WHAT IS P’AWARE
P-pituitary &aware -awareness
This is a website about the rare pituitary disease namely Acromegaly and Cushing’s. P’aware serves to provide information and support to the public, increase awareness in the medical community and the general public, and be a resource for information and support to health care professionals.
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Cushing’s Disease
A rare disorder caused by excess cortisol in the body.
UnderstandingCushing’s Disease
Cushing’s Disease occurs when a pituitary tumor produces an excess of adrenocorticotropic hormone (ACTH), causing the adrenal glands to overproduce cortisol. Key symptoms:
UnderstandingAcromegaly
Acromegaly is a disorder that results from an overproduction of growth hormone, typically caused by a benign pituitary tumor. This leads to abnormal growth of bones and tissues, often resulting in enlarged hands, feet, and facial features.
Acromegaly
A rare disorder caused by excess cortisol in the body.
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Acromegaly and Cushing’s disease are both endocrine disorders caused by hormonal imbalances, but they result from different underlying issues:
Acromegaly
Cause: Acromegaly is caused by an excess of growth hormone (GH), usually due to a benign tumor (adenoma) in the pituitary gland.
Effects: Excess GH leads to abnormal growth of bones and tissues, particularly in the hands, feet, and face.
Symptoms: Enlarged hands/feet, facial changes (prominent jaw, enlarged nose), joint pain, thickened skin, and potential organ enlargement.
Cushing’s Disease
Cause: Cushing’s disease is caused by an excess of cortisol due to a pituitary adenoma that overproduces adrenocorticotropic hormone (ACTH).
Effects: High cortisol levels disrupt metabolism, immune function, and fat distribution.
Symptoms: Weight gain (especially around the abdomen and face), 'moon face,' buffalo hump, muscle weakness, thinning skin, high blood pressure, and increased susceptibility to infections.
Both conditions are primarily treated by surgical removal of the tumor, with medications and radiation therapy as secondary options if surgery is not completely effective.
Diagnosis of Acromegaly
Since acromegaly results from excess growth hormone (GH), diagnosis involves:
Blood Tests: Oral Glucose Tolerance Test (OGTT) with GH Measurement → In healthy people, glucose suppresses GH levels, but in acromegaly, GH remains high.
Imaging: MRI of the Pituitary Gland → To detect a pituitary adenoma, the most common cause of acromegaly.
Diagnosis of Cushing’s Disease
Cushing’s disease is due to excess cortisol, so diagnosis focuses on measuring cortisol and ACTH levels.
Initial Blood & Urine Tests: Dexamethasone Suppression Test (DST) → Patients take dexamethasone (a steroid) at night; in a healthy person, this suppresses cortisol, but in Cushing’s disease, cortisol remains high.
ACTH Testing: Blood ACTH Levels → If ACTH is high, it suggests a pituitary cause (Cushing’s disease); if ACTH is low, the problem may be in the adrenal glands (Cushing’s syndrome).
Imaging: MRI of the Pituitary Gland → Identifies a pituitary adenoma causing excessive ACTH production.
Treatment of Acromegaly
- Surgery (First-line Treatment)
- Medications (If Surgery Fails or is Incomplete)
- Radiation Therapy
Treatment of Cushing’s Disease
- Surgery (First-line Treatment)
- Medications (If Surgery Fails or is Incomplete)
- Adrenal Gland Removal (Bilateral Adrenalectomy – Last Resort)
Acromegaly
Since acromegaly results from excess growth hormone (GH), diagnosis involves:
Yes, acromegaly can be cured in some cases, especially if:
- The pituitary tumor is small (microadenoma) and completely removed via transsphenoidal surgery.
- Post-surgical IGF-1 and GH levels return to normal.
Challenges in Cure:
- Large or invasive tumors may not be fully removed, requiring medications or radiation to control GH levels.
- Even after successful treatment, some symptoms (e.g., bone growth changes) may be permanent.
If not cured, acromegaly becomes a chronic condition, but it can be managed effectively with medications and radiation.
Cushing’s Disease
Yes, Cushing’s disease can be cured if:
- The pituitary tumor is completely removed and cortisol levels normalize.
- Early diagnosis and successful surgery improve the chances of full recovery.
Challenges in Cure:
- Some tumors are too small to detect or invasive, making complete removal difficult.
- After surgery, cortisol levels may stay high, requiring additional treatment.
- If untreated for too long, Cushing’s can cause permanent damage (e.g., osteoporosis, diabetes, heart disease).
If not cured, patients may need lifelong medication to manage cortisol levels.
Lifestyle Changes for Acromegaly
Since acromegaly affects bone growth, metabolism, and heart health, managing symptoms focuses on reducing strain on the body.
✅ Diet & Nutrition
✅ Exercise & Mobility
✅ Sleep & Stress Management
✅ Regular Health Monitoring
Lifestyle Changes for Cushing’s Disease
Since Cushing’s disease causes high cortisol levels, leading to weight gain, bone loss, and metabolic issues, lifestyle changes focus on hormonal balance and reducing complications.
✅ Diet & Nutrition
✅ Exercise & Weight Management
✅ Stress & Mental Health
✅ Health Monitoring
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