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Disease & Condition

Cushing Syndrome

Cushing syndrome occurs when your body is exposed to high levels of the hormone cortisol for a long time. The most common cause of Cushing syndrome, sometimes called hypercortisolism, is the use of oral corticosteroid medication. The condition can also occur when your body makes too much cortisol.

Symptoms

The signs and symptoms of Cushing syndrome vary.

Common signs and symptoms involve progressive obesity and skin changes, such as:

  • Weight gain and fatty tissue deposits, particularly around the midsection and upper back, in the face (moon face), and between the shoulders (buffalo hump)
  • Pink or purple stretch marks (striae) on the skin of the abdomen, thighs, breasts and arms
  • Thinning, fragile skin that bruises easily
  • Slow healing of cuts, insect bites and infections
  • Acne

Women with Cushing syndrome may experience:

  • Thicker or more visible body and facial hair (hirsutism)
  • Irregular or absent menstrual periods

Men with Cushing syndrome may experience:

  • Decreased libido
  • Decreased fertility
  • Erectile dysfunction

Other signs and symptoms include:

  • Fatigue
  • Muscle weakness
  • Depression, anxiety and irritability
  • Loss of emotional control
  • Cognitive difficulties
  • New or worsened high blood pressure
  • Glucose intolerance that may lead to diabetes
  • Headache
  • Bone loss, leading to fractures over time

When to see a doctor

If you’re taking corticosteroid medications to treat a condition, such as asthma, arthritis or inflammatory bowel disease, and experience signs and symptoms that may indicate Cushing syndrome, see your doctor for an evaluation. Even if you’re not using these drugs and you have symptoms that suggest the possible presence of Cushing syndrome, contact your doctor.

Causes

Cushing syndrome results from excess levels of the hormone cortisol in your body. Your endocrine system consists of glands that produce hormones that regulate processes throughout your body. These glands include the adrenal glands, pituitary gland, thyroid gland, parathyroid glands, pancreas, ovaries (in females) and testicles (in men)..

Your body’s own overproduction

The condition may also be due to your body’s own overproduction of cortisol (endogenous Cushing syndrome). This may occur from excess production by one or both adrenal glands, or overproduction of the adrenocorticotropic hormone (ACTH), which normally regulates cortisol production. In these cases, Cushing syndrome may be related to:

  • A pituitary gland tumor (pituitary adenoma).
  • An ectopic ACTH-secreting tumor. .
  • A primary adrenal gland disease.
  • Familial Cushing syndrome.

Complications

If you don’t receive prompt treatment for Cushing syndrome, other complications may occur, such as:

  • Bone loss (osteoporosis), which can result in unusual bone fractures, such as rib fractures and fractures of the bones in the feet
  • High blood pressure (hypertension)
  • Diabetes
  • Frequent or unusual infections
  • Loss of muscle mass and strength

When the cause of Cushing syndrome is a pituitary tumor (Cushing disease), it can sometimes lead to other problems, such as interfering with the production of other hormones controlled by the pituitary.

Tests and diagnosis

Cushing syndrome can be difficult to diagnose, particularly endogenous Cushing syndrome, because other conditions share the same signs and symptoms.

Your doctor will conduct a physical exam, looking for signs of Cushing syndrome. He or she may suspect Cushing syndrome if you have signs such as rounding of the face (moon face), a pad of fatty tissue between the shoulders and neck (buffalo hump), and thin skin with bruises and stretch marks.

If you’ve been taking a corticosteroid medication for a long time, your doctor may suspect that you’ve developed Cushing syndrome as a result of this medication. If you haven’t been using a corticosteroid medication, these diagnostic tests may help pinpoint the cause:

  • Urine and blood tests.
  • Saliva test.
  • Imaging tests.

Treatments and drugs

Treatments for Cushing syndrome are designed to lower the high level of cortisol in your body. The best treatment for you depends on the cause of the syndrome. Treatment options include:

  • Reducing corticosteroid use.
  • Radiation therapy
  • Medications

Lifestyle and home remedies

The length of your recovery from Cushing syndrome will depend on the severity and cause of your condition. Remember to be patient. You didn’t develop Cushing syndrome overnight, and your symptoms won’t disappear overnight either. In the meantime, these tips may help you on your journey back to health.

  • Increase activities slowly.
  • Eat sensibly.
  • Monitor your mental health.
  • Gently soothe aches and pains.
  • Exercise your brain.

 

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