Microscopic image of an adrenal cortical adenoma, a benign tumor of the adrenal gland

‘I was going crazy’: Woman’s mystery symptoms lead to startling diagnosis

Angela Yawn’s list of strange symptoms increased over six years. She felt like she was growing crazy over these seemingly unrelated effects. For instance, she began to gain weight, 115 pounds over six years, despite limiting her food intake. Her skin became fragile, tearing easily and healing bruises took months. Her face would suddenly become red and hot, like a severe sunburn. Headaches and joint swelling became regular. Her hair fell out. She felt anxious, tired, and depressed.

Plus, her heart raced. “I would put my hand on my chest because it made me feel like that’s what I needed to do to hold my heart in,” said Yawn, 49. “I noticed it during the day, but at night when I was trying to lie down and sleep, it was worse because I could do nothing but hear it beat, feel it thump.”

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Image credit: Angela Yawn via TODAY

“The Last Hope

All of her symptoms were frustrating, but the weight gain bothered her the most. At one point, she was eating only 600 calories in a day, mostly in lettuce leaves. Regardless, she gained about two pounds a day. When she consulted a doctor, she was told to exercise more. The weight gain took a toll on her confidence. “I stayed away from cameras as I felt horrible about myself.”

During this period, she went to about a dozen doctors. She received treatment for high blood pressure and congestive heart failure but nothing seemed to work. Finally, as a last resort, she saw an endocrinologist in February 2021 and sobbed during the appointment. 

“That was the last hope I had of just not lying down and dying because, at that point, that’s what I wanted to do,” Yawn said to TODAY. “I thought the problem was me… that I’m making up these issues, that maybe I’m bipolar. I was going crazy.” [1]

However, Yawn was in for a surprise. Without prompting, the endocrinologist began to list all of her symptoms. Yawn underwent an MRI and blood tests and confirmed what the doctor suspected: a tumor in the pituitary gland, the small organ at the base of the brain. The tumor made the gland release too much adrenocorticotropic hormone. This makes the body high in cortisol, a steroid hormone that releases during stressful or dangerous situations. When it’s flooding the body like this on a regular basis, it causes many harmful side effects. The official diagnosis is called Cushing disease. 

Read: Infant born with rare skin condition becomes miracle to parents

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What is Cushing’s Disease?

In Yawn’s case, she was receiving six times the amount of cortisol she needed, according to Dr. Nelson Oyesiku, chair of neurosurgery at UNC Health in Chapel Hill, North Carolina. Oyesiku successfully removed the tumor in fall 2021. “That’s a trailer load of cortisol. Day in, day out, morning, noon, and night, whether you need it or not, your body just keeps making this excess cortisol. It can wreak havoc in the body physiology and metabolism,” Oyesiku said. 

Cortisol regulates blood pressure and heart rate, as well as how fat is burned and stored in the body. Therefore, common symptoms of Cushing’s syndrome include weight gain, purple stretch marks and thinning of the skin, acne, fatigue, and muscle weakness. Complications can include headaches, infections, osteoporosis, high blood pressure, diabetes, depression, and memory loss. [2]

Cushing’s disease is very rare, with about five people per million cases every year. This leads to patients going undiagnosed for years. Many doctors will never come across such a case, leading to patients getting treated for common issues like high blood pressure and diabetes. While Cushing’s disease and Cushing’s syndrome are caused by an excess of cortisol, Cushing’s syndrome is when high cortisol comes from within the body or externally, like medications. Cushing’s disease comes from a tumor, like in Yawn’s case, and makes up about 70% of cases of Cushing syndrome. [3]

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“I am definitely moving in the right direction”

For now, Yawn is making a great recovery after her surgery. She has lost about 41 pounds so far and her hair has stopped falling out. However, other patients need months or even years for their cortisol levels to return to normal. “It takes some time to unwind the effects of chronic exposure to steroids, so your body has to adapt to the new world order as the effects of the steroids recede,” Oyesiku said. 

Yawn had to use steroid supplements after surgery because her body was used to high cortisol levels. She described it as an addict going through withdrawal. Next, she has to finish another round of supplements before slowly tapering off as her body learns to function with normal cortisol levels. “I am definitely moving in the right direction,” she said. “I hope that I’ll get back to that woman I used to be — in mind, body, and spirit.”

Keep Reading: ‘My Daughter’s Rare Disease Was A Mystery For Years. Here’s How We Finally Got A Diagnosis’

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Sources:

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  1. “Cushing Disease / Cushing Syndrome.” OHSU
  2. A. Pawlowski. “Woman’s mystery symptoms lead to startling diagnosis and a tiny tumor.” Today. April 27, 2022
  3. April Kahn. “Cushing Syndrome: Everything You Need to Know.” Healthline. March 17, 2022
Sarah Biren
Freelance Writer
Sarah is a baker, cook, author, and blogger living in Toronto. She believes that food is the best method of healing and a classic way of bringing people together. In her spare time, Sarah does yoga, reads cookbooks, writes stories, and finds ways to make any type of food in her blender.
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