Materiały źródłowe

• #1 Cushing Syndrome: Causes, Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/5497-cushing-syndrome

  You always need cortisol in your body. You need it to function. It manages your respiration, turns your food into energy, regulates your blood sugar, helps you cope with stress and more. Cortisol isn’t your body’s enemy, but too much of it can be. However, you can’t live without cortisol. […] Have your healthcare provider monitor your cortisol levels closely if you’re on glucocorticoids or steroids. Unfortunately, there’s no way to prevent a tumor that causes Cushing syndrome (hypercortisolism).

• #1 Cushing Syndrome – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK470218/

  Cushing syndrome caused by exogenous drugs is a reasonably preventable malady. Controlled use of corticosteroids in the clinical settings with regular health follow-up may reduce the burden of disease significantly. […] The most common cause of Cushing syndrome is the use of corticosteroids for a long time. Because these drugs are prescribed by many clinicians, it is important to manage Cushing syndrome with an interprofessional team; if the diagnosis is missed, the mortality is very high. […] When patients are prescribed corticosteroids, all clinicians including the pharmacist must educate the patient about the side effects of these hormones and the need for close follow-up. […] All patients diagnosed with Cushing syndrome need long-term follow-up until the syndrome has been cured or eradicated. Finally, clinicians, nurses, and pharmacists should educate patients about the potential adrenal crisis if the corticosteroid is stopped abruptly.

• #1 Cushing syndrome: MedlinePlus Medical EncyclopediaLock

  https://medlineplus.gov/ency/article/000410.htm

  If you take a corticosteroid, know the signs and symptoms of Cushing syndrome. Getting treated early can help prevent any long-term effects of Cushing syndrome. If you use inhaled steroids, you can decrease your exposure to the steroids by using a spacer and by rinsing your mouth after breathing in the steroids.

• #1 Cushing Syndrome – Adrenal Gland Diseases – Endocrinology – Diseases – McMaster Textbook of Internal Medicine

  https://empendium.com/mcmtextbook/chapter/B31.II.11.2.

  1) P jiroveci pneumonia prophylaxis should be considered in prolonged/severe Cushing syndrome or other conditions posing high risk of this infection. Trimethoprim/sulfamethoxazole (TMP/SMX) (TMP 80-160 mg/d or 160 mg 3 times/wk) is the first-line treatment and should be continued 2 weeks following curative surgery or normalization of UFC. […] 2) Venous thromboembolism (VTE) prophylaxis should be considered perioperatively along with active mobilization in high-risk patients. […] 3) Vaccines: Inactivated (eg, influenza, hepatitis, pneumococcal infections) and mRNA vaccines (eg, severe acute respiratory syndrome coronavirus 2 [SARS-CoV-2]) are generally safe. Live attenuated vaccines (eg, measles, mumps, rubella, varicella, herpes zoster) should be avoided in immunocompromised patients or those on immunosuppressants. In patients with Cushing syndrome, a live attenuated vaccine can be given when the disease has been in remission and patients are no longer immunocompromised.

• #1 Preventive strategies for hypercoagulation in Cushing’s syndrome: when and how | Thrombosis Journal | Full Text

  https://thrombosisjournal.biomedcentral.com/articles/10.1186/s12959-023-00515-1

  The endogenous hypercortisolism that characterizes Cushings syndrome (CS) is associated with a state of hypercoagulability that significantly increases the risk of thromboembolic disease, especially, venous events. […] Despite this certainty, there is no consensus on the best thromboprophylaxis strategy (TPS) for these patients. […] Literature is scarce regarding thromboprophylaxis strategies to be adopted in the context of endogenous hypercortisolism, most often being a case-by-case decision according to the centre expertise. […] The use of low molecular weight heparin is the most frequent option as TPS in CS context. […] The use of preoperative medical therapy is not routinely recommended to decrease the risk of postoperative venous thromboembolic events. […] The need to hypocoagulate CS patients, mainly in the post-operative period of a transsphenoidal surgery or an adrenalectomy, is undoubtable, especially in patients with an elevated risk of venous thromboembolic events, but the precise duration and the hypocoagulation regimen to institute is yet to be determined with prospective studies.

