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Pituitary Seminar Podcasts

podcasts

In Sept 2013, Emory Pituitary Center organized Emory Pituitary Education Day, another successful seminar for patients with pituitary diseases, families and friends.

Presenters: Adriana Ioachimescu, MD, PhD, Nelson Oyesiku, MD, PhD, Jared DeFife, PhD and Lisa Ward, PA.

Here are answers to questions asked during the seminar:

What is ACTH?
ACTH (Adrenocorticotropic Hormone) is a pituitary hormone that regulates the cortisol secretion from the adrenal glands

What is the difference between Cushing produced by a tumor of the pituitary gland and a tumor of the adrenal gland? Do these organs produce different types of hormones?
Cushing’s syndrome is most often the result of a pituitary tumor producing ACTH that drives the adrenal glands to secrete exaggerated amounts of cortisol. Less frequently, Cushing’s syndrome is the result of an adrenal tumor producing high amounts of cortisol independently of the pituitary gland.

Is it unusual to take the salivary test one night and the 24-hour urine the next day and to have one come back normal and the other abnormal?
No, this is not unusual. Mild cases of Cushing’s syndrome may be challenging to diagnose due to discrepancies between different test results. Repeating the tests and following the endocrinologist advice is important in such situations

Is there a correlation between PCOS and Cushing’s?
PCOS (polycystic ovarian syndrome) is a relatively frequent medical condition affecting women in their fertile years. Cushing’s syndrome also afflicts young women, but is much less frequent. Both PCOS and Cushing’s may cause weight gain, irregular menstrual cycles, insulin resistance/high glucose and other medical problems. It is important to differentiate the two medical conditions that overlap clinically, because they are treated differently. A thorough endocrinological evaluation is necessary to make an accurate diagnosis.

What does low cortisol look like?
Low cortisol levels usually cause fatigue, nausea, poor appetite, involuntary weight loss and lightheadedness.

Does Cushing’s syndrome always have to be treated?
Sustained elevation of serum cortisol levels has to be evaluated by an endocrinologist and treated according to the diagnosis.

Does the pituitary gland make you gain weight?
Dysfunction of the pituitary gland characterized by too high or too low hormone levels can make patients gain weight.

Currently I am taking cabergoline to control the effects of my pituitary tumor. Will I have to take this medication for the rest of my life?
This is an excellent question that should be addressed to an endocrinologist. The answer depends on the clinical, laboratory and imaging information.