The diagnosis of Cushing’s syndrome in pregnancy is often delayed because the symptoms overlap. We presented a thin 31-year-old woman, admitted 2 months after a normal-term delivery, with an atypical presentation of Cushing’s disease, unusual clinical features, and a challenging clinical course. She had no clinical discriminatory features of Cushing’s syndrome. 

Read more at https://cushings.invisionzone.com/topic/57656-a-case-report-of-cushing%E2%80%99s-disease-presenting-with-psychosis-and-muscle-weakness-postpartum/

We present a 9-year-old boy who presented at age 4 with cyclical Cushing syndrome and was eventually diagnosed with a novel, previously unreported, unpublished variant in PRKAR1A associated with Carney complex. He was treated with unilateral left adrenalectomy. At 1-year follow-up, he continues to be in remission of his symptoms of Cushing syndrome.

https://cushings.invisionzone.com/topic/57870-unilateral-adrenalectomy-for-pediatric-cyclical-cushing-syndrome-with-novel-prkar1a-variant-associated-carney-complex/

Endocrinology is a complex field that requires a deep understanding of the endocrine system and its role in regulating the body’s hormones. An endocrinologist can help patients with PCOS and diabetes manage their conditions and achieve their health goals. By working with an endocrinologist, patients can get the help they need to manage their PCOS or diabetes and achieve their health goals.

Read more at https://cushings.invisionzone.com/topic/57638-basics-the-role-of-endocrinology-in-managing-polycystic-ovary-syndrome-and-diabetes/

Myth: “You should be all better by now! You found out what was wrong, you got the surgery, it’s been quite some time, and you are STILL not better?! You SHOULD have gotten better by now!” Chronic illness follows the same pattern as normal illness. You get diagnosed, treated, and then go back to a state of recovery, eventually leading you back to a state of “normal health”.

Read more at https://cushieblogger.com/2021/04/27/myth-you-should-be-all-better-by-now-2/

The most common cause of Cushing syndrome (CS) is exposure to exogenous glucocorticoids. There is an increasing incidence of adulterated over-the-counter (OTC) supplements containing steroids.

Read more at https://cushings.invisionzone.com/topic/57624-exogenous-cushing-syndrome-and-hip-fracture-due-to-over-the-counter-supplement-artri-king/

The higher IGF-1 index was independently associated with lower prevalence of low bone mass in young CD patients, and IGF-1 might play an important role in the pathogenesis of CD-caused low bone mass.

Read more at https://cushings.invisionzone.com/topic/57619-association-of-igf-1-level-with-low-bone-mass-in-young-patients-with-cushing%E2%80%99s-disease/

The case was a 45-year-old female from the adrenal disease diagnosis and treatment centre in West China Hospital of Sichuan University. The patient presented with hypertension, moon-shaped face, central obesity, fat accumulation on the back of the neck, disappearance of cortisol circadian rhythm, ACTH < 5 ng/L, failed elevated cortisol inhibition by dexamethasone, orthostatic aldosterone/renin activity > 30 (ng/dL)/(ng/mL/h), and plasma aldosterone concentration > 10 ng/dL after saline infusion testing.

Read more at https://cushings.invisionzone.com/topic/57676-bilateral-co-secretory-lesions-presenting-with-coexisting-cushing-syndrome-and-primary-aldosteronism/

Do you know how many people have told me that if I just “juice”, I will be cured from Cushing’s or Adrenal Insufficiency?! I appreciate the sentiment, but the sad reality is that no amount of juicing and no vitamin will cure Cushing’s. Some Cushing’s patients do take vitamins, some do eat raw food or paleo diets, and some even juice. However, this is just a lifestyle choice and not an attempt to cure Cushing’s. 

Read more at https://cushieblogger.com/2022/04/29/myth-vitamins-and-natural-remedies-can-cure-heal-cushings/

Ectopic Cushing’s syndrome due to metastatic neuroendocrine small-cell carcinoma is a rare condition with a poor prognosis. The options for treatment are few and not necessarily curative. There needs to be increased awareness of this serious and rare complication. Managing the condition can be a challenge and requires a multidisciplinary team approach to improve outcomes.

Read more at https://cushings.invisionzone.com/topic/57577-recurrent-neuroendocrine-tumor-of-the-cervix-presenting-with-ectopic-cushing%E2%80%99s-syndrome/

Cushing’s disease may sometimes make you feel that your life is out of your control. But there are some general things you can do to help take back control.

https://cushings-help.com/2024/11/05/tips-for-living-with-cushings/

Graphic Era Hospital has achieved a remarkable mileston by successfully treating two complex cases of the rare hormonal disorder Cushing’s Disease in Dehradun. The hospital’s experts used advanced technology and surgical skills to give the patients a new lease on life, marking this significant achievement.

https://cushings.invisionzone.com/topic/57868-graphic-era-hospital%E2%80%99s-milestone-treatment-of-two-complex-cases/

Posterior pituitary tumors (PPTs) are extremely rare, with fewer than 400 cases reported to date. In 2022, the WHO classified four types of tumors originating from the posterior pituitary

Read more at https://cushings.invisionzone.com/topic/57780-oncocytic-pituicytoma-in-a-patient-with-cushings-disease/

Neuropsychiatric symptoms of Cushing syndrome are well documented, including irritability, anxiety, depressed mood, and cognitive impairment.

https://cushings.invisionzone.com/topic/57800-first-episode-psychosis-and-cushing-syndrome/

Michelle is from Columbia,  MO.  She was diagnosed with Cushing's in 2020 and had pituitary surgery.  This year, it appeared that she had PCOS but it turned out to be a recurrence.

Read more at https://cushingsbios.com/2022/11/26/michelle-m-pituitary-bio/

As noted in a review published in the January 2024 issue of Operative Neurosurgery, endoscopic transnasal transsphenoidal surgery is increasingly applied to giant pituitary adenomas. 'We prefer this approach even when giant pituitary adenomas extend into the third ventricle because it's associated with lower postoperative morbidity and a higher likelihood of preserving normal pituitary and visual function,' Dr. Byrne says.

