The second episode of Pituitary Grand Rounds features Dr. Lewis Blevins in a compelling discussion with Sloan Hart, a patient with a dangerous, delayed diagnosis of Cushing’s disease, which caused tremendous hardship and suffering.
October 15, 2026
Pituitary, Video ACTH, Birth control, bruising, Buffalo hump, central obesity, cortisol, Cushing's disease, Deep Vein Thrombosis, Dr. Lewis Blevins, DVT, endocrinologist, fat-shamed, fatigue, hair growth, hair loss, high cholesterol, hirsuitism, hypertension, lethargy, memory loss, mood disorders, muscle atrophy, pain, PCOS, photos, pituitary, Pituitary Grand Rounds, plethora, pre-diabetic, ptsd, skin, straie, stress, video, Weight gain Leave a comment
The second episode of Pituitary Grand Rounds features Dr. Lewis Blevins in a compelling discussion with Sloan Hart, a patient with a dangerous, delayed diagnosis of Cushing’s disease, which caused tremendous hardship and suffering.
September 30, 2026
Golden Oldies, PCOS, Pituitary acne, anxiety, back pain, Buffalo hump, constipation, cysts, depression, double vision, edema, fat, fatigue, hair loss, hirsuitism, hypertension, irregular periods, kidney stones, libido, moonface, muscle weakness, Neurologist, PCOS, steroids, Stretch marks, striae 1 Comment
A Golden Oldie
I’m 31 years old and feel like I’m 80. I’ve been ill for so many different things over the past couple of years.
In the past year alone I’ve seen 5 doctors who couldn’t tell me the time. They made me feel like I was crazy. Even when I got double vision in my right eye and had to wear an eye patch for 3 months. No one could figure out why. I still have vision disturbances but after two med packs of steriods the double vision went away.
I came across this web site last week and connected with so many things from other people. I printed off the sheets and took them to a new neurologist I was scheduled to see. To my amazement he completly agreed with me! He said it was very likely I did have cushings and/or PCOS.
He scheduled an appointment for a Endocrinologist that specializes in this area and I am to see them Tuesday. I will update from then but I want to say I’m grateful for this site because it gave me some hope of an answer. I’ve been so miserable. I felt like my soul was trapped by my body and I didn’t even have the energy to make it better.
If you’re doctor makes you feel crazy, find another one. I know even with insurance it’s expensive but help is imperative.
Here’s a list of my symptoms:
-hump on my neck (have had for a while and thought it was from bad posture!)
-cyctic acne
-hair loss
-hair growth where it should not be
-loss of libido (I’m 31 this is so not right)
-fatigue
-muscle weakness
-back pain
-fat in the middle
-moon face
-horrible stretch marks
-no period for over a year (my last gyno told me I was just lucky)
-vision disturbances
-depression
-anxiety
-hypertension
-extremly low cholesterol
-hard to breathe, like there’s somthing heavy on my chest
-reoccurent kidney stones
-cyst on ovaries
-frequent bathroom visits
-terrible constipation
-swelling of legs and feet
-water rentention
HOME | Contents | Adrenal Crisis! | Abbreviations | Glossary | Forums | Donate | Bios | Add Your Bio
July 2, 2026
News Items, Pituitary, Pituitary Surgery, Recurrence, Treatments Alopecia, Asthma, depression, dyslipidaemia, headaches, hypertension, obesity, Osilodrostat, Pasireotide, Sleep apnea, transsphenoidal Leave a comment
A 45-year-old female developed clinical and biochemical recurrent Cushings’ Disease 2.5 years after transsphenoidal hypophysectomy for 2cm pituitary macroadenoma.
Past medical history included Type 2 Diabetes mellitus, asthma, hypertension, grade 3 obesity, dyslipidaemia, depression and sleep apnoea. MRI showed residual pituitary tissue with left sphenoid sinus extension.
