Are fatty hump on back, red cheeks, purple stretch marks signs of Cushing's syndrome?

Question

Hello doctor,

Do I need to be tested for Cushing's? I was diagnosed seven years ago as being insulin resistant, and since them, symptoms keep appearing. I have the fatty hump on my upper back, but when asking my doctor, she blamed weight. I ended up looking more in-depth and found a picture from my smallest weight, (125) and the hump was still present.

I have the rounded face, and my cheeks are always red as well as purple stretch marks that appear out of nowhere even when my weight stays slightly consistent. I was also in therapy for my hips around the time of insulin resistance diagnosis. My doctor will not test me, because she says there is nothing wrong with me other than weight. (185 lbs), and I cannot lose weight for the life of me, nothing works. My recent lab results showed elevated Alkaline Phosphatase, total protein, cholesterol, anion gap, white blood count, and platelets. As well as deficient vitamin D. All of which she explained as fine. Please help.

Answer 1

Hello,

Welcome to icliniq.com.

Considering the symptoms which you have described, the test should be done. You should undergo two of the following criteria since you have a high index of suspicion,

1. The overnight 1 mg Dexamethasone suppression test (DST) which involves taking one mg Dexamethasone tablets at 11.30 pm and doing serum cortisol at 8 am the next morning. Get this test done initially then we ll see about next step.

2. Late-night salivary cortisol. 24-hour urinary free cortisol (UFC) excretion.

However continue with a healthy lifestyle like avoiding fatty, oily, and high-calorie diet. Have a low salt diet and monitor blood pressure regularly. Regular exercises like brisk walking, jogging according to your capacity at least 30 minutes a day and five days a week. Lots of green leafy vegetables, fruits, fish once or twice a week, avoid meat. Avoid smoking and alcohol if any. Try to lose weight by dietary restrictions and exercise.