Read more at https://cushings-help.com/2024/07/26/choosing-the-optimal-approach-for-giant-pituitary-adenomas/

We present a 9-year-old boy who presented at age 4 with cyclical Cushing syndrome and was eventually diagnosed with a novel, previously unreported, unpublished variant in PRKAR1A associated with Carney complex. He was treated with unilateral left adrenalectomy. At 1-year follow-up, he continues to be in remission of his symptoms of Cushing syndrome.

https://cushings.invisionzone.com/topic/57870-unilateral-adrenalectomy-for-pediatric-cyclical-cushing-syndrome-with-novel-prkar1a-variant-associated-carney-complex/

Learning points

• Patients with CD do not always present with classical clinical features and may present with symptoms and biochemical findings that would otherwise suggest ectopic ACTH production.

• While most patients with CD typically lose weight after biochemical remission, some patients gain weight after the normalization of cortisol levels.

• This case highlights the need to entertain a broad differential in patients presenting with hypokalemia and weight loss and the need to exclude hypercortisolemia.

https://cushings.invisionzone.com/topic/57760-atypical-presentation-of-cushing%E2%80%99s-disease-with-weight-loss-and-hypokalemia/

A clinical-stage biopharmaceutical company focused on rare endocrine diseases, announced that the first patient has been successfully dosed in its ongoing Phase 2 clinical trial evaluating ST-002 for the treatment of Cushing's Syndrome.

https://cushings.invisionzone.com/topic/57846-sterotherapeutics-announces-first-patient-dosed-in-phase-2-clinical-trial-evaluating-st-002-for-cushings-syndrome/

Ocular hypertension was more common in people with Cushing’s illness. The usage of steroids in the body is a major contributor to high intraocular pressure (IOP). Topical or systemic glucocorticoid use may increase the prevalence.

Read more at https://cushings.invisionzone.com/topic/57588-cushing%E2%80%99s-disease-patients-are-more-likely-to-have-ocular-hypertension/

The most common cause of Cushing syndrome (CS) is exposure to exogenous glucocorticoids. There is an increasing incidence of adulterated over-the-counter (OTC) supplements containing steroids.

Read more at https://cushings.invisionzone.com/topic/57624-exogenous-cushing-syndrome-and-hip-fracture-due-to-over-the-counter-supplement-artri-king/

The higher IGF-1 index was independently associated with lower prevalence of low bone mass in young CD patients, and IGF-1 might play an important role in the pathogenesis of CD-caused low bone mass.

Read more at https://cushings.invisionzone.com/topic/57619-association-of-igf-1-level-with-low-bone-mass-in-young-patients-with-cushing%E2%80%99s-disease/

Ectopic Cushing’s syndrome due to metastatic neuroendocrine small-cell carcinoma is a rare condition with a poor prognosis. The options for treatment are few and not necessarily curative. There needs to be increased awareness of this serious and rare complication. Managing the condition can be a challenge and requires a multidisciplinary team approach to improve outcomes.

Read more at https://cushings.invisionzone.com/topic/57577-recurrent-neuroendocrine-tumor-of-the-cervix-presenting-with-ectopic-cushing%E2%80%99s-syndrome/

Like most everything else in my life, having had Cushing's (pituitary) made this surgery more difficult.  My surgeon had to plan with my endocrinologist how much cortisol I'd need during the operation, then I had to stay overnight to get me successfully weaned off the cortisone again.

Read more at https://cushings.invisionzone.com/topic/57682-what-was-the-most-memorable-thing-that-happened-to-you-last-year/

Since the advent of Facebook and others, these message boards are pretty lonely these days. So much so, that I was thinking about shutting down these boards - the most expensive of the lot - this year.

So, along came this most generous donation and I can't let people down so... we're good to go for another several months.

https://cushings.invisionzone.com/topic/57773-a-most-generous-gift/#comment-478960

Jason is from England.  Pituitary tumour found in 2020(posterior lobe),now test after test and 2nd MRI still shows microadenoma. He also had two traumatic brain injuries.

Read more at https://cushingsbios.com/2022/10/27/jason-t-pituitary-bio/

Complications of Cushing's syndrome include Hypertension, DM, infection, Bone fracture, mood swings, memory loss. If left untreated then life expectancy would be around 5 years.

Read more at https://cushings.invisionzone.com/topic/57677-what-is-the-life-expectancy-of-someone-with-cushings-syndrome/

Cushing’s disease may sometimes make you feel that your life is out of your control. But there are some general things you can do to help take back control.

https://cushings-help.com/2024/11/05/tips-for-living-with-cushings/

Our scoping review identified several cases of de novo conditions emerging following the remission of Cushing syndrome. They occurred mostly in women and within the year following remission.

Read more at https://cushings.invisionzone.com/topic/57726-emergence-of-de-novo-conditions-following-remission-of-cushing-syndrome-a-case-report-and-scoping-review/

Cushing's Syndrome (Hypercortisolism) patients United States
30-minute online survey, compensation is $60

https://cushings.invisionzone.com/topic/57799-take-part-in-a-cushings-clinical-trial/

Graphic Era Hospital has achieved a remarkable mileston by successfully treating two complex cases of the rare hormonal disorder Cushing’s Disease in Dehradun. The hospital’s experts used advanced technology and surgical skills to give the patients a new lease on life, marking this significant achievement.

https://cushings.invisionzone.com/topic/57868-graphic-era-hospital%E2%80%99s-milestone-treatment-of-two-complex-cases/

As the clinical presentation of Cushing’s disease changes over time, waiting for the typical Cushing’s clinic can delay diagnosis. It is important that clinicians take this into account when they suspect CD.

https://cushings.invisionzone.com/topic/57886-changing-face-of-cushing%E2%80%99s-disease-over-three-decades-in-pituitary-center/

Posterior pituitary tumors (PPTs) are extremely rare, with fewer than 400 cases reported to date. In 2022, the WHO classified four types of tumors originating from the posterior pituitary

Read more at https://cushings.invisionzone.com/topic/57780-oncocytic-pituicytoma-in-a-patient-with-cushings-disease/

A 55-year-old female patient was referred from the endocrinology department for evaluation of Cushing’s disease. She had been on medication for hypertension and diabetes for the past seven years. Two months prior, she suffered an acute cerebral infarction, resulting in left-sided hemiparesis.

https://cushings.invisionzone.com/topic/57835-utility-of-intraoperative-ultrasound-in-identifying-pituitary-adenoma-hidden-behind-a-cystic-lesion-in-cushing%E2%80%99s-disease/

We present a case of a middle-aged woman who presented with chest pain and shortness of breath. Laboratory tests revealed persistent hypokalaemia, hyperglycaemia, and metabolic alkalosis despite treatment. Imaging identified a mass near the right hilum suggestive of lung malignancy. Endocrine evaluation showed markedly elevated cortisol and adrenocorticotropic hormone levels, consistent with paraneoplastic Cushing syndrome caused by ectopic hormone production.

https://cushings.invisionzone.com/topic/57869-paraneoplastic-cushing-syndrome-unmasking-small-cell-lung-cancer-a-rare-presentation/

Endogenous Cushing’s syndrome (CS) is a rare endocrine condition caused by excess cortisol production with an annual incidence of 0.2–5 cases per million people

Read more at https://cushings.invisionzone.com/topic/57751-a-challenging-case-of-severe-cushing%E2%80%99s-syndrome-in-the-course-of-metastatic-thymic-neuroendocrine-carcinoma-with-a-synchronous-adrenal-tumor/

Please add your bio. Your information will help others.

