#519 Mild Autonomous Cortisol Secretion

#519 Mild Autonomous Cortisol Secretion

Author: The Curbsiders Internal Medicine Podcast March 30, 2026 Duration: 1:13:57

Become a master of cortisol and learn how to identify and treat a common condition in patients with adrenal tumors! Join us as we learn about mild autonomous cortisol secretion (MACS) with Dr. Irina Bancos (@irinabancos), an internationally renowned adrenal expert!

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Show Segments

  • Intro
  • Advice for listeners
  • Adrenal incidentaloma Definition (Case 1)
  • Hormonal workup for adrenal incidentalomas
  • Defining mild autonomous cortisol secretion (MACS)
  • Significance and prevalence of MACS
  • Diagnostic testing for MACS
  • Treatment options for MACS (surgery vs. comorbidity management)
  • Post surgical management of MACS (Case 2)
  • Diagnostic testing for adrenal insufficiency (AI)
  • Glucocorticoid withdrawal syndrome management
  • Deciding when patients are able to come off of steroids after AI
  • Outcomes after adrenalectomy in MACS
  • Take home points


Credits

Written and produced by Paul Wurtz MD. Show notes, cover art, and infographic also created by Paul Wurtz MD.

  • Producer, writer, show notes, and CME: Mobeen Ahmad MD
  • Cover art and infographic: Kate Grant MBChb, MRCGP
  • Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP; Mobeen Ahmad MD
  • Reviewer: Emi Okamoto MD
  • Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP
  • Technical Production: PodPaste
  • Guest: Irina Bancos MD, MSc

Disclosures

Dr. Bancos has the following disclosures:
  • Consulting, advisory board or safety monitoring board (all fees to institution): Recordati, Corcept, Esteve, Spruce, Sparrow, Diurnal, Neurocrine, Lufordi, Adaptyx, Crinetics, Xeris, AstraZeneca, NovoNordisc, Camurus.
  • Research grant for investigator initiated research (to institution): Esteve, Recordati


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Tune in to The Curbsiders Internal Medicine Podcast for a direct line to practical clinical knowledge and the ever-evolving art of patient care. This isn't a dry lecture series; it's a dynamic conversation among practicing physicians who break down complex topics into actionable insights you can use. Each episode delves into the nuances of internal medicine, from managing common chronic conditions to interpreting the latest guidelines and navigating diagnostic dilemmas. You'll hear honest discussions about challenges at the bedside, evidence-based debates, and expert interviews that go beyond textbook summaries to reveal how medicine works in the real world. The podcast serves as both a continuing education resource and a professional companion, offering thoughtful analysis and clinical pearls that resonate whether you're a seasoned hospitalist, a resident in training, or a primary care provider. The focus is consistently on deepening understanding and improving daily practice, making the rounds or the clinic day feel a little less daunting and a lot more informed. Listen for a blend of curiosity, camaraderie, and a genuine commitment to mastering the craft of medicine, all delivered through engaging dialogue that feels like consulting with a trusted colleague.
Author: Language: English Episodes: 100

The Curbsiders Internal Medicine Podcast
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