original Research
Bilateral Inferior Petrosal Sinuses Sampling in the Routine Investigation of Cushing's Syndrome: A Comparison with MRI
Ioannis S. Kaskarelis1, Emmanouela G. Tsatalou1, Stylianos V. Benakis1, Katerina Malagari2, Ioannis Komninos3, Dimitra Vasiliadou3, Stylianos Tsagarakis3 and Nikolaos Thalassinos3

1 Department of Radiology, Evangelismos General Hospital, 11 Amasias St., Athens, Greece 11634. 2 Second Department of Radiology, University of Athens, Athens, Greece. 3 Department of Endocrinology, Evangelismos General Hospital, Athens, Greece.

OBJECTIVE: Identifying the cause of Cushing's syndrome (CS) is a perplexing issue. Bilateral inferior petrosal sinuses sampling (BIPSS) is an invasive and elaborate but established procedure in distinguishing Cushing's disease (CD) from ectopic adrenocorticotropic hormone (ACTH) syndrome. We compare the diagnostic performance of BIPSS and MRI in detecting an ACTH-secreting source, and we suggest the diagnostic protocol that we found beneficial for the management of patients with CS.

MATERIALS AND METHODS: Seventy-eight consecutive patients with CS were included. All patients underwent biochemical investigation and pituitary MRI. Consequently, patients were routinely referred for BIPSS; 25 received stimulation with corticotropin-releasing hormone (CRH) and 53 with CRH and desmopressin. The diagnosis of CD was established on the basis of complementary biochemical, imaging, and BIPSS criteria. The diagnostic performances of BIPSS and MRI were calculated for patients with final diagnosis.

RESULTS: A final diagnosis was available for 54 patients (46 CD confirmed, five ectopic confirmed, three adrenals). No (known) patient was misclassified based on our suggested diagnostic criteria. MRI rendered 25 false-negatives and two false-positives (incidentalomas). Successful BIPSS yielded two false-negatives and three false-positives (adrenals). The calculated accuracy for detecting a pituitary source of ACTH was 50% and 88% for MRI and successful BIPSS, respectively.

CONCLUSION: MRI is of only limited diagnostic performance, while BIPSS is the most accurate way to establish the diagnosis of CD. The routine use of a multimodality diagnostic approach including BIPSS, MRI, and biochemical tests is suggested to avoid the risk of mismanagement for patients with CS.

Keywords: Cushing's disease • Cushing's syndrome • interventional radiology • MRI • neuroimaging • venography

from http://jcem.endojournals.org/cgi/content/abstract/92/1/172

Journal of Clinical Endocrinology & Metabolism, doi:10.1210/jc.2006-1328
The Journal of Clinical Endocrinology & Metabolism Vol. 92, No. 1 172-179
Copyright © 2007 by The Endocrine Society

Corticotroph Tumor Progression after Adrenalectomy in Cushing’s Disease: A Reappraisal of Nelson’s Syndrome

Guillaume Assié, Hélène Bahurel, Joël Coste, Stéphane Silvera, Michèle Kujas, Marie-Annick Dugué, Foued Karray, Bertrand Dousset, Jérôme Bertherat, Paul Legmann and Xavier Bertagna

Departments of Endocrinology (G.A., F.K., J.B., X.B.), Biophysics and Hormonology (M.-A.D.), and Digestive and Endocrine Surgery (B.D.), Cochin Hospital, Faculté René Descartes, Paris 5 University, Centre de Référence des Maladies Rares de la Surrénale, and Department of Radiology A (H.B., S.S., P.L.), Statistics and Medical Informatics (J.C.), and Department of Endocrinology-Metabolism-Cancer (G.A., J.B., X.B.), Institut National de la Santé et de la Recherche Médicale U567 and Centre National de la Recherche Scientifique Unité Mixte de Recherche 8104, Cochin Institute, 75014 Paris, France; and Department of Neuropathology (M.K.), Laboratoire R. Escourolle, Pitié Salpétrière Hospital, Paris 6 University, 75013 Paris, France

Address all correspondence and requests for reprints to: Xavier Bertagna, Department of Endocrinology, Cochin Hospital, 27, rue du Fg St. Jacques, 75014 Paris, France. E-mail: xavier.bertagna@cch.aphp.fr .

