“Cushing’s syndrome facts by John P. Cunha, DO, FACOE
Cushing’s syndrome, or “hypercortisolism,” is a relatively rare hormonal disorder caused by prolonged exposure of the body’s tissues to high levels of the hormone cortisol.”

John P. Cunha, DO, FACOE MedicineNet.com

Cushing’s syndrome describes the signs and symptoms associated with prolonged exposure to inappropriately high levels of the hormone cortisol. This can be caused by taking glucocorticoid drugs, or diseases that result in excess cortisol, adrenocorticotropic hormone (ACTH), or CRH levels.

^{Cushing’s syndrome appears when the body’s tissues are display to immoderate levels of cortisol for long periods of time.}

There are two types of the disease and they are known as exogenous and endogenous. Exogenous Cushing syndrome is caused by something outside of the body, like when hormones are given to a patient during a RX for another condition. Endogenous is caused by natural causing problems within the body. Endogenous is likely to be hereditary and not caused by an outside force like a steroid complex.

Causes of Cushing Syndrome

The most common cause of Cushing’s syndrome is ^{exogenous administration of glucocorticoids prescribed by a health care practitioner to treat other diseases (called iatrogenic Cushing’s syndrome}). This can be an effect of corticosteroid treatment of a variety of disorders such as ^{asthma and rheumatoid arthritis, or in immunosuppression after an organ transplant.}

Administration of synthetic ACTH(adrenocorticotropichormone) is also possible, but ACTH is less often prescribed due to cost and lesser utility. Although rare, Cushing’s syndrome can also be due to the use of medroxyprogesterone In this form of Cushing’s, the adrenal glands atrophy due to lack of stimulation by ACTH, since glucocorticoids downregulate production of ACTH. Cushing syndrome in childhood usually results from use of glucocorticoid medication.

^{Endogenous Cushing’s syndrome results from some derangement of the body’s own system of secreting cortisol. Normally, ACTH is released from the pituitary gland when necessary to stimulate the release of cortisol from the adrenal glands.}

 In pituitary Cushing’s, a benign pituitary adenoma secretes ACTH. This is also known as Cushing’s disease and is responsible for 70% of endogenous Cushing’s syndrome.^[3]

 In adrenal Cushing’s, excess cortisol is produced by adrenal gland tumors, hyperplastic adrenal glands, or adrenal glands with nodular adrenal hyperplasia.

 Tumors outside the normal pituitary-adrenal system can produce ACTH (occasionally with CRH) that affects the adrenal glands. This etiology is called ectopic or ^{paraneoplastic Cushing’s disease} and is seen in diseases like ^{small celllung cancer.[15]}

 Finally, rare cases of CRH-secreting tumors (without ACTH secretion) have been reported, which stimulates pituitary ACTH production.^[16]HYPERLINK “http://en.wikipedia.org/wiki/Cushing%27s_syndrome” \l “cite_note-Voyadzis_JM.2C_Guttman-Bauman_I.2C_Santi_M.2C_Cogen_P._2004_212.E2.80.936-16” [16]

Pseudo-Cushing’s syndrome

Elevated levels of total cortisol can also be due to estrogen found in oral contraceptive pills that contain a mixture of estrogen and progesterone, leading to ^{Pseudo-Cushing’s syndrome. Estrogen can cause an increase of cortisol-binding globulin and thereby cause the total cortisol level to be elevated. However, the total free cortisol, which is the active hormone in the body, as measured by a 24 hour urine collection for urinary free cortisol, is normal.}

“Excess dietary salt is most notorious for increasing blood pressure. Americans have a 90 percent lifetime probability of developing high blood pressure – so even if your blood pressure is normal now, if you continue to eat the typical American diet, you will be at risk.“

Joel FuhrmanM.D. (born December 2, 1953), is an American board-certified family physician who specializes in nutrition-based treatments for obesity and chronic disease.

The foods to buy are low sodium foods —-What to buy:

–Fruits – Fresh, canned or frozen. I recommend with canned look at the ingredients to make sure you know how much sodium is in a serving. Remember for a person with high b/p you want to keep your sodium count less than 1800 to 2000mg a day. Sodium causes the vessels to vasoconstrict (or narrow) which increases blood pressure in a person.