• #1 Cushing Syndrome – Adrenal Gland Diseases – Endocrinology – Diseases – McMaster Textbook of Internal Medicine

  https://empendium.com/mcmtextbook/chapter/B31.II.11.2.

  4) Osteoporosis: Given the absence of sufficient evidence, the management of bone mineral disease in Cushing syndrome should be similar to the one used in patients treated with exogenous glucocorticoids. Sufficient calcium and vitamin D intake should be encouraged. The decision on antiresorptive therapy should be made based on overall osteoporosis risk factors using risk calculators. The bone mineral density may be normal in these patients despite high fracture risk.

• #1 Dietary Guidance for Cushing’s Syndrome – Institute for Natural Medicine

  https://naturemed.org/dietary-guidance-for-cushings-syndrome/

  Low-carbohydrate diets can improve Cushings symptoms by facilitating weight loss and reducing inflammation and cholesterol. […] They can also bring down blood pressure and cortisol levels, with results similar to cortisol-blocking medications. […] For people with Cushings and poorly controlled diabetes, sugar restriction is especially important. […] Replacing high-sugar foods with whole grains, fruits, vegetables, and polyunsaturated fats may support the natural release of cortisol during stress. […] A ketogenic diet suppresses ghrelin, a hormone that triggers hunger, and may help keep cortisol in check. […] Very low-calorie ketogenic diets (VLCKDs) are even more restrictive. […] In a 2022 study that monitored 30 obese males on a VLCKD for eight weeks, scientists attributed the notable decrease in cortisol levels to reduced weight and less inflammation.

• #1 Is there a cure for Cushing syndrome?

  https://www.medicalnewstoday.com/articles/can-cushings-syndrome-be-cured-faqs

  Cushing syndrome is caused by long-term exposure to high cortisol levels. […] Lifestyle changes can also help with symptoms. […] Treatment of Cushing syndrome requires addressing the underlying cause of high cortisol levels. However, lifestyle measures may help manage symptoms and improve overall health. […] A balanced diet rich in fruits, vegetables, lean proteins, and whole grains can help reduce high blood pressure and blood sugar levels. Regular exercise can help prevent muscle weakness and maintain bone density. Stress management techniques, such as yoga or counseling, may help decrease cortisol levels. […] Early intervention and close medical supervision are key to managing the condition and preventing complications.

• #2 Is there a cure for Cushing syndrome?

  https://www.medicalnewstoday.com/articles/can-cushings-syndrome-be-cured-faqs

  Cushing syndrome is caused by long-term exposure to high cortisol levels. […] Lifestyle changes can also help with symptoms. […] Treatment of Cushing syndrome requires addressing the underlying cause of high cortisol levels. However, lifestyle measures may help manage symptoms and improve overall health. […] A balanced diet rich in fruits, vegetables, lean proteins, and whole grains can help reduce high blood pressure and blood sugar levels. Regular exercise can help prevent muscle weakness and maintain bone density. Stress management techniques, such as yoga or counseling, may help decrease cortisol levels. […] Early intervention and close medical supervision are key to managing the condition and preventing complications.

• #2 Cushing’s syndrome – symptoms, treatments and causes | healthdirect

  https://www.healthdirect.gov.au/cushings-syndrome

  Cushing’s syndrome can be caused by long-term use of high-dose corticosteroids to treat conditions such as asthma or rheumatoid arthritis. If you are taking a corticosteroid medicine, see your doctor regularly for monitoring. […] Unfortunately, you can’t prevent Cushing’s syndrome caused by a tumour.

• #2 Managing Your Cushing’s Syndrome – Symptoms & Treatment | Carle.org

  https://carle.org/conditions/managing-your-cushing-s-syndrome

  DOs and DONTs in Managing Cushings Syndrome: […] DO minimize using corticosteroid hormones. […] DO see your health care provider regularly. Have regular checkups for blood sugar level, blood pressure, and bone density. […] DO look for a nearby support group. […] DO tell your health care provider if you have had depression or drink alcohol daily. […] DO find an experienced surgeon if you need surgery. […] DO eat less fat and calories. […] DO call your health care provider if you have a fever, infection, or increased bruising or you gain too much weight. […] DO call your health care provider for weakness or dizziness after surgery. […] DONT become discouraged. […] DONT begin exercise until your health care provider checks blood pressure, blood sugar, and bones. […] DONT overeat.

