What is Cushing’s syndrome?
Cushing’s syndrome occurs due to abnormally high levels of
the hormone cortisol. This can happen for a variety of reasons. The most common
cause is overuse of corticosteroid medications.
Your doctor may recommend several different diagnostic tests
and treatments. In most cases, medication can help you manage your cortisol
Cushing’s syndrome is also known as Cushing syndrome or
are the symptoms of Cushing’s syndrome?
The most common symptoms of this condition are:
deposits, especially in the midsection, the face (causing a round, moon-shaped
face) and between the shoulders and the upper back (causing a buffalo hump)
stretch marks on the breasts, arms, abdomen, and thighs
skin that bruises easily
injuries that are slow to heal
increased incidence of infections
Women may also notice extra facial and body hair, as well as
absent or irregular menstruation.
Men may also have:
loss of sexual interest
Children with this condition are generally obese and have a slower rate of
are the causes of Cushing’s syndrome?
Your adrenal glands produce cortisol. It helps with a number of your body’s
blood pressure and the cardiovascular system
the immune system’s inflammatory response
carbohydrates, fats, and proteins into energy
the effects of insulin
Your body may produce high levels of cortisol for a variety of reasons,
stress levels, including stress related to an acute illness, surgery, injury,
or pregnancy, especially in the final trimester
panic disorders, or high levels of emotional stress
The most common cause of Cushing’s syndrome is the use of corticosteroid
medications, such as prednisone, in high doses for a long period. Doctors can prescribe
these medications to prevent rejection of a transplanted organ. They also use
them to treat inflammatory diseases, such as lupus and arthritis. High doses of
injectable steroids for treatment of back pain can also cause this syndrome.
Lower dose steroids in the form of inhalants, such as those used for asthma,
or creams, such as those prescribed for eczema, usually aren’t enough to cause
Other causes include:
pituitary gland tumor in which the pituitary gland releases too much
adrenocorticotropic hormone, which is also known as Cushing’s disease
ACTH syndrome, which causes tumors that usually occur in the lung, pancreas,
thyroid, or thymus gland
adrenal gland abnormality or tumor
Familial Cushing’s syndrome is another possible cause.
Cushing’s syndrome isn’t typically inherited, but it’s possible to have an
inherited tendency to develop tumors of the endocrine glands.
is Cushing’s syndrome diagnosed?
Cushing’s syndrome can have many different causes. The diagnosis is made
based on abnormal cortisol levels in the body. Your doctor will perform a
physical examination and review your medical history and symptoms. They may
also order laboratory tests, including:
24-hour urinary free cortisol test
plasma cortisol and late-night salivary cortisol measurements
low-dose dexamethasone suppression test
After you receive the diagnosis of this condition, your doctor still must
determine the cause of the excess cortisol production. Tests to help determine
the cause may include a corticotropin-releasing hormone stimulation test and a high-dose
dexamethasone suppression test. They may also order imaging studies, such as CT
and MRI scans.
is Cushing’s syndrome treated?
Treatment will depend on the cause. Your doctor may
prescribe a medication to help. Some medications decrease cortisol production
in the adrenal glands or decrease ACTH production in the pituitary gland. Other
medications block the effect of cortisol on your tissues.
If you use corticosteroids, a change in medication or dosage
may be necessary. Don’t attempt to change the dosage yourself. You should do
this under close medical supervision.
Tumors can be malignant, which means cancerous, or benign,
which means noncancerous. Surgical removal may be necessary. Your doctor may
also recommend radiation therapy or chemotherapy.
are possible complications?
If you don’t get treatment for it, Cushing’s syndrome can lead to:
loss and weakness
- enlargement of a pituitary
- kidney stones
Cushing’s syndrome due to pituitary tumors can interfere with the production
of other hormones.
The sooner you begin treatment, the better the expected outcome. It’s important
to note that your individual outlook depends on the specific cause and
treatment you receive.
It may take a long time for your symptoms to improve. Be sure to ask your
doctor for healthy dietary guidelines, keep follow-up appointments, and
increase your activity level slowly.
Support groups can help people cope with Cushing’s syndrome. Your local
hospital or doctor can provide you with information about groups that meet in