-Vegetables – Fresh or frozen (no sauce or plastic pouches) Canned (UNSALTED, AGAIN check the canned label for the amount of sodium in each serving.).

–Drinks – Fruits juices, fresh or frozen.

Canned low sodium or no salt added tomato & vegetable juice.

Instant breakfast* (all flavors but eggnog) —- limit to 1 cup /day

-Dairy choices – liguid or dry milk (1% or skim milk).

Homemade buttermilk (made from powdered milk) *limit these to 2-3 cups a day*

Cottage cheese, dry cured (low sodium)

Ricotta Cheese from low fat or skim milk

Farmer Cheese, part skim mozzarella neufchated *limit cheese to 1oz or 1/2 cup of one cheese/day.

-Fats, Oils – Canola, Olive, Corn, Cottonseed, Peanut, Safflower, Soybean &

Margarine (unsalted)

–Meats, Poultry, Fish

Fish, fresh or frozen (NOT BREADED): Canned tuna and salmon (Unsalted or rinsed).

Chicken or Turkey

Lean cuts of: BEEF, VEAL, PORK, LAMB.

BEEF TONGUE if you must have.

-Meat Substitutes

Dried beans, peas, lentils (not canned)

Nuts or seeds (UNSALTED, DRY ROASTED), sunflower seeds, peanuts, almonds, walnuts.

Unsalted peanut butter

Tofu (soybean curd)

–Breads, Cerals, Grains, Starches:

Loaf of bread and yeast rolls (limit to 3 slices a day)

Homemade breads with regular flour, not self rising.

Melba Toast

Matzo Crackers

Pita Bread

Taco Shell

Tortilla (corn)

Cooked cereals like corn grits, farina (regular), oatmeal, oat bran, cream of rice, cream of wheat (AVOID instant cereals).

Puffed Rice or wheat, shredded wheat (or any cereal with 100-150mg sodium–limit to 1 cup a day).

Wheat germ

Popcorn (no salt or fat added)

Starchy vegetables: corn, potato, green beans, etc… (not canned unless salt free).

Rice (enriched white or brown)

Pasta

– Cooking ingredients, seasonings

Corn starch, tapioca

Corn meal (not self rising)

Fresh or dried herbs, salt free herb seasonings.

Flour, regular white or whole wheat (not self rising)

Fresh fruits or vegetables (lemons, limes, onions, celery, etc.)

Fresh garlic or ginger

Louisiana – type hot sauce (limit to 1 tsp/day)

Low sodium baking powder

Onion or garlic powder

Tomato paste, unsalted tomatoes, unsalted tomato sauce.

Vinegar

Water chestnuts, yeast, butter substitute (such as Molly Mc Butter—limit to 1/2 tsp/day).

– Sweets

Carob powder, cocoa powder

Flavored gelatins

Fruits (fresh, canned, frozen)

Frozen juice bars, fruit ice, sorbet, sherbet

Sugar, honey, molasses, syrup (cane or maple)

Jelly, jams, preserves, apple butter

Graham and animal crackers, fig bars, ginger snaps

OTHER WAYS TO IMPROVE HEART FUNCTION:

1. Lose Weight, if you need to. The heart does not have to beat as hard to send blood to all parts of a slim body as opposed to a overweight or obese body.

2. Don’t smoke-Smoking makes blood vessels constrict making it more difficult to move the blood throughout the body to all tissue parts and it also makes it more difficult in breathing.

3. Avoid hard exercise and lifting heavy objects to prevent sudden pumping demands on your heart.

4. Wear clothes that permit good bloodflow in the legs. Garters, hose with tight tops (like thigh-high or knee high hose) may slow blood flow to and from your legs causing clots.

5. Avoid temperature extremes-The body works harder to keep a normal temperature when you’re too hot or cold.

6. Try to stay away from people who have colds or the flu. Ask your doctor if you should have a flu shot every year and a pneumonia shot every 6-10 years.

7. Talk with your doctor about how much alcohol (if any) is ok for you. Since alcohol weakens the heart, heart failure may improve if you stop drinking alcohol.

8. Reduce high blood pressure or high cholesterol and control your diabetes (one major way is be compliant with your meds, diet, exercise program as your M.D. orders. This can also help keep heart failure symptoms from getting worse.