• #2 Exogenous Cushing syndrome: MedlinePlus Medical EncyclopediaLock

  https://medlineplus.gov/ency/article/000389.htm

  If you take a corticosteroid, know the signs and symptoms of Cushing syndrome. Getting treated early can help prevent any long-term effects of Cushing syndrome. […] If you use inhaled steroids, you can decrease your exposure to the steroids by using a spacer and by rinsing your mouth after breathing in the steroids.

• #2 Cushing Syndrome – Adrenal Gland Diseases – Endocrinology – Diseases – McMaster Textbook of Internal Medicine

  https://empendium.com/mcmtextbook/chapter/B31.II.11.2.

  1) P jiroveci pneumonia prophylaxis should be considered in prolonged/severe Cushing syndrome or other conditions posing high risk of this infection. Trimethoprim/sulfamethoxazole (TMP/SMX) (TMP 80-160 mg/d or 160 mg 3 times/wk) is the first-line treatment and should be continued 2 weeks following curative surgery or normalization of UFC. […] 2) Venous thromboembolism (VTE) prophylaxis should be considered perioperatively along with active mobilization in high-risk patients. […] 3) Vaccines: Inactivated (eg, influenza, hepatitis, pneumococcal infections) and mRNA vaccines (eg, severe acute respiratory syndrome coronavirus 2 [SARS-CoV-2]) are generally safe. Live attenuated vaccines (eg, measles, mumps, rubella, varicella, herpes zoster) should be avoided in immunocompromised patients or those on immunosuppressants. In patients with Cushing syndrome, a live attenuated vaccine can be given when the disease has been in remission and patients are no longer immunocompromised.

• #2 Preventive strategies for hypercoagulation in Cushing’s syndrome: when and how | Thrombosis Journal | Full Text

  https://thrombosisjournal.biomedcentral.com/articles/10.1186/s12959-023-00515-1

  The risk of VTE associated with Cushings syndrome is significant and is increased, especially in the post-operative period, approaching that of a major orthopaedic surgery. […] The majority of the VTE events occurred between the first- and second-week post-surgery. […] The thromboprophylaxis agents most used in the postoperative period and approved by the European Medicines Agency (EMA) include the low-molecular weight heparin (LMWH) enoxaparin, the factor Xa inhibitor, fondaparinux, and the direct oral anticoagulants (DOAC) rivaroxaban, apixaban and dabigatran. […] Nevertheless, it should be offered on an individual basis, especially if surgery is delayed or if hypercortisolism is markedly severe.

• #2

  https://myhealth.alberta.ca/Health/aftercareinformation/pages/conditions.aspx?hwid=abl2533

  Eat a healthy diet that is high in protein and calcium. This can help prevent muscle and bone loss caused by the high cortisol levels in your body. Talk to your doctor about whether you should take a calcium and vitamin D supplement for bone health. […] Limit salt (sodium) in your diet. This is very important if you have high blood pressure because of Cushing’s syndrome. […] Get regular eye exams to check for glaucoma and cataracts. […] See your doctor regularly to help diagnose and treat diabetes, high blood pressure, and other possible complications.

• #2 Dietary Guidance for Cushing’s Syndrome – Institute for Natural Medicine

  https://naturemed.org/dietary-guidance-for-cushings-syndrome/

  Diet and supplements are two ways to ensure adequate vitamin D and calcium intake. […] One of cortisols many roles in the body is balancing salt levels. […] With Cushings syndrome, too much salt can further elevate blood pressure and contribute to weight gain. […] Replacing processed foods with fresh vegetables, fruits, and high-quality complex carbohydrates like peas, beans, and whole grains is the easiest way to reduce sodium intake. […] What you drink also matters. […] Excessive alcohol consumption can damage the hypothalamic-pituitary-adrenal (HPA) axis, a hub for endocrine pathways that produce and distribute hormones, including cortisol. […] People with Cushings should avoid soda and other sugary beverages, as blood sugar and cortisol spikes are linked.

