Cushings Syndrome

Overview

Definition

Cushing syndrome is too much of a hormone called cortisol in the blood. In normal doses, this hormone helps the body manage stress and infection. High levels over a long period of time can cause health problems.

Causes

High levels of this hormone may be caused by:

  • Long-term use of corticosteroid hormones, such as cortisone or prednisone
  • Excess production of cortisol from a:
    • Tumor or abnormality of the adrenal gland
    • Tumor or abnormality of the pituitary gland. A person with a pituitary tumor has Cushing disease.
    • Tumors of the lung , thyroid , kidney , pancreas , or thymus gland (rare)
Pituitary and Adrenal Glands
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Risk Factors

This problem is more common in people who use corticosteroids to treat problems, such as:

  • Lupus
  • Rheumatoid arthritis

SymptomsandDiagnosis

Symptoms

Problems may be:

  • Weight gain in the upper body and trunk
  • Rounded face
  • Severe fatigue or muscle weakness
  • Easily bruised, thin skin
  • Purple stretch marks
  • Excess hair growth or acne in women
  • Menstrual problems, especially irregular or absent periods
  • Low fertility and interest in sex
  • Personality changes or mood swings

Diagnosis

The doctor will ask about your symptoms and health history. A physical exam will be done.

Blood tests, urine tests, and saliva tests to check a person's levels of cortisol.

Images may be taken to look at the pituitary and adrenal glands, and other internal structures. This may be done with:

  • MRI scan
  • CT scan
  • Chest x-ray
  • Bone density test

Treatments

Treatment

Treatment of Cushing syndrome depends on the cause. Options are:

  • Stopping or changing corticosteroids
  • Surgical removal of a tumor
  • Surgical removal of part, all, or both adrenal glands
  • Radiation therapy to treat lasting tumors
  • Drugs that decrease the amount of cortisol the body makes or block the way other adrenal products work

Prevention

The risk of this problem may be lowered by limiting long-term corticosteroid use.

This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.

Edits to original content made by Denver Health.

a (Cushing Disease; Hypercortisolism)

RESOURCES

Cushing's Support and Research Foundation http://www.CSRF.net 

Family Doctor—American Academy of Family Physicians http://familydoctor.org 

CANADIAN RESOURCES

The College of Family Physicians of Canada http://www.cfpc.ca 

Health Canada https://www.canada.ca 

References

Cushing disease. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/cushing-disease. Accessed October 22, 2020.

Cushing's syndrome. National Institute of Diabetes and Digestive and Kidney Disorders website. Available at: http://www.niddk.nih.gov/health-information/health-topics/endocrine/cushings-syndrome/Pages/fact-sheet.aspx. Accessed October 22, 2020.

Nieman LK, Biller BM, et al. Treatment of Cushing's Syndrome: An Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab. 2015 Aug;100(8):2807-2831.