MDT advised repeat transphenoidal surgery over radiotherapy due to presence of a clearly visible surgical target. Neurosurgery was initially delayed at patient request. She commenced metyrapone, titrated to cortisol levels but this was poorly tolerated. Whilst awaiting neurosurgery, she developed pituitary apoplexy with right sixth nerve palsy and superior quadrantanopia. MRI showed reduced tumor volume but she became progressively hypercortisolaemic. MDT discussion felt redo transphenoidal surgery no longer appropriate but unfortunately, the patient declined radiotherapy.
Over the next 5 years, her metabolic control deteriorated, managed with intensive insulin regime, GLP-1 agonist and SGLT2 inhibitor, anti-hypertensives, statin, Levothyroxine for central hypothyroidism, prophylactic Rivaroxaban for thromboembolic risk and intermittent Metyrapone.
Despite this she developed worsening alopecia, arthralgia, myopathy and NAFLD and became wheelchair dependent.
Options of pituitary radiotherapy, bilateral surgical adrenalectomy or ablation were discussed. Bilateral surgical adrenalectomy was accepted by the patient but delayed due to Covid-19 pandemic. Whilst awaiting adrenalectomy she developed worsening headaches and superior quadrantanopia. Repeat MRI showed increase size of pituitary adenoma with supraseller extension. She commenced Pasireotide after MDT discussion but attended A/E with worsening headache, visual field defect and ongoing cushingoid symptoms after 3 doses. Repeat MRI scan showed no significant tumour growth or apoplexy and MDT recommended Osilodrostat, which the patient is awaiting.
Conclusion: This challenging case highlights the alternative options of managing resistant hypercortisolaemia in an individualized approach and the difficulty explaining complex treatment options with patients.
Adapted from https://www.endocrine-abstracts.org/ea/0094/ea0094p245
June 27, 2026
Golden Oldies, Insulin Resistance, PCOS Blood pressure, Conditions and Diseases, Endocrine Disorders, Health, hypertension, insulin resistance, PCOS, Polycystic ovary syndrome Leave a comment
Another Golden Oldie, this bio was last updated December 8, 2008.
~~~
Dear friends, I’ve made every possible test in these months, and I don’t have cushing.
I’m only an obese woman with PCOS, high blood pressure, insuline-resistence (thanks to this, even if I’m making the diet, I don’t succeed to lose many Kilos and moreover I can’t take the medicine for the insuline-resistence because my transaminases are still high) without diabetes (my glycemy after three months of diet is in a normal range). Now ‘m not happy…
In the end, I wanna wish you a wonderful Christmas day and a new year full of victories.
June 26, 2026
Adrenal, Adrenal Surgery, Sub-Clinical Cushing's, Treatments adrenal gland, Adrenalectomy, benign mass, bleeding gums, blood glucose, bruising, bursitis, calcium, carpal tunnel, cholesterol, cortisol, Cushing Syndrome, disability, Health, hypertension, hypothyroid, Hyzaar, lipitor, Magnetic resonance imaging, MRI, nerve block, nerve damage, neurontin, pain, Pain Management, prozac, spinal stimulator trial, steroids, tendonitis, thyroid, torn muscles, ulnar nerve entrapment, vitamin D 1 Comment
18 months ago I underwent an adrenalectomy (L) for a benign mass. My cortisol levels were slightly elevated, all tests suggested sub clinical cushings.
Before the surgery I felt great, no symptoms other than easy bruising, bleeding gums and mild hypertention. In fact, the reason I went to an endocrinologist was because I thought i had a hypothyroid issue and my fasting blood glucose was always around 110. The adrenal mass was an incidentaloma during a scan of my pancreas/abdomen.
During the surgery I suffered a positioning injury to my shoulder, arm, and hand. Permanent nerve damage and horribly painful to this day. My initial post op replacement dose of cortisone was 10mg twice a day even though the surgeon and my endo were quite aware of my injuries. I felt like I was dying. Short of breath, chest pain, no sleep ever to this day.
