MyMedExpert Health Articles

What is Cushing’s Syndrome?
Cushing’s syndrome is a condition that occurs when a person’s body is exposed to too much of the hormone cortisol.
 
What causes Cushing’s Syndrome?
Cushing’s syndrome happens for two reasons:

Medication either causes the body to make too much cortisol, or the medication itself contains extra cortisol and taking it pushes the level above normal.

A person’s body makes more cortisol than it needs
Normally, the hypothalamus in the brain triggers a chain of events that causes the adrenal glands to release cortisol into the bloodstream.  When everything is working correctly, the body is balanced, releasing the right amount of cortisol for daily needs.  But problems with the adrenal glands, pituitary gland, or hypothalamus can cause the glands to make too much cortisol.  

Conditions that might cause the body to make too much cortisol include:

Pituitary tumors
Ectopic ACTH syndrome
Adrenal tumors
Familial (genetic) Cushing’s syndrome
What are the symptoms of Cushing’s Syndrome?
Common symptoms of Cushing’s syndrome can include:
Upper body obesity, round face and neck, and thinning arms and legs
Slow growth rates in children
Skin problems, such as acne or reddish-blue streaks in the skin
High blood pressure
Muscle and bone weakness
Moodiness, irritability, or depression
High blood sugar
Women may also have increased growth of hair on their face and body and experience menstrual irregularities.   Men may become less fertile and have a reduced or absent sex drive.

What are the treatments for Cushing’s Syndrome?
Treatment for Cushing’s syndrome depends on the reason for the extra cortisol in the body.  If it is caused by the use of medicine to treat another disorder, a health care provider can reduce the dose or change the medicine. 
If the body is making too much cortisol, treatments may include oral medication, surgery, radiation, or a combination of these treatments.

In most cases Cushing’s syndrome can be cured.

Source: National Institute of Child Health and Human Development, NIH, DHHS

If you have any specific question, you can ask the doctors at www.mymedexpert.com

Hypoglycemia, also called low blood sugar, occurs when your blood glucose (blood sugar) level drops too low to provide enough energy for your body’s activities. In adults or children older than 10 years, hypoglycemia is uncommon except as a side effect of diabetes treatment, but it can result from other medications or diseases, hormone or enzyme deficiencies, or tumors.

Glucose, a form of sugar, is an important fuel for your body. Carbohydrates are the main dietary sources of glucose. Rice, potatoes, bread, tortillas, cereal, milk, fruit, and sweets are all carbohydrate-rich foods.

After a meal, glucose molecules are absorbed into your bloodstream and carried to the cells, where they are used for energy. Insulin, a hormone produced by your pancreas, helps glucose enter cells. If you take in more glucose than your body needs at the time, your body stores the extra glucose in your liver and muscles in a form called glycogen. Your body can use the stored glucose whenever it is needed for energy between meals. Extra glucose can also be converted to fat and stored in fat cells.

When blood glucose begins to fall, glucagon, another hormone produced by the pancreas, signals the liver to break down glycogen and release glucose, causing blood glucose levels to rise toward a normal level. If you have diabetes, this glucagon response to hypoglycemia may be impaired, making it harder for your glucose levels to return to the normal range.

Symptoms
Symptoms of hypoglycemia include

hunger
nervousness and shakiness
perspiration
dizziness or light-headedness
sleepiness
confusion
difficulty speaking
feeling anxious or weak
Hypoglycemia can also happen while you are sleeping. You might

cry out or have nightmares
find that your pajamas or sheets are damp from perspiration
feel tired, irritable, or confused when you wake up
 
If you have any specific question, you can ask the doctors at  www.mymedexpert.com

Children rarely develop hypoglycemia. If they do, causes may include

• Brief intolerance to fasting, often in conjunction with an illness that disturbs regular eating patterns. Children usually outgrow this tendency by age 10. 
• Hyperinsulinism, which is the excessive production of insulin. This condition can result in transient neonatal hypoglycemia, which is common in infants of mothers with diabetes. Persistent hyperinsulinism in infants or children is a complex disorder that requires prompt evaluation and treatment by a specialist. 
• Enzyme deficiencies that affect carbohydrate metabolism. These deficiencies can interfere with the body’s ability to process natural sugars, such as fructose and galactose, glycogen, or other metabolites. 
• Hormonal deficiencies such as lack of pituitary or adrenal hormones.

If you have any specific question, you can ask the doctors at  www.mymedexpert.com

Fasting Hypoglycemia

Diagnosis
Fasting hypoglycemia is diagnosed from a blood sample that shows a blood glucose level of less than 50 mg/dL after an overnight fast, between meals, or after exercise.