• #2 Cushing’s Syndrome Information & Treatment

  https://www.columbiadoctors.org/health-library/condition/cushing-s-syndrome/

  To avoid health problems from Cushing’s syndrome, there are many things you can do. […] Eat a healthy diet. […] Choose a variety of healthy foods that are high in protein and calcium. This can help prevent muscle and bone loss caused by high cortisol levels. […] Talk to your doctor about whether you should take a calcium and vitamin D supplement for bone health. […] Limit salt (sodium) in your diet. This is especially important if you have high blood pressure. […] Take good care of yourself. […] Get regular exercise. Talk to your doctor before you start any exercise program. […] Avoid falls, which can lead to broken bones and other injuries. Remove loose rugs and other tripping hazards from your home. […] Get regular eye exams to check for glaucoma and cataracts. […] See your doctor regularly to watch for other problems such as diabetes, high blood pressure, and osteoporosis.

• #2 Treatment Options for Cushing Syndrome – Cortisol Matters

  https://www.cortisolmatters.com/patient/treating-cushing-syndrome

  Staying in control of cortisol is important to prevent the complications and risks associated with untreated Cushing syndrome. […] Even if Cushing syndrome goes into remission, frequent health checkups are recommended to monitor remission status. […] If you have been treated for Cushing syndrome, be sure to speak to your doctor about any new or worsening health problems that may mean your Cushing syndrome has come back.

• #3 Cushing’s Disease in Dogs: Symptoms, Diagnosis, and Management | PetMD

  https://www.petmd.com/dog/conditions/endocrine/cushings-disease-in-dogs-symptoms-diagnosis

  Cushings disease is not preventable in dogs because it develops from pituitary or adrenal gland tumors. […] Iatrogenic Cushings disease can be prevented through careful dosing and monitoring of dogs who are taking steroid medications. […] Dogs who have been diagnosed with Cushings disease should have continued monitoring, such as bloodwork and ACTH stimulation tests, for the remainder of their life to ensure the medication dosage is appropriate and symptoms are controlled.

• #3 Cushing Syndrome – Adrenal Gland Diseases – Endocrinology – Diseases – McMaster Textbook of Internal Medicine

  https://empendium.com/mcmtextbook/chapter/B31.II.11.2.

  1) P jiroveci pneumonia prophylaxis should be considered in prolonged/severe Cushing syndrome or other conditions posing high risk of this infection. Trimethoprim/sulfamethoxazole (TMP/SMX) (TMP 80-160 mg/d or 160 mg 3 times/wk) is the first-line treatment and should be continued 2 weeks following curative surgery or normalization of UFC. […] 2) Venous thromboembolism (VTE) prophylaxis should be considered perioperatively along with active mobilization in high-risk patients. […] 3) Vaccines: Inactivated (eg, influenza, hepatitis, pneumococcal infections) and mRNA vaccines (eg, severe acute respiratory syndrome coronavirus 2 [SARS-CoV-2]) are generally safe. Live attenuated vaccines (eg, measles, mumps, rubella, varicella, herpes zoster) should be avoided in immunocompromised patients or those on immunosuppressants. In patients with Cushing syndrome, a live attenuated vaccine can be given when the disease has been in remission and patients are no longer immunocompromised.

• #3 Cushing’s Syndrome Information & Treatment

  https://www.columbiadoctors.org/health-library/condition/cushing-s-syndrome/

  To avoid health problems from Cushing’s syndrome, there are many things you can do. […] Eat a healthy diet. […] Choose a variety of healthy foods that are high in protein and calcium. This can help prevent muscle and bone loss caused by high cortisol levels. […] Talk to your doctor about whether you should take a calcium and vitamin D supplement for bone health. […] Limit salt (sodium) in your diet. This is especially important if you have high blood pressure. […] Take good care of yourself. […] Get regular exercise. Talk to your doctor before you start any exercise program. […] Avoid falls, which can lead to broken bones and other injuries. Remove loose rugs and other tripping hazards from your home. […] Get regular eye exams to check for glaucoma and cataracts. […] See your doctor regularly to watch for other problems such as diabetes, high blood pressure, and osteoporosis.