Context: Adrenalectomy is a radical treatment for hypercortisolismin Cushing’s disease. However, it may lead to Nelson’ssyndrome, originally defined by the association of a pituitarymacroadenoma and high plasma ACTH concentrations, a much fearedcomplication.

Objective: The objective of the study was to reconsider Nelson’ssyndrome by investigating corticotroph tumor progression basedon pituitary magnetic resonance imaging scan and search forpredictive factors.

Design: This was a retrospective cohort study.

Setting: The complete medical records of Cushing’s diseasepatients at Cochin Hospital were studied.

Patients: Patients included 53 Cushing’s disease patientstreated by adrenalectomy between 1991 and 2002, without previouspituitary irradiation.

Measurements: Clinical data, pituitary magnetic resonance imagingdata, and plasma ACTH concentrations for all patients and pituitarygland pathology data for 25 patients were recorded. Corticotrophtumor progression-free survival was studied by Kaplan-Meier,and the influence of recorded parameters was studied by Coxregression.

Intervention: There was no intervention.

Results: Corticotroph tumor progression ultimately occurredin half the patients, generally within 3 yr after adrenalectomy.A shorter duration of Cushing’s disease (adjusted hazardratio: 0.884/yr), and a high plasma ACTH concentration in theyear after adrenalectomy [adjusted hazard ratio per 100 pg/ml(22 pmol/liter): 1.069] were predictive of corticotroph tumorprogression. In one case, corticotroph tumor progression wascomplicated by transitory oculomotor nerve palsy. During follow-up,corticotroph tumor progression was associated with the increaseof corresponding ACTH concentrations (odds ratio per 100 pg/mlof ACTH variation: 1.055).

Conclusion: After adrenalectomy in Cushing’s disease,one should no longer wait for the occurrence of Nelson’ssyndrome: modern imaging allows early detection and managementof corticotroph tumor progression.



• From http://www.heraldtribune.com/apps/pbcs.dll/article?AID=/20061218/COLUMNIST82/612180450

Dr. Paul Donohue

Pituitary: small gland with a big job

Dear Dr. Donohue: A close friend of mine has been diagnosed with hypopituitarism. What can you tell me about this disease? I found little information at the library. -- T.K.

Dear T.K.: The pituitary gland is one of the body's smallest glands, but it has some of the most important functions for health.

It's attached to the underside of the brain, just a little way in from the bridge of the nose.

The pituitary orchestrates the way many other glands function. Its hormones turn on those other glands. ACTH, adrenocorticotropic hormone, prods the adrenal glands to make cortisone and hormones that regulate salt retention and blood pressure. Cortisone is involved in the production of glucose, the cells' fuel, and in controlling inflammation.

The pituitary also makes hormones that direct the function of the ovaries, testes and thyroid gland. It's the source of growth hormone and the hormone that promotes milk production.

Another important pituitary hormone prevents too much body water from being lost into the urine.

With hypopituitarism, the gland puts out too little or none of its hormones. Weakness, weight loss, a drop in blood pressure, excessive urination and a profound change in menstrual periods are some of the consequences. If the condition isn't treated, death is the eventual result.

Treatment consists of supplying the missing hormones.

The causes of hypopituitarism are many. Brain tumors, infections of the gland, interruption of its blood supply and head trauma are some of the things that bring about gland failure.

______

Dr. Donohue is unable to answer individual letters, but he will incorporate them into his column whenever possible. Readers may write him at P.O. Box 536475, Orlando, FL 32853-6475.

• Denney found an article (too long to post!). She writes: "I came across this in the middle of December when I was looking for a connection between my family's problems with blood vessel malformations and the fact that we also have a higher incidence of endocrine / tumors. I don't print a lot of things that catch my eye (I do however have a zillion bookmarked pages), but I did this.

I am on my 3rd read now and keep picking up on things that seem to help explain some of the things you read here on the board. For example, several board members have associated birth control hormones with the start of their symptoms. The article also makes some hypothesises about why some Pituitary tumors are recurring.

This is from 2003 so there may be progress on some of the questions asked throughout the article by now."