I would like to add that if anyone would like to do something for the Cushing's Awareness Challenge but you don't have (or want to have) a blog, why not consider adding your bio to the website this month?

More info at https://cushingsbios.com/2024/10/28/we-have-a-new-bio-form/

Blood tests and an MRI finally confirmed the doctor’s suspicion: Yawn had a tumor in her pituitary gland — a pea-size organ at the base of the brain — that was causing the gland to release too much adrenocorticotropic hormone. That, in turn, flooded her body with cortisol, a steroid hormone that’s normally released in response to stress or danger. The resulting condition is called Cushing disease.

Read more at https://cushings.invisionzone.com/topic/56889-media-attention-cushings-on-today/

We present a 9-year-old boy who presented at age 4 with cyclical Cushing syndrome and was eventually diagnosed with a novel, previously unreported, unpublished variant in PRKAR1A associated with Carney complex. He was treated with unilateral left adrenalectomy. At 1-year follow-up, he continues to be in remission of his symptoms of Cushing syndrome.

https://cushings.invisionzone.com/topic/57870-unilateral-adrenalectomy-for-pediatric-cyclical-cushing-syndrome-with-novel-prkar1a-variant-associated-carney-complex/

The most common cause of Cushing syndrome (CS) is exposure to exogenous glucocorticoids. There is an increasing incidence of adulterated over-the-counter (OTC) supplements containing steroids.

Read more at https://cushings.invisionzone.com/topic/57624-exogenous-cushing-syndrome-and-hip-fracture-due-to-over-the-counter-supplement-artri-king/

The trial will assess the drug's efficacy, tolerability, and safety in individuals with Cushing's.

https://cushings.invisionzone.com/topic/57785-sterotherapeutics-begins-phase-ii-trial-for-st-002-targeting-cushing%E2%80%99s-syndrome/

Cushing’s disease (CD) is characterized by hypercortisolism due to excessive adrenocorticotropic hormone (ACTH) secretion from a pituitary adenoma. Though more common in adults, pediatric cases constitute approximately 5% of those seen in adults. Early diagnosis and treatment are critical due to the severe impacts on growth and development in children. Endoscopic transsphenoidal surgery (ETSS) is the preferred first-line treatment for both children and adults.

https://cushings.invisionzone.com/topic/57801-clinical-and-surgical-outcomes-of-pediatric-cushing%E2%80%99s-disease-following-endoscopic-transsphenoidal-surgery/

The higher IGF-1 index was independently associated with lower prevalence of low bone mass in young CD patients, and IGF-1 might play an important role in the pathogenesis of CD-caused low bone mass.

Read more at https://cushings.invisionzone.com/topic/57619-association-of-igf-1-level-with-low-bone-mass-in-young-patients-with-cushing%E2%80%99s-disease/

Ectopic Cushing’s syndrome due to metastatic neuroendocrine small-cell carcinoma is a rare condition with a poor prognosis. The options for treatment are few and not necessarily curative. There needs to be increased awareness of this serious and rare complication. Managing the condition can be a challenge and requires a multidisciplinary team approach to improve outcomes.

Read more at https://cushings.invisionzone.com/topic/57577-recurrent-neuroendocrine-tumor-of-the-cervix-presenting-with-ectopic-cushing%E2%80%99s-syndrome/

Cushing’s disease may sometimes make you feel that your life is out of your control. But there are some general things you can do to help take back control.

https://cushings-help.com/2024/11/05/tips-for-living-with-cushings/

Cushing’s disease is a progressive pituitary disorder in which there is an excess of cortisol in the body. While the disease can be treated surgically, this option is not possible for all patients. This is one of the approved medications that assist in controlling cortisol levels in people with Cushing’s disease.

Recorlev was approved by the FDA in December 2021 to treat those Cushing’s patients for whom surgery is not a choice or has failed to lower cortisol levels.

Read more at https://cushings.invisionzone.com/topic/56549-meds-recorlev/

Graphic Era Hospital has achieved a remarkable mileston by successfully treating two complex cases of the rare hormonal disorder Cushing’s Disease in Dehradun. The hospital’s experts used advanced technology and surgical skills to give the patients a new lease on life, marking this significant achievement.

https://cushings.invisionzone.com/topic/57868-graphic-era-hospital%E2%80%99s-milestone-treatment-of-two-complex-cases/

HSD-1 inhibition with clofutriben is a completely novel approach to the treatment of endogenous Cushing’s syndrome that may overcome many of the serious problems with current therapies, including major safety, tolerability, and complexity issues such as the risk of adrenal insufficiency and adrenal crisis.

Read more at https://cushings.invisionzone.com/topic/57761-sparrow-pharmaceuticals-announces-completion-of-phase-2-trial-and-fda-orphan-drug-designation-of-clofutriben-for-endogenous-cushing%E2%80%99s-syndrome/

Posterior pituitary tumors (PPTs) are extremely rare, with fewer than 400 cases reported to date. In 2022, the WHO classified four types of tumors originating from the posterior pituitary

Read more at https://cushings.invisionzone.com/topic/57780-oncocytic-pituicytoma-in-a-patient-with-cushings-disease/

Cushing’s disease (CD) is associated with phenotypic traits and comorbidities that may persist after the normalization of cortisol levels. Medical therapy is usually given in recurrent or persistent CD after transsphenoidal surgery. We aimed to investigate the impact of long-term normalization of daily cortisol secretion on clinical picture and cardiometabolic comorbidities, comparing surgical remission to medical treatment.

https://cushings.invisionzone.com/topic/57817-cardiometabolic-complications-after-cushing%E2%80%99s-disease-remission/