Finally after 6 months a doctor at the hospital were I worked as an RN took over and directed me to pain management and ordered MRIs. Torn muscles, bursitis, tendonitis carpal tunnel and ulnar nerve entrapement etc….Since then i have had to change endos because mine has become rude and my appointments brief. I make 0.5 cortisol, nothing.
I am still on disability and will be terminated permenently in September. Every morning I lie there writhing in pain, short of breath, crying. I am so lethargic once I force myself up I bump into things. Some days I can’t get up at all. All pain management wants to do is inject steroids. I have had 3 nreve blocks and a spinal stimulator trial which did more harm than good. I KNOW I am in steroid withdrawl but what do I do now?
It’s been 18 months and I can’t find an endo who will pay any attention to me…………….I also believe I still have a thyroid problem. My levels are ‘borderline’ just like my cortisol was but the symptoms are all there and very obvious. Plus my cholesterol ,untreated, is 295. I don’t eat junk at all. never did.
My meds are Hyzaar, lipitor, neurontin, calcium, prozac,and 10mg of cortisone a day. I ditched the vitamin d3 because they only check my D-25 not 1-25 D and I am afraid of having dysregulated Vit D metabolisn which increases inflammation…..
I don’t know what to do. Help 🙁
~~~
Adrenal Crisis! | Abbreviations | CushieWiki | Glossary | Forums | Donate | Interactive | Bios | Bios Listed by Date | Add Your Bio |
June 24, 2026
Adrenal, Adrenal Surgery, Golden Oldies, Male, Nelson's, Pituitary Surgery, radiation, Treatments Adrenalectomy, bilateral adrenalectomy, BLA, Blood pressure, cushing, Cushing Syndrome, headache, hypertension, Magnetic resonance imaging, MRI, Nelson's Syndrome, Pituitary gland, radioactive cholesterol isotope, striae, tumor, weight 1 Comment
Michael B’s Story. Michael B was first diagnosed with Cushing’s in 1979 and had a bilateral adrenalectomy in 1980. In 1983 the symptoms reoccurred and he had a third adrenal removed in 1983. He then developed Nelson’s syndrome and had his pituitary (plus tumour) removed, followed by another pituitary surgery then 5 weeks of radiotherapy.
This Golden Oldie was last updated 06/07/2008
~~~~
I was diagnosed with Cushing’s in late 1979 and had a bilateral adrenalectomy in 1980. After the operation my weight reduced and my blood pressure stabilised to normal. In 1983 the symptoms re-occurred and I had a third adrenal removed in 1983 (this was found by the use of radioactive cholesterol isotope injection).
The anterior pituitary is the anterior, glandular lobe of the pituitary gland. (Photo credit: Wikipedia)
After this I felt good until 1987 when I developed Nelson’s syndrome and had my pituitary (plus tumour) removed. Again all went well until an MRI scan discovered that the tumour had returned.
In 1998 I had this removed followed by 5 weeks of radiotherapy in the hope of preventing a further growth of this tumour. To date and several MRI’s later it seems to be working.
In the early days my symptoms were all physical e.g. moon face, high blood pressure excess weight, abdominal striae, localised headache, I never suffered from depression.
I write to reassure people that it is possible to live a normal life after Cushing’s. Keep up the work on the website. I did not have the luxury of so much information. My information came from trawling through my local library for information for, like others, I got little information from my doctors.