Read this article at http://edrv.endojournals.org/cgi/content/full/24/5/600?
maxtoshow=&;HITS=10&;hits=10&;RESULTFORMAT=&;fulltext=angiogenesis+endocrine&;
searchid=1&;FIRSTINDEX=0&;sortspec=relevance&;
volume=24&;firstpage=600&;resourcetype=HWCIT



• From http://chronicle.uchicago.edu/070104/dspchair.shtml

Jan. 4, 2007
Vol. 26 No. 7

Eight on faculty receive DSPs, Named Chairs

Three members of the University faculty have been named distinguished service professors, while five other faculty members have received named professorships.

The three faculty members who have received distinguished service professorships are: James Chandler, the Barbara E. and Richard J. Franke Professor in English Language & Literature, and the College; Martha Roth, Professor in the Oriental Institute and the College; and Richard Strier, the Frank L. Sulzberger Professor in English Language & Literature, and the College.

The one that may be of interest to us...

Roy Weiss, Professor in Medicine, has been named the first Rabbi Morris I. Esformes Professor. Esformes, a grateful patient and friend of the University, gave $2.5 million to support the professorship, which will benefit endocrinology, pediatric surgery, gastroenterology, and radiation and oncology.

  
Roy Weiss
   

An authority on the genetics, biology and treatment of diseases of the thyroid and the pituitary, Weiss, along with colleague Samuel Refetoff, has described several genetic diseases of the thyroid. Together, they run one of the largest referral centers for genetic thyroid disease in the world. Weiss also leads one of the largest programs in the Midwest in the diagnosis and treatment of Cushing’s disease, a pituitary disorder.

Weiss serves on the editorial board of several journals and is an associate editor of the journal, Thyroid and of the Encyclopedia of Hormones. He has won many honors, including national awards from the March of Dimes and the National Institutes of Health as well as several teaching awards.

He completed his internship, residency and endocrine fellowship at Chicago and joined the faculty in 1990. Weiss rose quickly through the ranks, becoming a professor and program director of the Clinical Research Center in 2003 and chief of endocrinology in 2006.

He earned his B.Sc. in zoology from Duke University in 1975, his Ph.D. in cell biology from the University of South Carolina in 1978 and his M.D. from Sackler Medical School in Tel Aviv, Israel, in 1985.


Cortisol:

• From http://www.physorg.com/news86341034.html

Adults Who Go to Bed Lonely Get Stress Hormone Boost Next Morning A new study that takes a rare look at the physiological, social and emotional dynamics of day-to-day experiences in real-life settings shows that when older adults go to bed lonely, sad or overwhelmed, they have elevated levels of cortisol shortly after waking the next morning.

Elevated levels of cortisol -- a stress hormone linked to depression, obesity and other health problems when chronic -- actually cue the body on a day-to-day basis that it is time to rev up to deal with loneliness and other negative experiences, according to Northwestern University’s Emma K. Adam, the lead investigator of the study.

The study, “Day-to-day experience-cortisol dynamics,” was published online the week of Oct. 30 by the Proceedings of the National Academy of Sciences (PNAS).

“You’ve gone to bed with loneliness, sadness, feelings of being overwhelmed, then along comes a boost of hormones in the morning to give you the energy you need to meet the demands of the day,” said Adam, assistant professor of education and social policy and faculty fellow at the Institute for Policy Research.

The morning cortisol boost could help adults who went to bed with troubled or overwhelming feelings go out in the world the next day and have the types of positive social experiences that help regulate hormone levels, she said.

Adam also is a faculty fellow at C2S: The Center on Social Disparities and Health. C2S is a new center within the Institute for Policy Research that is reaching across Northwestern’s two campuses and a number of social, life and biomedical disciplines to offer a 21st century look at how biological, social and cultural dynamics intersect and affect health throughout the life span.

Cortisol is often characterized as a negative hormone because of evidence, mostly in animal models, that long-term elevations could be potentially harmful to physical health. But in the short term the stress hormone is adaptive and helpful, according to Adam.

“Cortisol helps us respond to stressful experiences and do something about them,” she said. “It is necessary for survival -- fluctuations in this hormone assist us in meeting the changing demands we face in our daily lives.”