I certainly know this to be true   I'm an 18 year survivor of yet another disease that I shouldn't have gotten:  kidney cancer.

https://cushings.invisionzone.com/topic/57758-cancer-risk-elevated-for-adults-after-cushing%E2%80%99s-syndrome-diagnosis/

We present a 9-year-old boy who presented at age 4 with cyclical Cushing syndrome and was eventually diagnosed with a novel, previously unreported, unpublished variant in PRKAR1A associated with Carney complex. He was treated with unilateral left adrenalectomy. At 1-year follow-up, he continues to be in remission of his symptoms of Cushing syndrome.

https://cushings.invisionzone.com/topic/57870-unilateral-adrenalectomy-for-pediatric-cyclical-cushing-syndrome-with-novel-prkar1a-variant-associated-carney-complex/

Crinetics Pharmaceuticals is conducting a study titled ‘A Phase 1b/2a Open-label Multiple-ascending Dose Exploratory Study of CRN04894 in ACTH-dependent Cushing’s Syndrome.’ This study aims to evaluate the safety, tolerability, and pharmacokinetics of CRN04894, an ACTH receptor antagonist, in treating Cushing’s Syndrome, a condition characterized by excessive cortisol production. The study’s significance lies in its potential to offer a new treatment avenue for patients with Cushing’s disease or Ectopic ACTH Syndrome.

https://cushings.invisionzone.com/topic/57905-crinetics-pharma%E2%80%99s-promising-study-on-crn04894-for-cushing%E2%80%99s-syndrome-a-potential-game-changer/

Laparoscopic adrenalectomy is the standard treatment for adrenal tumors caused by Cushing's syndrome. However, few pregnant women have undergone adrenalectomy because of the risk of general anesthesia and surgery.

Read more at https://cushings.invisionzone.com/topic/57639-cushings-syndrome-in-pregnancy-in-which-laparoscopic-adrenalectomy-was-safely-performed-by-a-retroperitoneal-approach/

While many patients with Cushing syndrome have a delayed diagnosis, this case highlights the critical need to increase awareness of the signs and symptoms of hypercortisolism and to improve the understanding of appropriate screening tests among nonendocrine providers.

Read more at https://cushings.invisionzone.com/topic/57707-delayed-diagnosis-of-ectopic-cushing-syndrome/

The most common cause of Cushing syndrome (CS) is exposure to exogenous glucocorticoids. There is an increasing incidence of adulterated over-the-counter (OTC) supplements containing steroids.

Read more at https://cushings.invisionzone.com/topic/57624-exogenous-cushing-syndrome-and-hip-fracture-due-to-over-the-counter-supplement-artri-king/

The higher IGF-1 index was independently associated with lower prevalence of low bone mass in young CD patients, and IGF-1 might play an important role in the pathogenesis of CD-caused low bone mass.

Read more at https://cushings.invisionzone.com/topic/57619-association-of-igf-1-level-with-low-bone-mass-in-young-patients-with-cushing%E2%80%99s-disease/

Cushing disease (CD) is the most common form of adrenocorticotropin (ACTH)-dependent Cushing syndrome (CS), whereas unilateral adrenal adenoma is the most common cause of ACTH-independent CS. However, the occurrence of different subtypes of CS in a single individual is very rare.

https://cushings.invisionzone.com/topic/57836-a-second-look-at-cushing-disease-hypercortisolism-recurrence-from-another-gland/

Ectopic Cushing’s syndrome due to metastatic neuroendocrine small-cell carcinoma is a rare condition with a poor prognosis. The options for treatment are few and not necessarily curative. There needs to be increased awareness of this serious and rare complication. Managing the condition can be a challenge and requires a multidisciplinary team approach to improve outcomes.

Read more at https://cushings.invisionzone.com/topic/57577-recurrent-neuroendocrine-tumor-of-the-cervix-presenting-with-ectopic-cushing%E2%80%99s-syndrome/

By Dr. Lewis Blevins: This book is perhaps something a little different than most would expect. Firstly, it's a single-author book on Cushing's syndrome. It is not, like most textbooks, a compendium of edited submissions from multiple authors where there are often divergent opinions from one chapter to the next. Instead, it's a treatise reflecting my education and experience. It is not referenced but instead each chapter is followed by suggested readings. It represents my thoughts, understanding and a personal reflection on a career of evaluating a multitude of patients suspected of having the disorder and treating those confirmed to have hypercortisolism due to one cause or another. It reflects my perspectives of the art and science of the field.

More info at https://cushings.invisionzone.com/topic/57752-cushings-a-comprehensive-guide-to-understanding-a-devastating-condition/

Cushing’s disease may sometimes make you feel that your life is out of your control. But there are some general things you can do to help take back control.

https://cushings-help.com/2024/11/05/tips-for-living-with-cushings/

Seliciclib (R-roscovitine) has been shown in preclinical studies to inhibit neoplastic corticotroph proliferation and the production of adrenocorticotropic hormone (ACTH) in the pituitary gland. Therefore, for a study, researchers sought to investigate the effectiveness of seliciclib as a pituitary-targeting treatment for patients with Cushing’s disease (CD).

Read more at https://cushings.invisionzone.com/topic/57604-seliciclib-for-the-treatment-of-cushing%E2%80%99s-disease-targeting-pituitary/

Graphic Era Hospital has achieved a remarkable mileston by successfully treating two complex cases of the rare hormonal disorder Cushing’s Disease in Dehradun. The hospital’s experts used advanced technology and surgical skills to give the patients a new lease on life, marking this significant achievement.

https://cushings.invisionzone.com/topic/57868-graphic-era-hospital%E2%80%99s-milestone-treatment-of-two-complex-cases/

A 48-year-old male with a history of hypertension presented to his primary care physician with complaints of bilateral leg swelling, occasional shortness of breath, dizziness, and a general feeling of malaise persisting for 10 days. The patient reported increased water intake and urinary frequency without dysuria. The patient was diagnosed with hypertension eight months ago. He experienced progressive muscle weakness over two months, hindering his ability to perform daily activities, including using the bathroom. 

