ping:Susan

[Chak]

Susan,

Could you point me to some PCOS references that an average intelligence
would understand? One of my students has had several cysts and I think she
should check it out, but she has no experience reading anything medical.


Thanks,

Chak

[Susan]

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Post by Chak
Susan,
Could you point me to some PCOS references that an average intelligence
would understand? One of my students has had several cysts and I think she
should check it out, but she has no experience reading anything medical.

That's really, really hard. The soulcysters web site often refuses to
allow discussion of Cushing's as a cause of much of what's misdiagnosed
as PCOS, so hard to rely on their info, but I did find that there are
discussions online in their ghosted archives at least. I suspect those
with hirsutism and poor responses to diet and metformin have
hypercortisolism or other adrenal disorder... VERY hard to get
intelligent evaluation. There are just no tests that nail either or
rule Cushing's out, it often takes months to years of serial testing.

Here are some articles my endo has worked on:

http://europepmc.org/articles/PMC2954657

http://www.goodhormonehealth.com/episodic%20cushings-hmr.pdf


I know so many women diagnosed with PCOS who have been ill for years or
decades with undiagnosed Cushing's, which is a frequent, but undiagnosed
cause of at leat 10% of type 2 diabetes, too. Super high frequency
among non responsive diabetes.

She should also google up PCOS vs. Cushing's to get a lot more threads
like this from folks in the trenches:


http://www.soulcysters.net/showthread.php/216392-Cushings-Disease-vs-PCOS


Susan

[Susan]

x-no-archive: yes

Another reference I just saw today, though the "rare" label hardly
belongs to Cushing's when you consider how many diabetics test positive
on tests that are more often false negative than not:


http://www.medscape.com/viewarticle/565417_3

"These findings imply that beneath the classical, rare presentation of
Cushing's syndrome with specific but insensitive features (e.g. purple
striae)[4] there exists an undercurrent of more prevalent subtle
cortisol excess,[9] which reinforces the importance of careful history
taking, examination and (potentially repeated) investigations in order
to exclude Cushing's syndrome. A recent survey, however, found that only
17% of endocrinologists and 6% of gynecologists screened 'PCOS
referrals' for Cushing's syndrome,[11] and Table 1 illustrates cases in
which the diagnosis of Cushing's syndrome was initially missed. In Case
B only written advice on PCOS management was issued by the initial
referral center. Case D presented with primary amenorrhea, the false
diagnosis of PCOS being made on the basis of ultrasonography findings
and hyperandrogenism.

The ability to distinguish between PCOS and Cushing's syndrome is
important because Cushing's syndrome, which is more frequent in women
than men, increases age-adjusted and sex-adjusted mortality fivefold;
yet--as shown by the case described here--once identified can be
cured.[9] By contrast, PCOS is a heterogeneous disorder that can be
managed but not eliminated.[1]"

[Chak]

Post by Susan
x-no-archive: yes
Another reference I just saw today, though the "rare" label hardly
belongs to Cushing's when you consider how many diabetics test

positive

Post by Susan
http://www.medscape.com/viewarticle/565417_3
"These findings imply that beneath the classical, rare presentation of
Cushing's syndrome with specific but insensitive features (e.g. purple
striae)[4] there exists an undercurrent of more prevalent subtle
cortisol excess,[9] which reinforces the importance of careful history
taking, examination and (potentially repeated) investigations in order
to exclude Cushing's syndrome. A recent survey, however, found that only
17% of endocrinologists and 6% of gynecologists screened 'PCOS
referrals' for Cushing's syndrome,[11] and Table 1 illustrates cases in
which the diagnosis of Cushing's syndrome was initially missed. In Case
B only written advice on PCOS management was issued by the initial
referral center. Case D presented with primary amenorrhea, the false
diagnosis of PCOS being made on the basis of ultrasonography findings
and hyperandrogenism.
The ability to distinguish between PCOS and Cushing's syndrome is
important because Cushing's syndrome, which is more frequent in women
than men, increases age-adjusted and sex-adjusted mortality fivefold;
yet--as shown by the case described here--once identified can be
cured.[9] By contrast, PCOS is a heterogeneous disorder that can be
managed but not eliminated.[1]"

Thanks for everything, Susan. I suspect all of this will be over her
head, so I'll try to summarize for her.

Chak

[Susan]

x-no-archive: yes

Post by Chak
Thanks for everything, Susan. I suspect all of this will be over her
head, so I'll try to summarize for her.

I know... maybe the soulcysters site or cushings-help.com message
boards? Both conditions are covered there, too.

Hope it helps.

Susan