The patient is a 61-year-old woman with a cortisol-producing right adrenal tumor causing subclinical Cushing’s syndrome.

Patients with subclinical Cushing’s syndrome have too much cortisol and can suffer from many signs and symptoms.

Heartburn, heart palpitations, muscle weakness, decreased sex drive, difficulty concentrating, anxiety, problems with memory, and Irritability are common symptoms of Cushing’s syndrome.

Patients can gain weight, especially on the mid-section, and their back, so called 'buffalo hump', and often develop diabetes.
Easy bruising, poor wound healing, hair loss, and sleep apnea are other symptoms of too much cortisol.

The tricky thing with subclinical Cushing’s syndrome is that the symptoms often sneak up on the patient over months and years. Many patients don’t even realize how bad they feel because they attribute their symptoms to getting older. Sometimes, they do not realize how bad they really feel until the adrenal tumor is removed.

This patient had an incidentally identified adrenal tumor on a CT scan for another reason. Fortunately, her doctors did not ignore the tumor. They ordered appropriate lab test. She had a low (suppressed) ACTH level, and a cortisol level over 1.8 following a low dose dexamethasone suppression test. This proves adrenal subclinical Cushing’s syndrome.

The patient had a Mini Back Scope Adrenalectomy and did very well. She did not require steroids after the operation.

6 weeks later the patient contacted me and said she felt better than she had done in decades. Her energy level improved, and the brain fog was gone. She had already lost 7 lbs., and her blood sugars normalized to the point where she was no longer pre-diabetic. She was thrilled to get rid of the toxic effects of too much cortisol. She wished she had gotten rid of her adrenal tumor a long time ago.

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