Read more at https://cushings.invisionzone.com/topic/57740-unveiling-the-uncommon-cushing%E2%80%99s-syndrome-cs-masquerading-as-severe-hypokalemia/

Posterior pituitary tumors (PPTs) are extremely rare, with fewer than 400 cases reported to date. In 2022, the WHO classified four types of tumors originating from the posterior pituitary

Read more at https://cushings.invisionzone.com/topic/57780-oncocytic-pituicytoma-in-a-patient-with-cushings-disease/

We report the case of a patient with double functional pituitary adenomas causing acromegaly and subclinical Cushing's disease. A 45-year-old woman was referred to our Department for suspected acromegaly. Her past medical history included diabetes mellitus treated with oral antidiabetic drugs and hypertension.

https://cushings.invisionzone.com/topic/57847-double-synchronous-functional-pituitary-adenomas-causing-acromegaly-and-subclinical-cushing-disease/

The Case Records of the Mayo Clinic Florida Neurosurgery featured an endoscopic transsphenoidal approach for a pituitary tumor resection.

Read more at  https://cushings.invisionzone.com/topic/57657-video-of-transsphenoidal-surgery/

We present a 9-year-old boy who presented at age 4 with cyclical Cushing syndrome and was eventually diagnosed with a novel, previously unreported, unpublished variant in PRKAR1A associated with Carney complex. He was treated with unilateral left adrenalectomy. At 1-year follow-up, he continues to be in remission of his symptoms of Cushing syndrome.

https://cushings.invisionzone.com/topic/57870-unilateral-adrenalectomy-for-pediatric-cyclical-cushing-syndrome-with-novel-prkar1a-variant-associated-carney-complex/

The most common cause of Cushing syndrome (CS) is exposure to exogenous glucocorticoids. There is an increasing incidence of adulterated over-the-counter (OTC) supplements containing steroids.

Read more at https://cushings.invisionzone.com/topic/57624-exogenous-cushing-syndrome-and-hip-fracture-due-to-over-the-counter-supplement-artri-king/

Since I just had Mohs surgery for squamous cell carcinoma, I immediately went to amazon to search for nicotinamide.

Read more at https://maryomedical.com/2021/05/30/testing-vitamin-b3/

The higher IGF-1 index was independently associated with lower prevalence of low bone mass in young CD patients, and IGF-1 might play an important role in the pathogenesis of CD-caused low bone mass.

Read more at https://cushings.invisionzone.com/topic/57619-association-of-igf-1-level-with-low-bone-mass-in-young-patients-with-cushing%E2%80%99s-disease/

Ectopic Cushing’s syndrome due to metastatic neuroendocrine small-cell carcinoma is a rare condition with a poor prognosis. The options for treatment are few and not necessarily curative. There needs to be increased awareness of this serious and rare complication. Managing the condition can be a challenge and requires a multidisciplinary team approach to improve outcomes.

Read more at https://cushings.invisionzone.com/topic/57577-recurrent-neuroendocrine-tumor-of-the-cervix-presenting-with-ectopic-cushing%E2%80%99s-syndrome/

There are several home cortisol tests available to purchase over the counter or online. These allow a person to take a sample of blood, urine, or saliva before sending it off for analysis.

After taking a home cortisol test, people can usually receive their results within 2–5 days online or via a telephone call with a healthcare professional.

However, there are currently no studies investigating the reliability of these home cortisol tests. Therefore, people should follow up on their test results with a healthcare professional.

Read more at https://cushings.invisionzone.com/topic/55639-home-cortisol-tests-3-of-the-best/

Some pain is normal after any surgery. Different people have different levels of sensitivity to pain. In general, you should experience a little less pain every day. Pain is usually worse in the evening when you are trying to go to sleep. Do not be afraid to take the pain medicine prescribed for you, particularly before you go to sleep, but you can stop taking it if you are comfortable. Most pain medications cause constipation and they can also cause drowsiness. Do not drive or operate power tools after you take narcotic pain medications. If you have only mild discomfort, try taking extra-strength Tylenol® as directed.

https://cushings-help.com/2024/10/30/adrenalectomy-and-bla/

The diagnosis of Cushing's Syndrome is often difficult due to the insidious onset of hypercortisolism, in absence of relevant early signs of the disease, as well as the rarity of the disease in childhood. For these reasons, the time to diagnosis has been reported as a mean of 33 months (95% CI 29–38) and not dissimilar to adult population.

https://cushings.invisionzone.com/topic/57762-cushing-syndrome-in-paediatric-population/

Cushing’s disease may sometimes make you feel that your life is out of your control. But there are some general things you can do to help take back control.

https://cushings-help.com/2024/11/05/tips-for-living-with-cushings/

Graphic Era Hospital has achieved a remarkable mileston by successfully treating two complex cases of the rare hormonal disorder Cushing’s Disease in Dehradun. The hospital’s experts used advanced technology and surgical skills to give the patients a new lease on life, marking this significant achievement.

https://cushings.invisionzone.com/topic/57868-graphic-era-hospital%E2%80%99s-milestone-treatment-of-two-complex-cases/

Three young female patients with a history of generalized body pain were diagnosed with fibromyalgia. They visited several specialities which related patients' symptoms to their previous diagnosis of fibromyalgia and were treated symptomatically. These patients developed a multitude of clinical features including fractures, hypertension, abnormal weight gain, proximal myopathic pain and bruising. They were seen by rheumatologists whose assessment was that their clinical features were not entirely due to fibromyalgia and suspected that patients have a possible underlying endocrine cause. Patients were referred to an endocrinologist for further tests with suspicion of Cushing’s syndrome. Laboratory tests and imaging confirmed a diagnosis of Cushing’s syndrome. Two of them had adrenal adenoma and one had iatrogenic corticosteroid use. These cases emphasize the need for thorough clinical evaluation for patients who are thought to have fibromyalgia. Fibromyalgia is a diagnosis of exclusion.

Read more at https://cushings.invisionzone.com/topic/57756-cushing%E2%80%99s-syndrome-masquerading-as-fibromyalgia-a-case-series/

Posterior pituitary tumors (PPTs) are extremely rare, with fewer than 400 cases reported to date. In 2022, the WHO classified four types of tumors originating from the posterior pituitary

Read more at https://cushings.invisionzone.com/topic/57780-oncocytic-pituicytoma-in-a-patient-with-cushings-disease/

Herein, national data of the clinical experience on paediatric CD have been presented. Our findings highlight that presenting complaints may be subtle in children, the sensitivities of the diagnostic tests are very variable and require a careful interpretation, and MRI fails to detect adenoma in approximately one-third of cases. Finally, clinicians should be aware of the recurrence of the disease during the follow-up after surgery.