• #3

  https://myhealth.alberta.ca/Health/aftercareinformation/pages/conditions.aspx?hwid=abl2533

  Eat a healthy diet that is high in protein and calcium. This can help prevent muscle and bone loss caused by the high cortisol levels in your body. Talk to your doctor about whether you should take a calcium and vitamin D supplement for bone health. […] Limit salt (sodium) in your diet. This is very important if you have high blood pressure because of Cushing’s syndrome. […] Get regular eye exams to check for glaucoma and cataracts. […] See your doctor regularly to help diagnose and treat diabetes, high blood pressure, and other possible complications.

• #3 Managing Your Cushing’s Syndrome – Symptoms & Treatment | Carle.org

  https://carle.org/conditions/managing-your-cushing-s-syndrome

  DOs and DONTs in Managing Cushings Syndrome: […] DO minimize using corticosteroid hormones. […] DO see your health care provider regularly. Have regular checkups for blood sugar level, blood pressure, and bone density. […] DO look for a nearby support group. […] DO tell your health care provider if you have had depression or drink alcohol daily. […] DO find an experienced surgeon if you need surgery. […] DO eat less fat and calories. […] DO call your health care provider if you have a fever, infection, or increased bruising or you gain too much weight. […] DO call your health care provider for weakness or dizziness after surgery. […] DONT become discouraged. […] DONT begin exercise until your health care provider checks blood pressure, blood sugar, and bones. […] DONT overeat.

• #4 Cushing’s Syndrome Information & Treatment

  https://www.columbiadoctors.org/health-library/condition/cushing-s-syndrome/

  To avoid health problems from Cushing’s syndrome, there are many things you can do. […] Eat a healthy diet. […] Choose a variety of healthy foods that are high in protein and calcium. This can help prevent muscle and bone loss caused by high cortisol levels. […] Talk to your doctor about whether you should take a calcium and vitamin D supplement for bone health. […] Limit salt (sodium) in your diet. This is especially important if you have high blood pressure. […] Take good care of yourself. […] Get regular exercise. Talk to your doctor before you start any exercise program. […] Avoid falls, which can lead to broken bones and other injuries. Remove loose rugs and other tripping hazards from your home. […] Get regular eye exams to check for glaucoma and cataracts. […] See your doctor regularly to watch for other problems such as diabetes, high blood pressure, and osteoporosis.

• #4 Managing Your Cushing’s Syndrome – Symptoms & Treatment | Carle.org

  https://carle.org/conditions/managing-your-cushing-s-syndrome

  DOs and DONTs in Managing Cushings Syndrome: […] DO minimize using corticosteroid hormones. […] DO see your health care provider regularly. Have regular checkups for blood sugar level, blood pressure, and bone density. […] DO look for a nearby support group. […] DO tell your health care provider if you have had depression or drink alcohol daily. […] DO find an experienced surgeon if you need surgery. […] DO eat less fat and calories. […] DO call your health care provider if you have a fever, infection, or increased bruising or you gain too much weight. […] DO call your health care provider for weakness or dizziness after surgery. […] DONT become discouraged. […] DONT begin exercise until your health care provider checks blood pressure, blood sugar, and bones. […] DONT overeat.

• #5 Cushing’s Syndrome Information & Treatment

  https://www.columbiadoctors.org/health-library/condition/cushing-s-syndrome/

  To avoid health problems from Cushing’s syndrome, there are many things you can do. […] Eat a healthy diet. […] Choose a variety of healthy foods that are high in protein and calcium. This can help prevent muscle and bone loss caused by high cortisol levels. […] Talk to your doctor about whether you should take a calcium and vitamin D supplement for bone health. […] Limit salt (sodium) in your diet. This is especially important if you have high blood pressure. […] Take good care of yourself. […] Get regular exercise. Talk to your doctor before you start any exercise program. […] Avoid falls, which can lead to broken bones and other injuries. Remove loose rugs and other tripping hazards from your home. […] Get regular eye exams to check for glaucoma and cataracts. […] See your doctor regularly to watch for other problems such as diabetes, high blood pressure, and osteoporosis.

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