Pain In Flank And Back, Fatigue, Insomnia, Hair Loss, Low Grade Fever. Cushing's Syndrome?

Posted on Wed, 30 Nov 2011

Medically reviewed by Ask A Doctor - 24x7 Medical Review Team

Wed, 30 Nov 2011 Answered on

Sat, 16 Jun 2012 Last reviewed on

Question : I am 35years old and 5'4" and for the past 2 years have been seeking constant medical help for pain in my flank and back. .I have had my gallbladder out and several back treatments but the discomfortis still there. I have seen a specialist and he ruled out anything gynocological When all of this started I was what was overweight for me at 156lbs and myTriclycerides and cholesterol were high..I am now having issues with my hip and bursitis. I am not usually an unhealthy person. Recently as I was going through my symptoms with my primary as she noticed I had lost 25 pounds in the last 4 months. i would be fine with the weight loss as I am now 129lbs except for along with that I have major fatigue,losing my hair, always have a low grade fever and sometimes spikes when my face flushes.,insomnia and feel like I have to urinate all through the night. She tested my thyroid and everything was great. She recently tested my cortisol and did bloodwork at 11am and it came back 26.5 which wasnt too bad. She said it was probably my birth control causing it to be high. I also see a DO to deal with my back pain which she treats with manipulation. She says I should get in with an endocrinologist because I have a buffalo hump. I have most of the Cushings sypmtoms but my blood pressure is actually low and I am losing weight not gaining. My question is should I get checked out or is a buffalo hump and 26.5 cortisol pretty normal. I feel awful and havent felt like myself for years and the depression meds havent really seemed to change anything. Any advice would be appreciated!

Answered by Dr. V. Kumaravel (10 hours later)

Hello,

Thanks for the query.

I do understand you are a 35 year old female with depression, overweight and buffalo hump. Your concern seems to be related to cushings syndrome.

Buffalo hump can be a feature of cushings syndrome and seen in obesity. The best way to rule out cushings syndrome is to do a "dexamethasone suppresion test", where dexamethasone tablet is given at night and the a blood cortisol level is measured at morning or to measure a 24 hours urinary cortisol.

It is preferable to have your thyroid function retested too.

I feel an endocrine evaluation would be definitely required in your case.

Hope i had answered your query. Should you have any additional queries with regards to my opinion, I will be available to address them.

Regards

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. V. Kumaravel (1 hour later)

I am not obese. I have actually lost 25 pounds and now weigh 129 so I don't know why my cortisol would be up and why the buffalo hump. Do have pain in my back. So even though I'm not overweight you would advise getting to an endocrinologist?

Answered by Dr. V. Kumaravel (10 hours later)

Hello,

Thanks for your follow-up query.

Even if your weight is normal, in view of cervical hump, it is preferable to have an endocrine evaluation done, so that we do not miss out on something like Cushing's syndrome.

Hope I answered all your questions. Please accept my answer in case you do not have further queries. Wish you Good Health.

Regards,

Above answer was peer-reviewed by : Dr. Shanthi.E