
Diabetes & high cortisol
Diabetes is prevalent, estimated to affect 10% of population. Cushing’s syndrome (CS) on the other hand is rare, 2–3 cases/million per year. Clinical manifestations of diabetes and early CS are similar; increased glucose, blood pressure, cholesterol and abdominal circumference. Authors find that subtle cortisol elevation is present in 3.5% of persons with type 2 diabetes, with the main source being adrenal adenomas. It is reasonable to screen DM2 patients with “cushing’s syndrome” features, as surgical cure is…
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Pheochromocytoma & its effect on carotids and heart
Adrenal medulla is responsible for production of catecholamines, mainly epinephrine and nor-epinephrine. Catecholamines are physiologically important as they contribute to the sympathetic nervous system. Excessive production of epinephrine and nor-epinephrine leads to pheochromocytoma, which can manifest clinically as severe hypertension, increased heart rate, excessive sweating, flushing, headaches and even anxiety. This article shows that successful removal of the cause of pheochromocytoma reverses abnormal thickening of carotid arteries and heart muscles; adding value to good longer-term prognosis.…
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Aldosterone & Vertebral Fractures
Elevated autonomous aldosterone production is more common than previously believed. Primary aldosteronism is estimated to cause “essential” and resistant hypertension in up to 10% and 20% of adults. These numbers are significant given wide prevalence of high blood pressure in the general population. This original study suggests that primary aldosteronism is also a unique contributor to vertebral fracture, raising its risk by 3 fold. Authors hypothesize that excessive aldosterone causes fracture by reducing bone quality…
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Subclinical hypercortisolism & DHEAs
Cortisol, produced by adrenal glands, is central to human physiology. It helps maintain proper blood pressure, glucose metabolism and electrolyte homeostasis, among other processes. Its direct involvement is also seen in the fight or flight response. However when abnormally high, it can lead to detrimental health issues, best summarized in Cushing’s syndrome. Although Cushing’s syndrome is rare, subtle cortisol elevations are not. Recent research indicates that slight to moderate rise in cortisol could also lead…
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2016 Endocrine Society Guidelines: CENTRAL Adrenal Insufficiency
Adrenal Insufficiency (AI) is defined by low cortisol production. It could be due to failure, infection, injury, bleeding or inflammation of the adrenal glands, or from limited production of ACTH hormone by the pituitary. Adrenal Insufficiency as a result of low ACTH is called “central” or “secondary”. These guidelines were developed by Endocrine Society to address specifically Central AI. They were released in November 2016. Please find below excerpts with slightly modified wording for…
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Categorized as Adrenal Health, Blog, Clinical Guidelines, Insights from Dr. Tashko, Pituitary Health

