Question about Cushings diseaseHow many tests are usually needed to confirm Cushing's disease in a female and approximately how long does it take to get a result from the 24 hour urine test? I'm feeling very poorly with flushing in head, high temperatures, bad one-sided headaches & much more but am lost in NHS system. Thank you.
One needs a clinical suspicion of Cushing's syndrome and the 24h urine test can support this with evidence of high cortisol levels.
Then it needs evidence of elevated, somewhat autonomous, cortisol levels and a reliable way to do that is with a dexamethasone suppression test, which takes 2 days.
If that test shows cortisol that fails to suppress after the dexamathasone, then one must measure cortisol and ACTH (at 9am). The ACTH is quite difficult to sample and measure, it usually takes a week or two from when it is taken. If the cortisol is high with detectable/ high ACTH then one must go on to look where the ACTH is from. This usually requires sampling from the blood veins that drain the pituitary; it is a very specialised test and can take weeks to set up in one of the centres that do it, often needing a repeat evaluation before performing it +/- CT chest and MRI pituitary.
Cushing's disease can be very difficult to diagnose.
Other questions answered by Doctoralia's experts:
- What is glossitis?
- I've had glossitis for 3 days now but i do not smoke or drink, and haven't got any kind of allergy. What else can cause it?
- I have been getting red patches on my tongue. They last for a while and then go away. Could I have benign migratory glossitis?
- Can an operated fissure reappear?
- Can you come out of anemia through methods other than iron-rich diet?
- My friends 17 year old son has been diagnosed with Avascular Necrosis in September 2016. He is on crutches and receiving pain relief and hydrotherapy. His mother is getting increasingly frustrated and worried that not enough is being done. what next? Any advice gratefully received.
- What treatment is there for glossitis?
- I have been told today that my Avascular Necrosis, for which I was given an urgent appt with the Consultant is temporary, and will clear itself. This is contrary to everything I have read, can someone please advise me.?
- I have avn in multiple joints, areas within my femur & tibia caused by steriod treatment for leukaemia 19 years ago. Ive had both hips replaced & need major knee surgery soon. After removal of dead bone & joint replacement, can avn come back in remaining healthy bone?
- Is avascular necrosis of the hips the same disease as infarct in the knee?
Do you have a question about Cushings disease?
Our experts answered the following question about Cushings disease:
Ask thousands of Doctoralia experts anonymously and for free
- Your question will be published anonymously
- Make it one, clear, medical question
- Be brief
- This service doesn´t replace a consultation with a medical professional. If you have a problem or emergency, go to a doctor or an emergency room.
- Questions about a specific case or second opinion requests will not be allowed.
Legal Notice - doctoralia.co.uk - All contents published on Doctoralia are informative, and should never be considered a substitute for medical advice.