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Thyroid Diseases

Could I Have Cushing's Disease or Hypothyroidism?

09/26/2006

Question:

I am a 35 yr old female. I just had to have a hysterectomy due to endomitrial cancer. I was diagnosed with sleep apnea at that time. I have battled weight all of my life, however I had a significant weight increase 2 yrs ago leaving me with stretch marks. I have high blood pressure, and my feet and ankles swell up very badly sometimes (my doctor put me on BP meds that contain diuretics)

My lower legs are starting to look reddish purplish, and bruises or scratches I get take a month or more to heal. My belly is very prominent, and I look very heavy in the face and neck. I have been experiencing depression, which seems to be unaffected by depression meds which I have since stopped taking, and about 2 years ago, I started growing hair under my chin, on my chin,and on my cheeks that I never had before. I have developed a hump behind my neck, and there is discoloration in the folds of my neck that are dark and very embarrassing. I am experiencing cycles where I go from having some energy, countered by times of complete lack of energy or motivation.

I also sometimes feel like I cannot think straight, and my memory has become horrible, compared to how I used to be. While my hair is drier than it used to be and not quite as thick (I`ve always had VERY thick hair) I wouldn`t consider it as thinning.

One year ago, I asked my GP to run thyroid tests, and the results were a touch low, but she said that they were still within normal range. She said I needed to lose weight, which I understood. But have found it almost impossible to do so. To be honest, I thought the energy challenge could be attributed to the cancer, and to the sleep apnea, but now that I am 4 months out from my surgery, and one and a half months into sleeping w/a C-PAP machine, while it is better, I still don`t feel right. My questions:

Answer:

1. Is it possible I have either Cushing's or hypothyroidism? If your thyroid tests were within normal limits when your doctor ordered them, the I doubt that any of your symptoms are due to hypothyroidism. You should definitely be checked out for Cushing's syndrome. However, be prepared for the possibility that the tests will turn out to be normal. Many people have unexplained weight gain, depression, high blood pressure, swelling in the legs, and facial hair growth without having Cushing's syndrome.

2. Is Cushing's or hypothyroidism curable? Both are treatable.

3. If so, what do I say to my doc to get her to take me seriously and get me the right help? I think you should definitely be checked for Cushing's syndrome. If it turns out that you don't have Cushing's syndrome then your doctor may be correct in saying that the best possible treatment for your problems would be weight loss.

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Response by:

Thomas A Murphy, MD, FACP, FACE Thomas A Murphy, MD, FACP, FACE
Associate Professor of Medicine
School of Medicine
Case Western Reserve University