Causes and Treatment
Causes include certain medications, alcohol, critical illnesses, hormonal deficiencies, some kinds of tumors, and certain conditions occurring in infancy and childhood.

Medications
Medications, including some used to treat diabetes, are the most common cause of hypoglycemia. Other medications that can cause hypoglycemia include

• salicylates, including aspirin, when taken in large doses 
• sulfa medicines, which are used to treat infections 
• pentamidine, which treats a very serious kind of pneumonia 
• quinine, which is used to treat malaria

If using any of these medications causes your blood glucose to drop, your doctor may advise you to stop using the drug or change the dosage.

Alcohol
Drinking, especially binge drinking, can cause hypoglycemia because your body’s breakdown of alcohol interferes with your liver’s efforts to raise blood glucose. Hypoglycemia caused by excessive drinking can be very serious and even fatal.

Critical Illnesses
Some illnesses that affect the liver, heart, or kidneys can cause hypoglycemia. Sepsis (overwhelming infection) and starvation are other causes of hypoglycemia. In these cases, treatment targets the underlying cause.

Hormonal Deficiencies
Hormonal deficiencies may cause hypoglycemia in very young children, but usually not in adults. Shortages of cortisol, growth hormone, glucagon, or epinephrine can lead to fasting hypoglycemia. Laboratory tests for hormone levels will determine a diagnosis and treatment. Hormone replacement therapy may be advised.

Tumors
Insulinomas, insulin-producing tumors, can cause hypoglycemia by raising your insulin levels too high in relation to your blood glucose level. These tumors are very rare and do not normally spread to other parts of the body. Laboratory tests can pinpoint the exact cause. Treatment involves both short-term steps to correct the hypoglycemia and medical or surgical measures to remove the tumor.

Two types of hypoglycemia can occur in people who do not have diabetes: reactive (postprandial, or after meals) and fasting (postabsorptive). Reactive hypoglycemia is not usually related to any underlying disease; fasting hypoglycemia often is.

Symptoms

Symptoms of both types resemble the symptoms that people with diabetes and hypoglycemia experience: hunger, nervousness, perspiration, shakiness, dizziness, light-headedness, sleepiness, confusion, difficulty speaking, and feeling anxious or weak.

If you are diagnosed with hypoglycemia, your doctor will try to find the cause by using laboratory tests to measure blood glucose, insulin, and other chemicals that play a part in the body’s use of energy.

Reactive Hypoglycemia

In reactive hypoglycemia, symptoms appear within 4 hours after you eat a meal.

Diagnosis
To diagnose reactive hypoglycemia, your doctor may

• ask you about signs and symptoms 
• test your blood glucose while you are having symptoms (The doctor will take a blood sample from your arm and send it to a laboratory for analysis. A personal blood glucose monitor cannot be used to diagnose reactive hypoglycemia.) 
• check to see whether your symptoms ease after your blood glucose returns to 70 or above (after eating or drinking)

A blood glucose level of less than 70 mg/dL at the time of symptoms and relief after eating will confirm the diagnosis.

The oral glucose tolerance test is no longer used to diagnose hypoglycemia; experts now know that the test can actually trigger hypoglycemic symptoms.

Causes and Treatment
The causes of most cases of reactive hypoglycemia are still open to debate. Some researchers suggest that certain people may be more sensitive to the body’s normal release of the hormone epinephrine, which causes many of the symptoms of hypoglycemia. Others believe that deficiencies in glucagon secretion might lead to hypoglycemia.

A few causes of reactive hypoglycemia are certain, but they are uncommon. Gastric (stomach) surgery, for instance, can cause hypoglycemia because of the rapid passage of food into the small intestine. Also, rare enzyme deficiencies diagnosed early in life, such as hereditary fructose intolerance, may cause reactive hypoglycemia.

To relieve reactive hypoglycemia, some health professionals recommend taking the following steps:

• eat small meals and snacks about every 3 hours 
• exercise regularly 
• eat a variety of foods, including meat, poultry, fish, or nonmeat sources of protein; starchy foods such as whole-grain bread, rice, and potatoes; fruits; vegetables; and dairy products 
• choose high-fiber foods 
• avoid or limit foods high in sugar, especially on an empty stomach

Your doctor can refer you to a registered dietitian for personalized meal planning advice. Although some health professionals recommend a diet high in protein and low in carbohydrates, studies have not proven the effectiveness of this kind of diet for reactive hypoglycemia.

If you have any specific question, you can ask the doctors at  www.mymedexpert.com