Read more at https://cushings.invisionzone.com/topic/57658-clinical-features-diagnosis-and-treatment-outcomes-of-cushings-disease-in-children-a-multicenter-study/

We report a case of a 16-year-old female with recurrent Cushing’s disease secondary to a pituitary microadenoma, confirmed by elevated urinary free cortisol and magnetic resonance imaging (MRI). It was initially treated with transsphenoidal resection in 2019; disease recurrence was confirmed and again treated in 2024.

https://cushings.invisionzone.com/topic/57848-reconstructive-liposuction-for-residual-lipodystrophy-after-remission-of-cushing%E2%80%99s-disease/

Relacorilant was deemed well tolerated in the trial. The most common adverse events were nausea, edema, back and extremity pain and fatigue, all of which were mild or moderate in nature and are consistent with symptoms people experience after surgery or the start of therapy to treat hypercortisolism.

Read more at https://cushings.invisionzone.com/topic/57728-investigational-cushing%E2%80%99s-syndrome-medication-reduces-bp-glucose-in-open-label-trial/

We present a 9-year-old boy who presented at age 4 with cyclical Cushing syndrome and was eventually diagnosed with a novel, previously unreported, unpublished variant in PRKAR1A associated with Carney complex. He was treated with unilateral left adrenalectomy. At 1-year follow-up, he continues to be in remission of his symptoms of Cushing syndrome.

https://cushings.invisionzone.com/topic/57870-unilateral-adrenalectomy-for-pediatric-cyclical-cushing-syndrome-with-novel-prkar1a-variant-associated-carney-complex/

Cushing's Syndrome, a rare but complex endocrine disorder characterized by excessive cortisol production, presents unique challenges and risks during pregnancy. Recent advancements in medical understanding have led to greater awareness of the implications of this syndrome when coupled with conditions like diabetes insipidus, particularly in pregnant patients. The coexistence of these disorders emphasizes the need for a multidisciplinary approach to manage these high-risk pregnancies effectively.

https://cushings.invisionzone.com/topic/57872-pregnancy-case-cushing%E2%80%99s-syndrome-with-diabetes-insipidus/

The most common cause of Cushing syndrome (CS) is exposure to exogenous glucocorticoids. There is an increasing incidence of adulterated over-the-counter (OTC) supplements containing steroids.

Read more at https://cushings.invisionzone.com/topic/57624-exogenous-cushing-syndrome-and-hip-fracture-due-to-over-the-counter-supplement-artri-king/

The higher IGF-1 index was independently associated with lower prevalence of low bone mass in young CD patients, and IGF-1 might play an important role in the pathogenesis of CD-caused low bone mass.

Read more at https://cushings.invisionzone.com/topic/57619-association-of-igf-1-level-with-low-bone-mass-in-young-patients-with-cushing%E2%80%99s-disease/

As a rare endocrine disorder, Cushing’s Syndrome (Cushing’s) is characterized by numerous symptoms and a non-specific presentation, leading to a delay to diagnosis for patients with this disease. To date, research examining the lived experiences of patients with Cushing’s in healthcare is absent in the literature. This preliminary inquiry into the healthcare experiences of women with Cushing’s aimed to examine the utility of this line of inquiry to support the patient centered care of individuals with Cushing’s.

https://cushings.invisionzone.com/topic/57759-%E2%80%9Cthe-healthcare-system-did-fail-me-repeatedly%E2%80%9D-a-qualitative-study-on-experiences-of-healthcare-among-canadian-women-with-cushing%E2%80%99s-syndrome/

Ectopic Cushing’s syndrome due to metastatic neuroendocrine small-cell carcinoma is a rare condition with a poor prognosis. The options for treatment are few and not necessarily curative. There needs to be increased awareness of this serious and rare complication. Managing the condition can be a challenge and requires a multidisciplinary team approach to improve outcomes.

Read more at https://cushings.invisionzone.com/topic/57577-recurrent-neuroendocrine-tumor-of-the-cervix-presenting-with-ectopic-cushing%E2%80%99s-syndrome/

Cushing’s disease may sometimes make you feel that your life is out of your control. But there are some general things you can do to help take back control.

https://cushings-help.com/2024/11/05/tips-for-living-with-cushings/

Did't we all do this?

A young woman saved her own life after successfully self-diagnosing cancer/Cushing's that doctors had missed because she researched her own worrying symptoms on TikTok.

https://cushings.invisionzone.com/topic/57819-tiktok-saved-my-life-student-discovers-life-threatening-tumour-after-self-diagnosing-rare-condition/

Graphic Era Hospital has achieved a remarkable mileston by successfully treating two complex cases of the rare hormonal disorder Cushing’s Disease in Dehradun. The hospital’s experts used advanced technology and surgical skills to give the patients a new lease on life, marking this significant achievement.

https://cushings.invisionzone.com/topic/57868-graphic-era-hospital%E2%80%99s-milestone-treatment-of-two-complex-cases/

Cyclic Cushing syndrome (CCS) is a rare variant of Cushing syndrome (CS) characterized by intermittent episodes of cortisol peaks alternating with variable periods of normal or subnormal adrenocorticotropic hormone (ACTH) and cortisol levels.

https://cushings.invisionzone.com/topic/57906-three-cases-of-ectopic-cyclic-cushing-syndrome-a-new-square-wave-variant/

Facial plethora is a main symptom of Cushing syndrome, a rare condition that’s caused by high levels of cortisol, known as the stress hormone.

Read more at https://cushings.invisionzone.com/topic/56564-what-is-facial-plethora/#comment-477092

The Phase III GRADIENT trial for relacorilant has missed its primary endpoint of improving SBP for Cushing's syndrome patients.

https://cushings.invisionzone.com/topic/57763-corcept%E2%80%99s-relacorilant-gradient-trial-misses-primary-endpoint/

Posterior pituitary tumors (PPTs) are extremely rare, with fewer than 400 cases reported to date. In 2022, the WHO classified four types of tumors originating from the posterior pituitary

Read more at https://cushings.invisionzone.com/topic/57780-oncocytic-pituicytoma-in-a-patient-with-cushings-disease/

We present a case of anorexia nervosa (AN), which is a rare cause of hypercortisolism. We discuss the case of a female patient with a body mass index (BMI) of 12.4 kg/m2 who was referred to us because of hypercortisolism. When the patient was evaluated for Cushing's syndrome (CS), the clinical presentation was not suggestive.

https://cushings.invisionzone.com/topic/57873-a-rare-case-of-hypercortisolemia-alongside-anorexia-nervosa/

In our Daily Dose, a viewer is asking about hormone problems that can cause your face to become round. Dr. Lacy Anderson joined News 9 to explain how some hormone disorders, like Cushing syndrome work.

