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Warning-sign checks

Cushing disease: when to get help

Go through these in order and stop at the first one that applies. If you are reading this for someone else, answer for them.

  1. 1

    Is any of this happening now?

    Call 911

    These need timely assessment but are not always emergencies.

    Seek urgent or emergency help for:

    • Fainting, confusion, severe weakness, or inability to stay awake
    • Repeated vomiting or severe diarrhea when you rely on cortisol replacement
    • Severe dehydration or symptoms of very low blood pressure
    • Chest pain, sudden shortness of breath, or coughing up blood
    • Sudden one-sided weakness, facial drooping, or difficulty speaking
    • A severe infection with rapid worsening
    • Thoughts of suicide or immediate risk of self-harm

    These symptoms may indicate adrenal crisis, a blood clot, stroke, severe infection, or another serious complication.

    Other emergency signs, for anyone
    • Someone who is struggling to breathe, gasping, choking, or cannot get words out
    • Someone who has chest pain, tightness or pressure lasting more than a few minutes
    • Someone who has sudden weakness or drooping on one side of the face or body, slurred speech, or sudden confusion
    • Someone who is unconscious, or cannot be woken
    • Someone who is bleeding heavily and it will not stop with firm pressure
    • Someone who has had a seizure that will not stop, or does not wake up afterwards
    • Someone who has lips or skin that look pale, blue, grey or blotchy
    • Someone who you believe has taken an overdose or swallowed something poisonous
  2. 2

    Does any of this apply?

    Book an appointment

    Arrange a routine appointment if you develop a combination of progressive features such as easy bruising, wide purple stretch marks, increasing weakness, unexplained weight gain around the abdomen and face, irregular periods, or newly difficult-to-control blood pressure or blood sugar.

The article also says

After treatment, contact your care team for possible signs of high cortisol, worsening headaches, vision changes, or symptoms of low cortisol such as persistent nausea, unusual weakness, dizziness, or loss of appetite.

Every sign above is quoted from the sofidex article on Cushing disease. If you are not sure, err upward — it is always reasonable to be checked.