You're likely to start by seeing your family doctor or a general practitioner. However, in some cases when you call to set up an appointment, you may be referred immediately to an endocrinologist, a doctor who specializes in endocrine (hormonal) disorders.
It's a good idea to prepare for your appointment so that you can make the most of your time with your doctor. Here's some information to help you get ready, and what to expect from your doctor.
What you can do
- Be aware of any pre-appointment restrictions. At the time you make the appointment, be sure to ask if there's anything you need to do in advance to prepare for diagnostic tests.
- Write down any symptoms you're experiencing, including any that may seem unrelated to the reason for which you scheduled the appointment. For example, if you've had headaches more frequently or if you've been feeling down or more tired than usual, this is important information to share with your doctor. Also tell your doctor about changes in your physical appearance, such as weight gain, new acne or increased body hair.
- Write down key personal information, including any changes in your personal relationships and in your sex life. Let your doctor know if the people closest to you have noticed that you seem irritable or that you seem to have more mood swings than in the past. It may help to take along a photo of yourself that shows any changes in your physical appearance since you've started experiencing symptoms.
- Make a list of all medications, as well as any vitamins, creams or supplements, that you're currently taking or have used in the past. Include on your list the specific name, dose and dates of any steroid medications you've taken in the past, such as cortisone injections.
- Take a family member or friend along, if possible. Sometimes it can be difficult to soak up all the information provided to you during an appointment. Someone who accompanies you may remember something that you missed or forgot.
- Write down questions to ask your doctor.
Your time with your doctor is limited, so preparing a list of questions will help you make the most of your time together. List your questions from most important to least important in case time runs out. For Cushing syndrome, some basic questions to ask your doctor include:
- What is likely causing my symptoms or condition?
- Are there other possible causes for my symptoms or condition?
- What kinds of diagnostic tests do I need? How are these tests performed?
- What are my treatment options?
- Will my physical signs and symptoms improve with treatment? Will I see a difference in my appearance as well as in the way I feel?
- Will treatment help make me feel more emotionally stable?
- What long-term impact could each treatment option have? Will there be an impact on my ability to have children?
- How will you follow my response to treatment over time?
- Are there any alternatives to the primary approach that you're suggesting?
- I have these other health conditions. How can I best manage them together?
- Are there any restrictions that I need to follow?
- Should I see a specialist?
- Is there a generic alternative to the medicine you're prescribing?
- Are there any brochures or other printed material that I can take home with me? What websites do you recommend?
In addition to the questions that you've prepared to ask your doctor, don't hesitate to ask questions during your appointment.
What to expect from your doctor
Your doctor is likely to ask you a number of questions. Being ready to answer them may reserve time to go over any points you want to spend more time on. Your doctor may ask:
- When did you first begin experiencing symptoms?
- Have your symptoms been continuous or occasional? Have they gotten worse over time?
- Have you noticed any changes in your sexual performance or your interest in sex?
- For women, has your menstrual cycle changed or have you stopped having your period?
- Have you gained weight? On what part of your body?
- Have you had difficulty controlling your emotions?
- Have you noticed that you bruise more easily, or that wounds and infections take longer to heal than in the past?
- Do you have weakness in your muscles, such as difficulty getting out of the tub or walking stairs?
- Have you developed new acne or more body or facial hair?
- Have you been taking a corticosteroid medication? For how long?
- What, if anything, seems to either improve or worsen your symptoms?
Diagnosing Cushing syndrome can be a long and extensive process. You may not have any firm answers about your condition until you've had a series of medical appointments.
March 28, 2013
- Stratakis CA. Cushing syndrome in pediatrics. Endocrinology Metabolism Clinics of North America. 2012;41:793.
- Wein AJ, et al. Campbell-Walsh Urology. 10th ed. Philadelphia, Pa.: Saunders Elsevier; 2012. http://www.mdconsult.com/das/book/body/208746819-6/0/1445/0.html. Accessed Jan. 2, 2013.
- Guaraldi F, et al. Cushing syndrome: Maybe not so uncommon of an endocrine disease. Journal of the American Board of Family Medicine. 2012;25:199.
- Mazziotti G, et al. Diabetes in Cushing syndrome: Basic and clinical aspects. Trends in Endocrinology and Metabolism. 2011;22:499.
- Nieman LK. Overview of the treatment of Cushing's syndrome. http://www.uptodate.com/home. Accessed Jan. 1, 2013.
- Kliegman RM, et al. Nelson Textbook of Pediatrics. 19th ed. Philadelphia, Pa.: Saunders Elsevier; 2011. http://www.mdconsult.com/das/book/body/208746819-6/0/1608/0.html. Accessed Jan. 2, 2013.
- Cushing's syndrome. National Institute of Diabetes and Digestive and Kidney Diseases. http://www.endocrine.niddk.nih.gov/pubs/cushings/cushings.aspx. Accessed Jan. 2, 2013.
- Nieman LK. Causes and pathophysiology of Cushing's syndrome. http://www.uptodate.com/home. Accessed Jan. 1, 2013.
- The Surgeon General's report on bone health and osteoporosis: What it means to you. National Institute of Arthritis and Musculoskeletal and Skin Diseases. http://www.niams.nih.gov/health_info/bone/SGR/surgeon_generals_report.asp. Accessed Jan. 2, 2013.
- Nippoldt TB (expert opinion). Mayo Clinic, Rochester, Minn. Jan. 24, 2013.
- FDA approves Korlym for patients with endogenous Cushing's syndrome. U.S. Food and Drug Administration. http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm292462.htm. Accessed Jan. 25, 2013.