9. Herbal supplements may interact with heart failure drugs. Ask your doctor before taking any herbal medicine.

**Recommended is to get clearance for any changes you decide to make with this advice on blood pressure since you may have other conditions that may not allow certain food, or activity changes. If you have high blood pressure get yourself a cardiologist if you don’t have one yet and is a specialist in knowing the best treatment for you.**

Look at the average American diet: ice cream, butter, cheese, whole milk, all this fat. People don’t realize how much of this stuff you get by the end of the day. High blood pressure is from all this high-fat eating.

Jack LaLanne

Factors in helping to reduce or decrease high blood pressure, also noted as hypertension are:

-STRESS REDUCTION

Stress is defined as feeling tense on the inside due to pressures from the outside. Most of us have many of these pressures, and some handle them better than others. Since stress makes the heart work harder, try to find ways to relieve the pressure you felt when stressed.

One way of coping with stress is to deal with your feelings. You may feel depressed, angry or anxious because you have high blood pressure. These feelings are normal. It may help to talk about how you feel with your family and friends. When you accept that you have high B/P, you can put your efforts into living a more productive, good life with dealing with the hypertension.

Many people find yoga, meditation and prescribed exercise helpful. Always check with your doctor before starting an exercise program to make sure you get clearance of what is safe for you by your primary doctor or cardiologist.

-Eat less SODIUM

Sodium is an important substance. It helps your body balance the level of fluid inside and outside of the cells. To keep up this balance, the body needs about 2000mg of sodium a day or less. Yet most of us eat 3000 to 6000mg of sodium each day.

Most people with high b/p are asked to eat less sodium. Sodium attracts water and makes the body hold fluid. To pump the added fluid the heart works harder. Also sodium in the body causes the arteries to vasocontrict increasing pressure in the vessels causing the pressure to rise.

Most people with high b/p are asked to eat less sodium at 2000mg or less a day and this is to prevent water retention and vasoconstriction in which both actions increase the blood pressure. Follow your doctor’s advice about your sodium intake.

Many prepared foods and spices are high in sodium. But, the most common source of sodium is table salt. Table salt is 40% sodium and 60% chloride. One teaspoon of table salt contains 2000mg of sodium.

HINTS TO LOWER YOUR SODIUM IN YOUR DIET:

-Season foods with fresh or dried herbs, vegetables, fruits or no-salt seasonings.

-Do not cook with salt or add salt to foods after they are on the table.

-Make your own breads, rolls, sauces, salad dressings, vegetable dishes and desserts when you can.

-Stay away from fast foods. They are almost all high in salt.

-Eat fresh, frozen or canned, unsalted vegetables. These have less sodium than most processed foods. Read the labels and if they don’t have a label DON’T EAT IT. Read the labels and eat the portioned size it says to for 1 portion with keeping a diary of what you ate with adding the sodium and when it reached 2000mg no more food that day with salt in it unless the doctor prescribes less.

-Buy water packed tuna and salmon. Break it up into a bowl of cold water, and let stand for 3 minutes. Rinse, drain and squeeze out water.

-Don’t buy convenience foods such as prepared or skillet dinners, deli foods, cold cuts, hot dogs, frozen entrees or canned soups. These have lots of salt. Be picky on what you eat.

-Again, read all labels for salt, sodium or sodium products (such as sodium benzoate, MSG). Ingredients are listed in the order of amount used. A low sodium label means 140mg of less per serving. Try to buy products labeled low sodium/serving. Do not eat products that have more sodium than this per serving.

-When you eat out, order baked, broiled, steamed or pouched foods without breading or butter or sauces. Also ask that no salt be added. Go easy on the salad dressing. Most are high in salt.

What not to buy:

-Canned Vegetables, sauerkraut. Self rising flour and corn meal. Prepared mixes (waffle, pancake, muffin, cornbread, etc…)

-Dairy Products- like buttermilk (store-bought), canned milks unless diluted and used as regular milk). Egg substitute limit to ½ cup/day. Eggnog (store bought) and salted butter or margarine do not buy.

-Soups: Boullon (all kinds), canned broth, dry soup mixes, canned soups.

