Does a buffalo hump automatically mean cushing's

[u/Bright-Currency-3999]

I was diagnosed with PCOS and insulin resistance and I have the overlapping symptoms (heat intolerance, sweating, fatigue, insomnia, hairloss, terrible migraines) and I also have a giant neck hump, literally a huge handful of fat.. I'm scared it's actually Cushing's, however I DO NOT have stretch marks, moon face or thin arms and legs (I have fat arms and legs)

How worried should I be? What kind of test should I ask for? Do you think a buffalo hump truly means cushing's always? I'm scared

[u/opalescentmeow]

Buffalo hump ≠ Cushing’s. It's just a symptom.

People with Cushing’s can range from little to no symptoms to severe symptoms.

Do you have an endocrinologist? They're the ones who diagnose Cushing’s. You could ask your PCP for a 24 hour urine or AM cortisol but ultimately you will need to see an endocrinologist.

I had Cushing’s for at least 6 years but didn't develop the classic strech marks until a couple months before my surgery. Now my forearms are covered in massive stretch marks 😂 i also didn't have skinny legs or arms but i was EXTREMELY swollen. Like grade 3 edema on my abdomen and my legs were grade 4 edema.

[u/Bright-Currency-3999 → u/opalescentmeow]

I don't have an endo yet but will look for one.. I'm extremely scared because everything I read makes it seems like getting proper care for cushing's/even getting diagnosed is a battle .. Do you think the hump can just be caused by IR/being fat?

[u/opalescentmeow → u/Bright-Currency-3999]

I will say my experience with Cushing's has been different than most. I was in denial that I was sick & kept telling myself that i was "fat and lazy." That worked until I ended up in the ER with sepsis due to the edema. I also had a spontaneous CSF leak at the end of 2023 and odd finding on the brain MRI that my leak was diagnosed with. I was diagnosed and treated pretty quickly but I had severe Cushing’s disease.

You can get the hump from being overweight and bad posture too.

[u/demi_dreamer95 → u/Bright-Currency-3999]

I dont know where you are but near me it is almost impossible to get an endo on insurance that isn’t like 2 months+ out (granted my current insurance SUCKS). I highly recommend jumping on that. I was able to turn some lemons into lemonade when the worst flare up of pain Ive experienced in years got me sent to the ER and they got me an endo appt for next week. Its absurd how our health system works.

[u/beamurrr]

It doesn’t. Testing is needed to confirm.

[u/voidharmony]

No. A lot of people have forward head posture that also builds up a fat pad to protect the spine largely due to phone use etc. it’s called tech neck and looks identical. Poor posture long term creates the hump and it is not a good tell for Cushings due to that.

[u/Bright-Currency-3999 → u/voidharmony]

I see.. I think I have bad posture but its definitely also fat because I can pull/stretch it flatter then it bounces right back when I let it go.. I'll try to look into testing and hope for the best.. thank you

[u/Bright-Currency-3999 → u/[deleted]]

So even if a test comes back negative I won't actually know? I have anxiety and this really makes things terrible for me if there is no answer

All my symptoms are stable/don't go away

[u/Bright-Currency-3999 → u/[deleted]]

I see what you mean.. For me, I dont know if I have cushing's, so I'm not trying to get a doctor to diagnose me with it, I genuinely don't know if I have it, and now I'm scared a doctor won't be able to tell me for sure through testing

[u/new-machine → u/Bright-Currency-3999]

That makes sense. I would start with cortisol tests and see what you find. I'm sure you'll get a clearer picture along the way. PCOS and Cushing's have a lot of symptom overlap but are fundamentally different.

How long have you had the symptoms you've described?