What is Cushing syndrome?

Cushing syndrome (also known as hypercortisolism; not be confused with it’s sub-form Cushing disease) is an endocrine disorder characterized by excessive cortisol levels in the blood.

The hallmark signs of Cushing syndrome include a fatty hump between your shoulders, a rounded face, and pink or purple stretch marks on your skin.

What are the symptoms of Cushing syndrome?

  • Weight gain/obesity
  • Fatty deposits, especially in the midsection, the face (causing a round, moon-shaped face) and between the shoulders and the upper back
  • Purple stretch marks on the breasts, arms, abdomen, and thighs
  • Thinning skin that bruises easily
  • Acne
  • Fatigue
  • Muscle weakness
  • Glucose intolerance
  • Bone loss
  • High blood pressure
  • Cognitive dysfunction
  • Anxiety and irritability
  • Depression

Women may experience:

  • Extra facial and body hair
  • Absent or irregular menstruation

Men may experience:

  • Erectile dysfunction
  • Reduced libido
  • Decreased fertility

What causes Cushing syndrome?

The two most common causes of Cushing syndrome are the use of oral corticosteroid medication and the body’s overproduction of cortisol.

Other causes include:

  • A pituitary gland tumor in which the pituitary gland releases too much adrenocorticotropic hormone, which is also known as Cushing’s disease
  • Ectopic ACTH syndrome, which causes tumors that usually occur in the lung, pancreas, thyroid, or thymus gland
  • An adrenal gland abnormality or tumor

How is Cushing syndrome diagnosed?

A diagnosis is made based on abnormal cortisol levels in the body. Doctors will perform a physical and review medical history and symptoms. Further steps to confirm diagnosis include:

  • 24-hour urinary free cortisol test
  • Midnight plasma cortisol and late-night salivary cortisol measurements
  • Low-dose dexamethasone suppression test
  • Corticotropin-releasing hormone stimulation test
  • High-dose dexamethasone suppression test
  • Imaging exams

What are the treatments for Cushing syndrome?

The only way to treat Cushing disease long term is by transsphenoidal removal (surgery) of the adenoma.

Other alternative treatments include:

  • Adrenal-directed medications ketoconazole, aminoglutethemide, and metyrapone, to help control cortisol levels
  • Radio therapy

Where can I find out more about Cushing syndrome?


Cushing Syndrome Articles