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
- Muscle weakness
- Glucose intolerance
- Bone loss
- High blood pressure
- Cognitive dysfunction
- Anxiety and irritability
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?