The first of its type, the study shows that it is not just on average that people who have more negative emotions have higher levels of cortisol. Rather, with its detailed and intricate methodology, the study shows a sensitive day-to-day dance between experience and cortisol. Experience influences stress hormones, and stress hormones influence experience, the study shows.

“Cortisol responds to and interacts with our daily experiences in subtle and important ways,” Adam concluded.

Cortisol levels are generally high immediately upon waking, increase in the first 30 minutes after waking and then decline to low values at bedtime.

Adam, with her colleagues John T. Cacioppo and Louise C. Hawkley at the University of Chicago, and Brigitte M. Kudielka from the University of Trier, Germany, showed that changes in this pattern from one day to the next are closely interwoven with changes in our daily experiences.

The study, based on data from the Chicago Health, Aging, and Social Relations Study (CHASRS) at the University of Chicago includes 156 older adults living in Cook County who were born between 1935 and 1952 and represent a range of socioeconomic classes. Their cortisol levels were measured from small samples of saliva provided three times a day for three consecutive days. Study participants reported their feelings each night in a diary, and researchers looked at whether cortisol levels on a particular day were predicted by experiences the day before or were predictive of experiences that same day.

In addition to noting that loneliness the night before predicted higher cortisol the next morning, Adam and colleagues found that people who experience anger throughout the day have higher bedtime levels of cortisol and flatter overall levels of the stress hormone, typically considered a risk factor for disorder. “High levels of cortisol in the evening are a kind of biological signature of a bad day,” Adam noted.

The study also provided evidence that, in addition to simply being at the mercy of your daily experiences, cortisol also plays a role in influencing them. Individuals with lower levels of cortisol in the morning experienced greater fatigue during the day, a result with potential implications for understanding chronic fatigue.

In all of her work, Adam is interested in how people’s changing social environments get under the skin to influence their biology and health. “Stress systems are designed to translate social experience into biological action,” she said. “They are designed to be a conduit from the outside world to our internal worlds so that we can better respond to our social context. The overarching question of my studies of these systems in a variety of contexts is whether overuse of these systems plays a role in disease outcomes.”

Source: Northwestern University

http://www.spectator.org/dsp_article.asp?art_id=10834

Reader Mail
Purge Protection

Published 1/5/2007 12:01:04 AM

LIBRARY OF PROGRESS
Re: G. Tracy Mehan, III's Purging the Classics From the Local Library:

In reference to Mr. Mehan's article on the Fairfax County Library's ruthless purging of texts -- I am a lifelong resident of Annandale, Virginia and use the library system regularly and have watched as books have disappeared from the catalog.

One of my favorite books is Harvey Cushing's brilliant life of Sir William Osler -- a book for which Cushing, a distinguished neurosurgeon, won the Pullitzer Prize (1925). One copy of this book was available in the Fairfax County system -- and I tried to check it out once in a while to make sure that it stayed in the system. I neglected my duties for the past few years and the book is now gone -- shame on me.

Librarians, when not chatting about their pets, like to talk about a thing called "serendipitous browsing" that occurs when a patron wandering the stacks comes across a title by accident and is enlightened. Some of my favorite books have come to me in this way -- especially Cushing's Life of Osler.

One has to wonder what the content of those stacks would be like if they were only to be filled with books people have checked out over the previous two years. If we are to judge by the quality of the television shows they watch, the music they listen to, the news services they revere and the politicians they elect, someday soon I may have to browse my old Mad magazines for pith.
-- Joseph Provenzano
Fairfax County Librarian Patron
Annandale, Virginia


• From http://ajp.psychiatryonline.org/cgi/content/abstract/164/1/163

Post Traumatic Stress Disorder

Am J Psychiatry 164:163-166, January 2007
doi: 10.1176/appi.ajp.164.1.163
© 2007 American Psychiatric Association


Brief Report Effects of Parental PTSD (Post Traumatic Stress Disorder) on the Cortisol Response to Dexamethasone Administration in Their Adult Offspring Rachel Yehuda, Ph.D., William Blair, B.A., Ellen Labinsky, Ph.D. and Linda M. Bierer, M.D.