June 14, 2026
Adrenal, Adrenal Surgery, Ectopic, Golden Oldies, Pituitary, Pituitary Surgery, Thyroid ACTH, adrenal adenoma, adrenal gland, Adrenalectomy, Adrenocorticotropic hormone, antidepressant, anxiety, April 2004, BLA, blood clot, Blood pressure, brain fog, Buffalo hump, cardiologist, cardiomyopathy, cholesterol, CRH/Dex test, CT scan, Cushing Syndrome, December 2004, depression, dexamethasone suppression test, diarrhea, digestive, Dr. David Cook, ectopic, edema, EKG, endocrinologist, gallbladder, gallstones, heart, hypertension, hyperthyroidism, hysterectomy, imipramine, Inferior petrosal sinus sampling, IPSS, Klonopin, Levoxyl, Magnetic resonance imaging, memory, OHSU, Oregon Health & Science University, ovarian mass, panic attack, periods, phlebitis, phobia, pituitary, suicidal, surgery, thyroid, UFC, ultrasound, uterine mass, weight, X-ray computed tomography, Xanax Leave a comment
Another Golden Oldie, this bio was originally posted 01/22/2008
Hi, I’m ORKitty. I live in Portland, OR, with my wonderful husband and kitty. I just turned 50 in 2005.
I began this journey quite possibly 17 years ago when I had some isolated panic attacks and then suddenly had panic 24 hours a day. I also kept crying and didn’t know why. I was eventually put on Xanax and then found a psychiatrist who put me on the anti-depressant imipramine and weaned me off the Xanax. It worked well for both the panic and depression for about 10 years. I gained some weight which I attributed to the anti-depressant. During this time I was still able to work and ran my own home-based business for 3 years. About seven years ago my anxiety worsened and my psychiatrist added Klonopin to deal with it. About this time I began gaining even more weight.
Due to a terrible (and terrifying) experience with a doctor, I developed a real phobia about seeing doctors. I managed to overcome this in early 2003 and have a large lump on my neck examined. An ultrasound showed normal tissue, but while I was there the doctor took my blood pressure at 160/100 and then decided to do an EKG. She found an abnormality and sent me to a cardiologist who diagnosed me with severe cardiomyopathy (next step dead). I was put on medication and had regular echocardiograms every few months and each one showed more improvement.
In fall of 2003 I was diagnosed with hypothyroidism and began taking Levoxyl, increasing by very small doses because it seemed to increase my anxiety every time I upped the dose. At the same time I was taken off the imipramine because there was some concern that it may have contributed to my heart problems. As my thyroid meds increased I began to lose weight and began having serious digestive problems including constant diarrhea. I had burning sensations in both arms, edema in both legs and my periods stopped. After some misdiagnoses and some doctor abuse I was finally found to have gallstones and had my gallbladder removed in April of 2004. I had hoped this would clear up the digestive issues, but that wasn’t the case.
After the surgery I noticed that my depression was getting much worse. By July I found that I couldn’t stand to listen to music or watch TV without getting anxious and upset. I was also feeling like I was in a fog and had racing, looping thoughts. I had trouble with reasoning and memory. My psychiatrist began prescribing a variety of medications, none of which seemed to help any of my symptoms. Things were so bad that I became suicidal for the first time in my life.
I finally persuaded my doctor to do a CAT scan to see what was wrong with my digestive system. Nothing showed up there but they found a uterine/ovarian mass and an adrenal adenoma. My doctor didn’t tell me about the adenoma until a later visit when she mentioned it in passing, saying it was nothing to worry about.
That was when I saw my first endocrinologist hoping to get help with my thyroid and an explanation of what was going on with my adrenal gland. He did a 24-hr. urine collection and my cortisol was high (200). He did an 8mg Dex test and I didn’t suppress completely so he sent me to Dr. Cook at OHSU who did a CRH/Dex test. The results were somewhat ambiguous, but he decided that the most likely source was the adrenal adenoma and recommended having the gland removed. I had that surgery in December of 2004. The day of the surgery I developed phlebitis in my right arm starting at the site of the IV. My arm became red and swollen from wrist to shoulder and all the superficial veins in that arm clotted up and disappeared. Ten months later I still can’t have blood drawn from that arm.