Read more at https://cushings.invisionzone.com/topic/57733-cushing-syndrome-and-hormone-disorders/

The first-line treatment for Cushing’s disease is transsphenoidal surgery for pituitary tumor resection. Ketoconazole has been used as a second-line drug despite limited data on its safety and efficacy for this purpose.

Read more at https://cushings.invisionzone.com/topic/57605-ketoconazole-as-second-line-treatment-for-cushing%E2%80%99s-disease-after-transsphenoidal-surgery/

Abstract

This case report describes a 42-year-old female with a rare pheochromocytoma presenting without classic Cushingoid features but with uncontrolled hypertension, type 2 diabetes, and recurrent headaches. Despite the absence of typical signs, biochemical analysis revealed elevated cortisol and ACTH levels, and imaging showed a 6 cm adrenal mass. The patient was stabilized preoperatively with alpha-blockers and metyrapone before undergoing a successful laparoscopic adrenalectomy. Histopathology confirmed pheochromocytoma with aggressive features. Postoperatively, her blood pressure and symptoms improved, and her cortisol levels normalized. This case underscores the diagnostic challenges of ACTH-secreting pheochromocytomas without classic hypercortisolism signs and emphasizes the need for thorough endocrine and imaging assessments. Surgical resection remains the definitive treatment, with long-term follow-up essential to monitor for recurrence. This case contributes to the limited literature on the coexistence of pheochromocytoma and ectopic ACTH secretion.

https://cushings.invisionzone.com/topic/57818-ectopic-acth-secreting-pheochromocytoma-without-typical-signs-of-cushing-syndrome/

We present a 9-year-old boy who presented at age 4 with cyclical Cushing syndrome and was eventually diagnosed with a novel, previously unreported, unpublished variant in PRKAR1A associated with Carney complex. He was treated with unilateral left adrenalectomy. At 1-year follow-up, he continues to be in remission of his symptoms of Cushing syndrome.

https://cushings.invisionzone.com/topic/57870-unilateral-adrenalectomy-for-pediatric-cyclical-cushing-syndrome-with-novel-prkar1a-variant-associated-carney-complex/

Cushing syndrome (CS) and Mild Autonomous Cortisol Secretion syndrome (MACS) are states of endogenous hypercortisolemia, associated with multiple metabolic complications.

https://cushings.invisionzone.com/topic/57887-liver-impairment-and-medical-management-of-cushing-syndrome-and-macs-provisionally/

We describe a case of a 56-year-old woman with a history of recurrent pituitary adenoma, not well followed, and known comorbidities of coronary artery disease, hypertension, and type 2 diabetes mellitus. She arrived with severely high blood pressure and signs pointing to hypercortisolism. Further evaluation revealed left ventricular hypertrophy, reduced global longitudinal strain, and preserved left ventricular ejection fraction, consistent with heart failure with preserved ejection fraction (HFpEF). Workup for amyloidosis was negative.

This case highlights that chronic hypercortisolism may cause pathophysiological changes in the heart, leading to HFpEF, and may induce myocardial fibrosis and impaired myocardial mechanics, producing an echocardiographic pattern that can mimic infiltrative cardiomyopathy. Recognition of this overlap is crucial to avoid misdiagnosis and to ensure timely endocrine and cardiovascular management.

https://cushings.invisionzone.com/topic/57888-global-longitudinal-strain-reduction-with-apical-sparing-in-cushing-syndrome-related-heart-failure-with-preserved-ejection-fraction-hfpef/

“In general, cortisol levels tend to peak in the late morning and gradually decline throughout the day,” he explains. “When a stressful event occurs, the increased cortisol will work alongside our ‘fight or flight’ mechanisms to either upregulate or downregulate bodily functions. [Affected systems include] the central nervous system, cardiovascular system, gastrointestinal system, or immune system.”

Read more at https://cushings.invisionzone.com/topic/57552-basics-what-causes-abnormal-cortisol-levels/

ave the Date: In-depth information for nurses and patients in two separate curated sessions.

https://cushings.invisionzone.com/topic/57828-2025-neuro-endocrine-pituitary-conference-for-physicians-nurses-patients/

The most common cause of Cushing syndrome (CS) is exposure to exogenous glucocorticoids. There is an increasing incidence of adulterated over-the-counter (OTC) supplements containing steroids.

Read more at https://cushings.invisionzone.com/topic/57624-exogenous-cushing-syndrome-and-hip-fracture-due-to-over-the-counter-supplement-artri-king/

The higher IGF-1 index was independently associated with lower prevalence of low bone mass in young CD patients, and IGF-1 might play an important role in the pathogenesis of CD-caused low bone mass.

Read more at https://cushings.invisionzone.com/topic/57619-association-of-igf-1-level-with-low-bone-mass-in-young-patients-with-cushing%E2%80%99s-disease/

Ectopic Cushing’s syndrome due to metastatic neuroendocrine small-cell carcinoma is a rare condition with a poor prognosis. The options for treatment are few and not necessarily curative. There needs to be increased awareness of this serious and rare complication. Managing the condition can be a challenge and requires a multidisciplinary team approach to improve outcomes.

Read more at https://cushings.invisionzone.com/topic/57577-recurrent-neuroendocrine-tumor-of-the-cervix-presenting-with-ectopic-cushing%E2%80%99s-syndrome/

Like most everything else in my life, having had Cushing's (pituitary) made this surgery more difficult.  My surgeon had to plan with my endocrinologist how much cortisol I'd need during the operation, then I had to stay overnight to get me successfully weaned off the cortisone again.

Read more at https://cushings.invisionzone.com/topic/57682-what-was-the-most-memorable-thing-that-happened-to-you-last-year/

While American actress Amy Schumer is spreading the word about Cushing’s in general, I think that in some ways she is hurting things for everyone else.  CBS News reports that “she says she now feels ‘reborn’ after her diagnosis, and while some forms of Cushing can be fatal, she has a type that ‘will just work itself out.’”

How many others will try to get diagnosed and only be told not to worry, that it “will just work itself out”?