OBJECTIVE: The authors used a low-dose dexamethasone suppressiontest to examine the effect of a PTSD risk factor, parental PTSD,on cortisol negative feedback inhibition in adult offspringof Holocaust survivors with PTSD (N=13) versus without PTSD(N=12) as well as a comparison group of offspring whose parentshad no Holocaust exposure (N=16).

METHOD: Blood samples wereobtained at 8:00 a.m. for the determination of baseline cortisol.Participants ingested 0.5 mg of dexamethasone at 11:00 p.m.,and blood samples were obtained again at 8:00 a.m. the followingday.

RESULTS: Enhanced cortisol suppression in response to dexamethasonewas associated primarily with parental PTSD status, with minimalcontribution of subjects’ own trauma-related symptoms.

CONCLUSIONS: Enhanced cortisol negative feedback inhibitionmay be associated with PTSD because it is related to the PTSDrisk factor of parental PTSD.

General Health:

Herbs, Vitamins and Minerals.

From another message board I'm on. It's for kidney cancer, but some of this info is good, just the same...

I am always worried/concerned about everything we think of doing in addition to standard dr. prescribed treatments. So as usual I research everything. In my research of the mushroom supplements I found the following website. Since this is Memorial-Sloan Kettering and is not a marketing ploy of any type. I thought I would post to the list. When people recommend you should take this vitamin or herb for this or that, this may be a good place to start to get informed without having to go through all of the sales sites promising a natural cure for everything. And as always, verify everything you want to take prior to with your doctor. http://www.mskcc.org/mskcc/html/11570.cfm?search=&x=16&y16

• from http://www.jg-tc.com/articles/2007/01/03/features/features002.txt


Stress can affect overall well-being

By COURTNEY KLEMM, Staff Writer
cklemm@herald-review.com

Day after day brings a new, seemingly endless list of responsibilities.

You have shopping to do, meals to prepare, homework to help with and bills to pay; then, there’s work and keeping your loved ones happy. There’s so much to do, and it seems there are just not enough hours in the day to get it done.

And, to top it off, you begin to feel sick and come down with a cold. A coincidence? Probably not.

Approximately 43 percent of adults suffer adverse health side effects due to stress, according to the National Stress Institute. Stress, and its side effects, may result in up to half of the 550 million missed days of work annually.

Stress is difficult to define because everyone reacts to stressful situations differently. What is stressful for one person may have little effect on another. But stress is more than simply a feeling, more than just tight muscles and feeling tense and worn out.

“Pretty much everyone, no matter how laid back, has some stress in their lives,” said Becky Wolter, exercise physiologist and manager of the Decatur Memorial Hospital Wellness Center. “Telltale signs that stress is starting to consume your life include gaining or losing excessive amount of weight, losing sleep and other signs of depression. Signs of depression often run parallel to overabundance of stress.”

When under extreme stress, our bodies release large amounts of cortisol, adrenaline, which can affect blood pressure, and other stress-related hormones, according to the American Institute of Stress.

Certain types of chronic stress are associated with immune system resistance to disorders ranging from the common cold to cancer.

Stress levels can affect nearly every area of the body, including metabolism, the cardiovascular system, the brain and even the health of your skin and hair, according to the institute.

“Stress is very devastating and can lead to all types of chronic diseases, especially long-term stress,” said Mike King, president of Mari-Mann Herb Co. Inc. “It can lead to headaches, depletion of minerals in the body, ulcers, stomach problems and mental and emotional dysfunction. I believe that high, intensive stress is toxic to the immune system. A little bit of stress is OK, but it’s how we respond to it that is the problem.”

While some stress is beneficial, such as pushing yourself when on deadline, many people don’t realize just how negatively stress can affect overall well being, said Susan Rasar, a registered nurse with the Wellness Center.

“Some people become so negative toward themselves when they are under stress,” she said, “it causes irritability, nervousness, apathy, low self-esteem and a rapid heartbeat, which can cause poor circulation. I’ve heard of nurses who take an aspirin at a certain stoplight every day because they know what’s coming.”

Surprisingly, our bodies are better adapted to acute stress, such as a car accident, than the day-to-day chronic stress that many endure continually. Many parents and individuals turn to exercise, friends and even meditation to combat or prevent stress.