In the months after my surgery my heart went back to normal and my cholesterol and blood pressure improved, my periods came back and the burning sensations lessened. My legs were still swollen and suddenly became very red and hot. Doctors suggested it might be cellulitis or vasculitis. After 10 days of antibiotics the redness went away and a few months later the edema did, too. An ultrasound of my legs showed a thickened vein in my right leg that suggested there might have previously been a blood clot there. The mental fog slowly improved but I’m still not back to where I was. The anxiety and depression did not improve and have even gotten worse.
I planned to have the uterine mass removed after the adrenal surgery. This would be a total hysterectomy and my surgeon feels that my blood clotting problems need to be treated before the surgery. He is 99% certain that it is not cancerous since it hasn’t changed in over a year so I have the option of having the surgery when and if I choose. Of course there is a very slight chance that this mass could be the ACTH source.
Dr. Cook wants to do the IPSS before the MRI of my pituitary but this clotting problem needs to be dealt with before we stick 3-foot catheters in my veins. Plus I am running out of arm veins for the IVs.
Right now I’m waiting for my doctors to decide how to deal with this clotting problem before I can get the IPSS done.
I had a follow-up visit with Dr. Cook in September of 2005 and he ran all the tests again including the CRH/Dex. Since we thought the adrenalectomy had cured the problem, we were both surprised when my ACTH did not suppress. Dr. Cook wants to do an IPSS to see if the source is ectopic or pituitary. As I mentioned above, there is a slight chance that the growth on my uterus and right ovary could be the source of the ACTH. Neither my Gyn surgeon nor Dr. Cook feel that this is very likely, but it does make having the IPSS even more important than it would normally be.
June 7, 2026
Acromegaly, Adrenal Surgery, Cyclic, Golden Oldies, Pituitary, Pituitary Surgery 17- Ketosteroids, 17-Hydroxysteroids, Acromegaly, Atkins diet, bilateral adrenalectomy, BLA, Blood pressure, blood sugar, bone pain, cortisol, cushing, Cushing Disease, Cushing Syndrome, cyclical Cushing's, Dr. Theodore Friedman, exercise, exhaustion, GERD, hair, Health, heat intolerance, hypertension, Magnetic resonance imaging, MRI, pituitary, Pituitary gland, pituitary surgery, rash, salivary, spastic colon, UFC, Weight gain Leave a comment
This bio was originally posted 1/26/2008
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
My Cushing’s and Acromegaly Odyssey
During the summer of 1999 I was a trim and fit 130 pound woman. I was very athletic and worked out all the time. At that time I had also been taking Tae Kwon Do. I was able to eat anything that I wanted and not gain weight. I wore size 8 pants.
Fast forward to May of 2000. I developed increasing stomach and bowel problems. I had a spastic colon and serious GERD. Along with that came a poof in my belly. Although I was still wearing the same size my stomach started to look “pregnant”. I was referred to a gastroenterologist who began treating my myriad of health issues. He really couldn’t find a reason for all of it but said he could treat it. For awhile I managed okay on the drugs and diet that I was treated with. Everything went in cycles.
During the summer of 2001 my naturally light blonde hair began to change color. It got black and mousy looking at the roots. At the same time it started thinning, the texture was horrible and no longer shiny and baby soft. I developed heat intolerance. I was uncomfortable in 80 degree weather. I also developed strange rashes and red dots on my skin. Later that fall my neck and face started to turn beet red. It stayed that way.
I could no longer fit in my wedding rings and my shoe size went from a size 7 ½ to and 8 1/2. Doctors didn’t find this impressive. My neck went from 13 inches around to 16. I gained 12 pounds in 1 week alone. I started getting real fat in my stomach and armpits, and I could no longer wear normal bras. I also started getting a lot of fat on my upper back. I grew hair in places that women should not grow hair. My face was huge with strange acne outbreaks. I also got acne in weird spots.