Read more at https://cushings.invisionzone.com/topic/56733-day-1-cushings-awareness-challenge-2022/?do=findComment&comment=478703

Cortisol is a hormone which produced by the adrenal gland (cortex) to control blood sugar. The production of cortisol is triggered by the pituitary hormone ACTH. Cortisol is a glucocorticoid which stimulates an increase in blood glucose. Cortisol will also stimulate the release of amino acids from muscle tissue and fatty acids from adipose tissue. The amino acids are then converted in the liver to glucose (for use by the brain). The fatty acids can be used by skeletal muscles for energy (rather than glucose) thereby freeing up glucose for selective utilization by the brain. Cortisol levels are often measured to evaluate the function of the pituitary or adrenal glands. Some of the cortisol is metabolized by the liver to produce 17 hydroxycorticosteroids, which is then excreted in the urine.

Read more at https://cushings.invisionzone.com/topic/56255-what-is-cortisol/

Cushing’s disease may sometimes make you feel that your life is out of your control. But there are some general things you can do to help take back control.

https://cushings-help.com/2024/11/05/tips-for-living-with-cushings/

Cushing’s disease (CD) is a clinical syndrome caused by excessive secretion of adrenocorticotropic hormone (ACTH) from a pituitary corticotroph adenoma, resulting in adrenal cortical hyperplasia and overproduction of cortisol. The T-box transcription factor (TPIT) is crucial for regulating ACTH secretion in pituitary corticotroph adenomas. This study aims to explore the ubiquitin-mediated degradation of TPIT and identify potential pharmaceutical agents for treating CD.

https://cushings.invisionzone.com/topic/57874-the-stub1-tpit-axis-regulates-the-secretion-of-adrenocorticotrophic-hormone-in-cushing-disease/

Bilateral adrenalectomy (BA) still plays an important role in the management of Cushing's disease (CD). Nelson’s syndrome (NS) is a severe complication of BA, but conflicting data on its prevalence and predicting factors have been reported. The aim of this study was to determine the prevalence of NS, and identify factors associated with its development.

Read more at https://cushings.invisionzone.com/topic/55708-prevalence-of-nelson%E2%80%99s-syndrome-after-bilateral-adrenalectomy-in-patients-with-cushing%E2%80%99s-disease/

Acute adrenal crisis is a life-threatening state caused by insufficient levels of cortisol, which is a hormone produced and released by the adrenal gland.

Read more at https://cushings.invisionzone.com/topic/56238-call-911-adrenal-crisis-addisonsadrenal-insufficiency/

Key takeaways:

• Cushing’s syndrome symptoms moderately impact quality of life for adults with the condition.
• Weight gain, muscle fatigue and menstrual changes decline in severity from diagnosis to follow-up.

Read more at https://cushings.invisionzone.com/topic/57630-adults-with-cushing%E2%80%99s-syndrome-report-high-burden-of-illness-despite-ongoing-treatment/

We report a case of a recently diagnosed adrenocorticotropic hormone (ACTH)-dependent Cushing's syndrome in a 30-years-old female who presented initially with a three-month history of progressive weight gain, generalized weakness, acne, menstrual irregularity, and severe hypokalemia, and then developed a gastric ulcer perforation only one month after her ACTH-dependent Cushing's syndrome diagnosis and was managed through emergent surgery.

Read more at https://cushings.invisionzone.com/topic/57659-adrenocorticotropic-hormone-dependent-cushings-syndrome-complicated-with-gastric-ulcer-perforation-in-a-30-year-old-saudi-female/

Cushing’s syndrome (CS) is associated with severe cardiovascular (CV) morbidity and mortality. Cardiac magnetic resonance (CMR) is the non-invasive gold standard for assessing cardiac structure and function; however, few CMR studies explore cardiac remodeling in patients exposed to chronic glucocorticoid (GC) excess. We aimed to describe the CMR features directly attributable to previous GC exposure in patients with cured or treated endogenous CS.

Read more at https://cushings.invisionzone.com/topic/57734-cardiac-magnetic-resonance-reveals-biventricular-impairment-in-cushing%E2%80%99s-syndrome/

Endogenous Cushing's syndrome (CS) has been linked with an increased risk of cancer. We aimed to evaluate the association between cancer risk and disease remission post-surgery in adrenal CS and Cushing's disease (CD).

https://cushings.invisionzone.com/topic/57786-impact-of-remission-status-in-endogenous-cushings-syndrome-on-cancer-incidence/

Graphic Era Hospital has achieved a remarkable mileston by successfully treating two complex cases of the rare hormonal disorder Cushing’s Disease in Dehradun. The hospital’s experts used advanced technology and surgical skills to give the patients a new lease on life, marking this significant achievement.

https://cushings.invisionzone.com/topic/57868-graphic-era-hospital%E2%80%99s-milestone-treatment-of-two-complex-cases/

We report the case of a 29-year-old male who presented with new-onset diabetes mellitus, resistant hypertension and significant weight gain. Physical examination revealed features consistent with Cushing’s syndrome. 

https://cushings.invisionzone.com/topic/57889-a-silent-invader-asymptomatic-rhodococcus-infection-unmasked-in-a-patient-with-ectopic-acth-dependent-cushing%E2%80%99s-syndrome/

Surgery beyond the age of 75, mainly relying on an endoscopic endonasal transsellar approach, is effective and safe, provided that patients are managed in tertiary centers.

Read more at https://cushings.invisionzone.com/topic/57640-pituitary-surgery-outcome-in-patients-75%C2%A0years-and-older/

Posterior pituitary tumors (PPTs) are extremely rare, with fewer than 400 cases reported to date. In 2022, the WHO classified four types of tumors originating from the posterior pituitary

Read more at https://cushings.invisionzone.com/topic/57780-oncocytic-pituicytoma-in-a-patient-with-cushings-disease/

Diagnosing Cushing's disease involves a series of tests to confirm excessive cortisol production and determine its source.

https://cushings.invisionzone.com/topic/57787-how-is-cushings-disease-diagnosed/

The pituitary gland produces hormones. A tumor in this gland can cause it to produce too much of the hormone cortisol. Too much cortisol in the body causes Cushing disease. This disease causes many problems. Some of these problems might persist after the disease is cured.

Read more at https://cushings.invisionzone.com/topic/56742-long-term-follow-up-of-survivors-of-pediatric-cushing-disease/

Has your doctor ever tried to dissuade you from using an alternative treatment?

Read more at https://cushings.invisionzone.com/topic/57567-what-do-you-think-alternative-treatments/