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How Amy Schumer's Cushing's revelation highlights the significance and dangers of cortisol

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LA Post: How Amy Schumer's Cushing's revelation highlights the significance and dangers of cortisol
March 11, 2024
Nahal Garakani - LA Post

When comedian Amy Schumer shared her Cushing's syndrome diagnosis, she put the spotlight on this little-known disorder caused by too much "stress hormone." Cortisol is supposed to help our bodies deal with stress, but when levels stay high for too long, big problems start. Symptoms like sudden weight gain, mood swings, weak muscles and more can take over your life. Schumer even said the constant cortisol made her feel like "a different person." Cushing's is complex, confusing and nothing to joke about.

While Schumer's candid admission has raised public awareness, it has also fueled anxiety and uncertainty surrounding cortisol balance and Cushing's syndrome. With misinformation swirling online, endocrinologists are striving to provide facts and clarify common myths about cortisol, Cushing's diagnosis, and treatment options. They aim to equip the millions of Americans dealing with stress-related issues with knowledge and hope.

Cortisol plays a vital role in managing stress response and regulating metabolism, blood sugar, blood pressure, and inflammation. When well-balanced, this steroid hormone synthesized by the adrenal glands helps us cope with everyday stresses. But when excess cortisol floods the body 24/7, it wreaks havoc on physical and mental health.

"Cortisol is meant to be high during acute stress, not prolonged elevation," explains Dr. Divya Yogi-Morren, an endocrinologist at Cleveland Clinic. "Too much for too long can negatively impact numerous body systems and hormonal balance."

So what defines too much cortisol? Testing guidelines consider normal blood serum concentration to range from 6-19 mcg/dL upon waking and 3-10 mcg/dL around bedtime. Levels can spike up to 10 times higher when acutely stressed. If cortisol remains constantly elevated, Cushing's syndrome may be suspected.

"Cushing's arises from extended overproduction of cortisol, often traced to tumors or genetic conditions," says Dr. Travis McKenzie, Mayo Clinic endocrine surgeon. "But not all cortisol imbalances indicate Cushing's."

Pinpointing the difference requires thorough medical investigation. Common Cushing's symptoms including unexplained weight gain, thinning skin, abdominal fat accumulation, severe fatigue, muscle weakness, easy bruising, facial rounding, and distinctive purple stretch marks can also stem from other causes. Self-diagnosis is often inaccurate.

"Many symptoms of cortisol excess overlap with other medical issues," cautions Dr. McKenzie. "Diagnosing Cushing's requires blood, urine, and saliva tests administered by an endocrinologist."

For patients like Amy Schumer struggling with Cushing's, locating the underlying source of excess cortisol enables proper treatment. Tumors on the pituitary or adrenal glands provoking overproduction must be precisely located, usually via MRI scan, then surgically removed if noncancerous. Oral medications may help inhibit cortisol synthesis in other cases. Lifestyle adjustments also assist managing symptoms.

Endocrinologists emphasize that even garden variety stress can push cortisol too high for too long, disrupting hormone equilibrium. Sleep deprivation, poor diet, lack of exercise, and excess caffeine intake are common culprits. Anxiety, depression, work burnout, and relationship conflicts can also keep us in a constant state of stress.

"Modern life chronic stressors often leave cortisol flowing nonstop," notes endocrinologist Dr. Angela Chen. "This can seriously impact metabolism, blood sugar regulation, libido, fertility, stamina, immunity and cognitive function."

To counteract, Dr. Chen advises stress-fighting techniques like sufficient sleep, regular exercise, mindfulness meditation, therapy, and spending time outdoors.

For those currently battling stress-related health issues, endocrinologists recommend getting cortisol levels tested by an endocrinology specialist. Look for endocrine clinics associated with academic medical centers for state-of-the-art diagnosis and treatment.

"Don't try quick fixes like over the counter adrenal supplements that can do more harm than good," Dr. McKenzie cautions. "Work with a credentialed endocrinologist to accurately diagnose and properly treat any cortisol imbalance."

With cortisol research still evolving, some gray areas persist. But endocrinologists are actively investigating key questions like: Do certain groups face increased cortisol-related risks? How early can hormone imbalances be detected? And what new treatment innovations are on the horizon?

"We've made huge strides understanding cortisol's impact on health and disease risk, but more discoveries lie ahead," says Dr. Chen. "Patients dealing with unexplained symptoms shouldn't lose hope. Help is available."

Amy Schumer's high-profile Cushing's announcement has accelerated public awareness of the condition. Extensive media coverage has prompted many experiencing possible symptoms to seek medical advice. While Schumer's candid revelation has raised concerns for some, experts believe it will ultimately empower more people to take control of their health.

"This heightened awareness is a good thing," asserts Dr. McKenzie. "It enables earlier screening, accurate diagnosis and better outcomes. We encourage anyone with questions around cortisol balance to work with their doctor. Relief from the effects of excess cortisol is possible with proper treatment."

In weighing Cushing's costs, experts also underline associated strength and resilience benefits. "Finding solutions requires fortitude and self-care," notes Dr. Yogi-Morren. "But patients can tap inner reserves to not just survive but thrive. With cortisol properly balanced, vitality returns."

While Cushing's syndrome and cortisol imbalances raise complex health questions, endocrinologists emphasize cause for hope, not fear. Accurate diagnosis and tailored treatment can curb symptoms, reduce disease risks and help patients regain their best health - as comedian Amy Schumer boldly aims to do by countering cortisol's effects one laugh at a time.

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