-Meats and meat substitutes not to buy= Canned meats, canned fish, cured meats, all types of sausages, sandwich meats, peanut butter, salted nuts.

-Prepared mixes (pie, pudding, cake) or store bought pies, cakes, muffins.

-Cooking ingredients to use low sodium type or limit to 2 tbsp/day=

Catsup, chili sauce, barbeque sauce, mustard, salad dressing.

-Drinks to stay away from Athletic Drinks (such as Gatorade), canned tomato or vegetable juice (unless unsalted).

Stay tune for part 3 on What to buy when dealing with high b/p or hypertension plus more.

QUOTE FOR THURSDAY

Look at the average American diet: ice cream, butter, cheese, whole milk, all this fat. People don’t realize how much of this stuff you get by the end of the day. High blood pressure is from all this high-fat eating.

Jack LaLanne

“Fruit juice timebomb: Health experts say stick to one glass a day as teenagers’ poor diets are blamed for increased diabetes risk

• Fruit juice should be limited as it contains a lot of sugar, experts warn

• Those aged 11 to 19 are eating 42 per cent more sugar than recommended

• Age group also eating 14 per cent too much fat, risking diabetes and stroke”

By Sophie Borland writer Published:14 May 2014 www.dailymail.co.uk/health/article-2628585/Fruit-juice-timebomb

Fructose is a simple sugar found in fruit, is metabolized to fat in your liver, and eating large amounts has been linked to negative metabolic and endocrine effects. When eating fruits in very large amounts=High levels of fructose or glucose in the bloodstream which can logically increase your risk number of health conditions, from insulin and leptin resistance to even cancer. Insulin and leptin work together to control the quality of your metabolism and to a great deal your rate of metabolism (the resistance of them are associated with obesity). Research shows fructose can impact risks on pancreatic cancer. It has been proven fructose is used by pancreatic cancer cells for cell division=an increase in the spread of pancreatic cancer. So eat fruits with vegetables in 50% of your meals and it will impact more of a positive effect on your health and can even help with weight maintenance or weight loss if used right in proportions. Studies have shown fructose (in many fruits), especially taken in large proportions can induce the following in the human body, that are:

*Elevation of triglycerides *abdominal obesity *endothelial dysfunction *kidney damage *metabolic syndrome * hypertension (high b/p) * fatty liver disease * microvascular disease * diabetes and more. So make fruits with vegetables part of your daily life with eating them in 50% of your meals and it will surely impact more of a positive effect on your health. It can even help with weight loss if used in proper proportions. Fruit is delicious but if not a fruit fan there is plenty of ways it can be added to vegetables and your meats or fishes=high protein, where you end up falling in love with fruit alone or just find it a great flavor added with other foods as an extra treat. Making this diet adjustment with having fruit and other good low glycemic foods in your diet can help you reach your goal in losing weight with reaching your optimal level of health in time. For further information, go to healthyusa.tsfl.com and join me with others who have seen this pathway work in our own lives. So far, I lost over 20lbs. through the guidance of Dr. Anderson’s healthy habits which covers all types of foods in your diet, to types of light exercise to even work out (it you want it in your life) and so much more. Now you know where to look, it’s up to you to make the right choice. Take a peek with no charge or fee or obligation, just a simple way of adding new ideas possibly to your life to only make it better. This will make you and possibly impact the people around you with wanting to reach this happier, healthier and longer lifetime. Just like the car, the better you treat it the longer it lasts the same principle with the human body. Only you make the choice with possibly spreading this good news that puts a decrease in diseases/illnesses for you and others. Wouldn’t it be great if this knowledge could spread to the future decade and further on. Haven’t we lived long enough making poor decisions in our society relating to health overall. Do you want this to go on in America’s future? Make the change for the people that make up our country. Should we just let our politicians and government do the deciding on how much we can drink or what we are allowed to eat. They only got involved when it started affecting our economy drastically with not enough citizens doing the right healthy habits to keep our health care system affordable, which it isn’t for many. Let us, the people, make the right choice. Click onto healthyusa.tsfl.com if you want to take that step for no money, no hacking but just to peek on what the website offers. Remember to check with your general practitioner before starting any new diet or exercise program, especially if you have any health concerns or diseases.