At the time I had put on about 20 pounds all in my stomach. When I would try other clothing it wouldn’t work because the next size bigger fit in the waist but the butt and legs were huge. I gave up on real pants and started to wear stretch clothes all the time. At this time I could no longer exercise to my peak performance. I was tired all the time and never felt well and I looked like I was 6 months pregnant. I thought that I was getting old.
January of 2002 my bowel and stomach troubles peaked. I was in and out of the hospital. Although I was following the healthy eating plan and exercising no doctors believed me. My PCP did a TSH test and it came back at 27.48. I was hypothyroid, at that time my estradiol levels were also non-existent. So off I was sent to an Endocrinologist. I was given replacements for both yet nothing improved.
This started an intense year of doctors. I was diagnosed with anything and everything at this point. I was started on the Atkins diet plan. I followed this religiously and walked for up to 2 hours a day and continued to gain weight. By this time I was 165 pounds. Finally realizing that something horrible was wrong with me I started seeking out Endo’s on my own. It led me to one who thought he should do a few 24 UFC’s. One came back high, 2 others came back high normal (33.4 and 33.9 with a range of 2.9-34). They then did serum cortisols which came back below normal. I was frustrated.
It was November by now and I was getting no where fast. At this point I had seen 11 different doctors. The last of which told me that there was no way I was eating healthy and not losing. He even suggested that my fresh sliced berry snack was making me fat. By now I’ developed high blood pressure and high blood sugars. My fasting blood glucose came in at 170.
By this time I was so exhausted and developed such horrid bone pain that I could not even exercise anymore. I remember waking up late one morning and crying. I went downstairs and told my hubby I was sure my back was breaking. It was horrible. I weighed 196 pounds and looked 9 months pregnant with triplets.
I came home and looked the tests up on the internet. I started reading everything that I could find. I knew then that I had Cushing’s. I found the Cushing’s help site. The trouble was that some tests were normal and some were abnormal. Finally in January of 2003 I went to see Dr. Friedman after another patient emailed me. Dr. Friedman tested my 17-Hydroxysteroids and 17- Ketosteroids which came back elevated. He also did some additional salivary cortisols testing. He finally figured out that I not only had Cyclic Cushing’s but also Acromegaly.
After many more tests and some MRI’s my tumors were found. I had pituitary surgery to remove them. I was devastated that I was not cured from the Cushing’s. After much consulting I decided to proceed with a Bilateral Adrenalectomy to cure it once and for all. I am recovering slowly but surely.
I am now 4 months post-op.
Click any thumbnail to view the larger image.
May 31, 2026
Undiagnosed ADHD, anxiety, bruising, concentration, cushing's syndrome, depression, fatigue, Health, high blood pressure, hirsuitism, hypertension, memory, migraines, mood swings, muscle weakness, obesity, sleeping problems, Stretch marks, Symptom, thin skin, Weight gain, Weight loss 2 Comments
Hello, I am in search of opinions please.
I present with most of the outward physical characteristics: age 57 “weight gain (obese which began about 1991 with a sudden 60 lb increase in 2 months and no explanation, physician had wanted me to go to a Mayo clinic for eval but at the time I could not spare time nor expense…and more recently continuring weight gain, easy bruising, (menses stopped at age 50, but don’t recollect too many probs except migraines), ravenous appetite, occasional trouble sleeping, depression or mood swings, anxiety, fatigue and altered mentation which is trouble concentrating or decreased memory and now diagnosed ADHD.
1-3. Physical abnormalities include new onset obesity, mine is more recent weight gain, primarily in the abdominal, buffalo hump which presented suddenly a few summers ago but has been brushed off by doctors…, rounding and reddening of the face which began about ten years ago, thin skin, decreased muscle strength, high blood pressure, and excess hair growth on face, have to shave every day, some times twice, have 5 o’clock shadow, but I have already been to a local endocrinologist in Billings, Montana, there are only a couple in this sparsely populated area, and none of the lab tests showed anything particularly abnormal…open to suggestions, thanks so much…
Recent Comments