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Are Backache And Acne Along With Vertigo Indicative Of Cushing's Syndrome?
Question: My 21 yr old adopted daughter from russia has central obesity, abide and extreme striae some acne that started in her twenties and headaches. she is being tx for Migraines , and vertigo. I am unable to address the menses as she is presently on OCP's that control this. she does occasionally c/o backache but we dismissed it due to wt. she did do some activity prior to 2 yrs ago but now no longer does anything unless we coax her to. Just wondering if this is Cushing. I did have her cortisol level checked but it was nml at that time.
Brief Answer:
Information
Detailed Answer:
Hello and welcome,
One cortisol level that is normal will not rule out the possibility of Cushing syndrome (endogenous hypercortisolism).
Screening tests for Cushing should be one of the following:
Midnight serum or salivary cortisol (the midnight salivary test can be done from home rather than going in to a clinic if the doctor/lab provides you with a kit for it)
24-hour urine free cortisol (urine is collected in one container given by the lab, for 24 hours).
Low dose dexamethasone suppression test (this involves an IV where the medicine dexamethasone is given and then blood cortisol levels are measured - needs to be done in a clinic).
In addition, I recommend the following tests:
1. TSH and T4 (blood tests to check her thyroid function)
2. A1C (Blood test to check the average of her blood sugar)
3. Liver function panel (to check for fatty liver or other liver disease)
I hope this information helps. Please let me know if I can provide further help.
Information
Detailed Answer:
Hello and welcome,
One cortisol level that is normal will not rule out the possibility of Cushing syndrome (endogenous hypercortisolism).
Screening tests for Cushing should be one of the following:
Midnight serum or salivary cortisol (the midnight salivary test can be done from home rather than going in to a clinic if the doctor/lab provides you with a kit for it)
24-hour urine free cortisol (urine is collected in one container given by the lab, for 24 hours).
Low dose dexamethasone suppression test (this involves an IV where the medicine dexamethasone is given and then blood cortisol levels are measured - needs to be done in a clinic).
In addition, I recommend the following tests:
1. TSH and T4 (blood tests to check her thyroid function)
2. A1C (Blood test to check the average of her blood sugar)
3. Liver function panel (to check for fatty liver or other liver disease)
I hope this information helps. Please let me know if I can provide further help.
Note: For more detailed guidance, please consult an Internal Medicine Specialist, with your latest reports. Click here..
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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