According to Hershel Raff, Ph.D, a professor of medicine at the Medical College of Wisconsin, Cushing syndrome is one of the most difficult diseases to diagnose.
Raff maintains that by using a simple test, the late-night salivary cortisol test, which was created decades ago, a correct Cushing diagnosis can be acquired 95% of the time. The test has gained greater traction over the past 20 years, and is considered to be one of the most sensitive of diagnostic testing. You can watch a video about it here.According to Raff, the level of cortisol in a person’s saliva should be low when tested at night, and if it isn’t, there is a 95% probability of a Cushing diagnosis. Cushing’s syndrome occurs when too much cortisol is produced by the adrenal glands. If the salivary cortisol is not elevated at night, there is a 95% chance the patient doesn’t have Cushing’s. There are two other tests that are used, however. Twenty-four-hour urine free cortisol, and low-dose dexamethasone suppression. If any of these tests is abnormal, patients are generally referred to an endocrinologist.
Treatment is essential for people with Cushing’s syndrome. If left untreated, complications may include type 2 diabetes, bone loss (leading to fractures), and high blood pressure.