“When you start worrying about the future, you get overwhelmed,” said Cat RunningElk, a national motivational speaker and certified Reiki Master. “Take a break from the treadmill and from your shopping list, and take a minute to appreciate everything around you.”

RunningElk said she recommends taking 15 minutes each day for “quiet time,” such as a walk in the park.

“Your breath is also really important,” she said. “Take a deep breath in, tense your body and release after 10 seconds. Instead of fighting the tension, bring it all in, and then blow it out and let it all go. It can really make a difference doing that for 60 seconds, especially if you are waiting in line or in traffic.”

Although stress usually comes from outside sources, your mental state is very important, King said.

“Your emotions are not attached to you; you can change the way you feel and address your environment differently,” he said. “If you can learn to cope with it to where it’s not damaging your body, there you go -- you can sit there and deal with it. But sometimes you may have to make lifestyle changes. The important thing is you’ve got to enjoy life.”

Contact Courtney Klemm at cklemm@herald-review.com or 421-6968.


• From http://www.sun-herald.com/NewsArchive2/123006/hn1.htm?date=123006&story=hn1.htm 12/30/06

No Pain, No Gain Revisited

DEAR DR. DONOHUE: I am 18 and into bodybuilding, which I've been doing for three years. I have achieved some success, but not the success I want and not the success I see others have gotten. I know many of them are on steroids.

I am considering trying them too. I don't think I will ever get the size I want without them. I would like the truth. Are they really dangerous? Do they really work? -- D.F.

ANSWER: The word ''steroid'' creates confusion. One class of steroids is the cortisone drug family. Prednisone is a much-used member of this family. These steroids have a place in medicine to fight inflammation.

The steroids you're talking about are muscle-building (anabolic) steroids, male hormones. They have a limited place in medicine but no place in athletics. They really do work. They produce rapid gains in muscle growth.

They are dangerous. They cause breast growth in men and breast shrinkage in women. They shrivel the testicles. They might enlarge the prostate gland. They cause acne and hair loss. They can weaken tendons. They're reputed to cause heartbeat abnormalities.

They lead to cardiovascular problems. Recently, it was shown that a group of muscle-building-steroid users, at young ages, had a buildup of calcium in their heart arteries. Calcium buildup in arteries is a signal that those arteries are likely to clog up and obstruct blood flow to heart muscle.

You don't want to use these steroids.



New Feature! Add your Helpful Hints for Dealing with Cushing's to the website and the email Newsletters.

