New scientist profile: Dr. Luciana Martel-Duguech leading innovation in the science and care of cortisol disorders

Dr. Luciana Martel-Duguech’s fascination with the endocrine system (the human body’s network of glands that produce and release hormones) began in medical school in Argentina. The complex nature of the system was a challenge, one that changed how she saw her future in health care: hormones are difficult to understand, often leading to their role being dismissed or misidentified. “Even in the medical field, it’s very hard to really grasp what hormones do and how delicate and fine-tuned the system is,” says Dr. Martel-Duguech. “It does everything silently and invisibly, which is why it’s easy to overlook when diagnosing.”

Her passion sharpened as she continuing her training, encountering patients whose hormonal imbalances manifested in striking physical ways. Simply seeing a patient was sometimes enough for her to begin connecting the dots between an internal dysfunction and external symptoms, sparking her interest in cortisol, the body’s stress hormone, and her chosen area of expertise. Cortisol, she says, is “the one hormone that you cannot live without for even one day.” 

Yet disorders like Cushing’s disease (chronic cortisol excess due to a tumor in the pituitary gland, which causes the body to produce excess cortisol) remain poorly understood and often misdiagnosed. Unlike normal stress, patients with these disorders cannot switch off being exposed to the stress hormone. Their muscles waste away, their bones fracture, they suffer from depression, psychosis, diabetes and cardiovascular disease. And most of them are women. 

This gender disparity — women are five to eight times more likely to develop Cushing’s disease— drives Dr. Martel-Duguech’s research. “We still don’t know why. That’s what I want to figure out,” she says. Her mission is twofold: to uncover the risk factors for this disorder and to speed up diagnosis, which can often be delayed by years of complicated and inconclusive testing. 

Since joining the Ottawa Hospital Research Institute as an Associate Scientist with the Inflammation and Chronic Disease Program, the University of Ottawa as an assistant professor and the Ottawa Hospital as an endocrinologist, Dr. Martel-Duguech has launched a comprehensive research program focused on improving diagnosis and care for patients with cortisol-related diseases. She has already uncovered new insights into muscle dysfunction and quality of life in patients with Cushing’s and acromegaly and has published extensively on the long-term impacts of hormonal disorders. She’s also advocating for systemic change: “If we’re going to lead research that can influence how these patients are treated across Canada, or even globally, then we must be ready to deliver the best care possible.”