Cushing's Syndrome

Cushing's syndrome is a hormone disorder. Cortisol, in normal doses, helps the body manage stress and infection. However, these high levels over a long period of time can cause several health problems.

  • Causes

    Cushing's syndrome is caused by extended exposure to a hormone called cortisol. Prolonged or excess exposure to cortisol may be caused by:

    • Long-term use of corticosteroid hormones such as cortisone or prednisone

    • Excess production of cortisol by:

      • Tumor or abnormality of the adrenal gland.

      • Tumor or abnormality of the pituitary gland. In the case of a
        pituitary tumor
        ,
        it is called Cushing's disease
      • Rarely, tumors of the lungs, thyroid, kidney, pancreas, or thymus gland.
    Pituitary and Adrenal Glands
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  • Definition

    Cushing's syndrome is a hormone disorder. Cortisol, in normal doses, helps the body manage stress and infection. However, these high levels over a long period of time can cause several health problems.

  • Diagnosis

    You will be asked about your symptoms and medical history. A physical exam will be done. Tests may be done to determine the level of cortisol and find a cause.

    Tests for cortisol levels may include:

    • 24-hour urinary free cortisol level
    • Late-evening cortisol saliva/blood level
    • Dexamethasone suppression test

    Tests to determine the cause of Cushing's Syndrome may include:

    • Blood test for adrenocorticotropin hormone (ACTH) level
    • High-dose dexamethasone suppression test

    Other tests may help to see if there is a tumor on the pituitary or adrenal glands. Images may be taken with:

    • MRI scan
    • CT scan
    • Chest x-ray

  • Prevention

    Work with your doctor to keep your use of corticosteroid drugs to a minimum.

  • Risk Factors


    Factors that increase your chances of getting Cushing's syndrome include:

    • Obesity
      with poorly controlled
      type 2 diabetes
    • High blood pressure

  • Symptoms

    Symptoms may include:

    • Weight gain of the upper body and trunk
    • Rounded face
    • Severe fatigue or muscle weakness
    • Easily bruised, thinner skin
    • Purple stretch marks
    • Excess hair growth or acne in women

    • Menstrual disorders, especially infrequent or
      absent periods
    • Reduced fertility and interest in sex
    • Personality changes or mood swings

  • Treatment

    Treatment of Cushing's syndrome depends on the cause. Talk with your doctor about the best treatment plan for you. Options include:

    • Surgical removal of tumor
    • Surgical removal of part, all, or both adrenal glands
    • Radiation therapy
      for some persistent tumors
    • Gradual withdrawal of cortisone-type drugs under close medical supervision
    • Drugs that decrease cortisol production or block the functioning of other adrenal products