Newest Bios:
To add or edit your bio, http://www.cushings-help.com/forms/bio.htm
Not Yet Diagnosed Patients
Carol (ZDreamer) Carol is not yet diagnosed with Cushing's but has many symptoms. She as an adrenal adenoma. Logan, Ohio
Michel-lee (Michel-lee) Michel-lee not yet diagnosed with Cushing's and hasn't tested yet but she hopes to find some answers for her many symptoms soon. Escondido, CA
Nicole (copacabana) Nicole is not yet diagnosed with Cushing's but has a long history of many Cushing's symptoms. Nicole has been diagnosed so far with PCOS and Fibromyalgia. A dynamic MRI suggests a pituitary microadenoma but she is not diagnosed with pituitary disease or Cushing's yet. She suspects steroid-induced Cushing's due to meds she has taken throughout her short life. Nicole has two areas on MySpace: a bio at http://www.myspace.com/labellavitabrasil
and an area for Cushies at http://groups.myspace.com/cushingssurvivors.
Minnesota
Stasia (tavernas) Stasia is not yet diagnosed with Cushing's but has a PCOS diagnosis. Her urine and cortisol is elevated so she will see an endocrinologist in March 2007. A doctor mentioned ectopic Cushing's. Portage, MI
Teraleann (Teraleann) Teraleann was diagnosed with secondary adrenal insufficiency and hypothyroidism. She has also been diagnosed with a rare intracellular bacterial disease known as brucellosis or undulant fever and had mononuclosis at 3 months. Missouri
Tracy Tracy is not yet been diagnosed but she has been suffering with bizarre symptoms for 12 years. She took a lot of steroids before her hysterectomy due to endometriosis. She has also been told that she has interstial cysitis. Wenatchee, WA
Pituitary Patients
Brook (on the boards sam is Brook's mom) Brook's final diagnosis was confirmed at the NIH *National Institutes of Health) and Brook will have surgery on February 14th 2007 to remove the tumor on the right side of her pituitary. She has a page on myspace. New Orleans, LA
Jean (jeand) Jean had unsuccessful pituitary surgery May 14, 2003. Her second surgery will be with Dr. Kassam in Pittsburgh. Erie, PA
JoAnn (on the boards mrsjones91730 is JoAnn's daughter) Updated bio
Dr. Friedman diagnosed JoAnn and confirmed that her Cushing's was caused by a pituitary tumor. Her surgery was January 3rd, 2004. JoAnn also had adrenal surgery August of 2005 and Gamma Knife in April 06.
She died of congestive heart failure September 2006.
Bakersfield, CA
Kathy  (lxkathybabezxl) Kathy has low growth hormone due to a pituitary problem. She is having symptoms again and may need to go back on the hormone injections. MA
Mary Jo (maryjo)   Mary Jo had a pituitary tumor removed at the Mayo Clinic in Rochester in September of 1992. She is now Addisonian and will take prednisone for the rest of her life. She would like to hear from others who have had Cushings and may now be Addisonian. Dent, Minnesota
Peggy (Peggy) Peggy was first diagnosed with a (pituitary) prolactinoma, but now has some Cushing's symptoms. She has taken bromocriptine and cabergoline to help control the overproduction of prolactin. Long Beach, CA
Steroid-Induced Patients
Denise's Father (Boopinit) Denise is looking for information for her father. He was diagnosed with cushings disease about four months ago. The endo told him it was from the prolonged use of cortisone injections that his other Dr. was giving him every three weeks for the last thirteen months for a disease he has called Pyronies. Another doctor has put him back on low-dose steroids and he has many Cushing's symptoms. Detroit, MI?
To add or edit your bio, http://www.cushings-help.com/forms/bio.htm

Newest Helpful Doctors:
Dr. Elaine Wong
West Los Angeles, VA Facilities
11301 Wilshire Blvd.
Los Angeles, CA 90073
phone: 3102683754
Endocrinologist
She's a resident doctor that's been treating me for the prolactinoma. I have been going to see her every three months for the last year and three months. She is probably good but I don't feel she has answered my questions. I would like to get a second opinio but for that I am probably going to have to go to a different hospital.
West Los Angeles, CA
Dr. Daniella Mittan
2120 Exchange Street
Suite 200
Astoria, OR 97103
Phone: 5033255360
Fax: 5033259373
Pituitary, Adrenal, Cyclical, Steroid use, Addison's, Endocrinologist, Diabetes
Astoria, OR
Dr. Maria Fleseriu
Oregon Health & Science University
3181 S.W. Sam Jackson Park Rd, BTE472
Portland, OR 97239
Pituitary, Adrenal,
Endocrinologist, Prolactinoma
Portland, OR
Dr. James Neifing
The Portland (OR) Diabetic And Endocrinology Clinic which is very close to Good Samaritan Hospital
phone: 503-274-4884

Dr. Neifing has taken care of e since my adrenalectomy in 2000. He is very thourough and listens to how I feel as well as being very thourough. I feel he is very accessible in person as well as by phone. That is important to me since I live 3.5 hours away from Portland. I though it would be helpful to have another endo who knows cushings since Dr. L is moving from Portlland.
Lynn in Oregon
Portland, OR
Dr. Anne LaRochelle
333 State Street
Erie, Pa 16507
phone: 8144548886
fax: 8144564609
Endocrinologist
She is a very nice dr...never had any problems with her... seems to know alot about Cushing's... she has diagnosed about 15 cases of Cushing's that I know of since she's been in practice... worth seeing if you don't live too far from Erie...
Erie, PA
To add your helpful doctor, http://www.cushings-help.com/forms/doctor.htm

If you've been diagnosed with Cushing's, please participate in the Cushing's Register

The information you provide will be used to create a register and will be shared with the medical world. It would not be used for other purposes without your expressed permission. Note: This information will not be sold or shared with other companies.

Lynne Clemens, President of CUSH Org is be the person responsible for the creation of this register.