“Any fruit or 100% fruit juice counts as part of the Fruit Group. Fruits may be fresh, canned, frozen, or dried, and may be whole, cut-up, or pureed.”

USDA on Choosemyplate.gov

You say HOW?

They are high in vitamins, minerals, some with antitoxins (helping the immune system) and have anti-inflammatory effects that can help you build up to your optimal health. Some fruits have soluble fiber in them that slows down the breakdown of complex carbohydrates and helps reduce blood sugar. Fruit taken in proper portions (moderate amts.) can even help lower blood cholesterol. Soluble fiber is not just in rye, barley, oats, and vegetables but in fruits as well. Insoluble fiber can’t be absorbed or digested by the human body but can still provide the body with advantages like reducing hunger, stimulates regular bowel movements, and can be found in fruits as well as vegetables, seeds whole wheat bread and other foods. One of my healthy eating rules is know what the food’s makeup is before eating it; yes this includes calories, fat, sugars, carbs and sodium but knowing the energy density in the foods you eat is very important too. Foods with the lowest density are foods that help curb your appetite that can help you maintain or even lose weight. The lowest energy density food group contains healthy foods like most vegetables and fruits with based broth soups & skim milk. The highest density groups are cookies, chips, nuts, full-fat condiments, chocolate and butter (not the best nutritional foods to be eating regularly). Remember, if you’re trying to be healthy or even losing weight than know fruits are high glycemic foods. If you eat too much fruit at one time it will result in high glycemic amounts in your body at that one time putting you at risk for fat storage=weight gain. You see, digestion of the foods whether calories, carbohydrates, sugars, or some fats get broken down into simple or complex sugar molecules=glucose or fructose. One of the body’s major fuels for energy so we can function with working properly & survive is glucose (the same concept like fuel for a car=gas=it operates).
The body utilizes glucose after digestion takes place in the stomach where the foods break down into simple and complex sugars than transferred into our bloodstream as our active fuel for energy (like our car’s tank sending gas to the engine to be able to run). Our fuel, being the glucose, then gets sent to all our tissues and into our cells but only for the amount they need at that time (sort of like the car in filling the gas tank to full). When our body reaches full for all energy needed to all areas of the body at that time if there is extra un-needed glucose in the bloodstream it has to go somewhere and the body stores it=fat storage=weight gain. Take the car, the storage reservoir is the gas tank it only stores in the tank, but if the tank reaches full with gas (its energy) it would just overflow as opposed to the human body with extra glucose in the bloodstream=our extra fuel which doesn’t overflow by leaving our body somehow but gets stored in our body as fat storage. Thus, when it’s needed (glucose) it will be released back in the bloodstream. If you more frequently have in your body more overflow of glucose versus the need for it you’ll have more fat storage occuring as opposed to energy utilized by the body. This causes you to be at a higher risk of becoming overweight to obese (that’s the logic in eating 6 small low glycemic meals a day which prevents this from happening). To prevent a high risk of becoming overweight to obese stay off of 3 large meals/day and high sugar snacks during the day. Also, don’t have constant healthy frequent high glycemic meals day in and day out especially with no activity/exercise other than your regular activities of daily living, which doesn’t count as exercise.
Remember, eat fruits in moderation not in excess; including the size of your meals (don’t allow the size of the plate greater than 9” including NO second helpings). The key to eating healthy is to include all 4 food groups (Meats/Fishes, Vegetables, Fruits, and Dairy) and eat your first meal for the day within 30 minutes. If you want to learn more information about this to begin eating healthier with the 4 food groups and in the proper portion sizes than go no further. My website can give you the information in knowing how to eat so that it affects your metabolism and weight distribution in the body therapeutically. You can also learn exercise that fits into your lifestyle (ranging from walking fast 30 minutes for 2 to 3 times a week to daily workouts) with knowing healthy habits to add in your life to stay or get within your ideal weight. The ending result is you feel better, look better, and have higher odds you’ll live a longer life that allows more excitement in it due to being in better shape. Let Dr. Anderson through his book and myself, being your health coach, give you direction onto the pathway you need until you get yourself on the right track of health independently. Before going to my website here is also information on how sugar affects the body on disease and illness.