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 lung, thyroid, kidney, pancreas, or thymus gland.
|Pituitary and Adrenal Glands|
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Cushing's syndrome may cause:
- 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
- Bone loss—osteoporosis
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
Imaging tests evaluate the pituitary and adrenal glands, and other internal structures. These may include:
- MRI scan
- CT scan
- Chest x-ray
- Bone density test
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
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.
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a (Cushing's Disease; Hypercortisolism)
Cushing's Support and Research Foundation http://www.CSRF.net
Family Doctor—American Academy of Family Physicians http://familydoctor.org
Health Canada http://www.hc-sc.gc.ca
The College of Family Physicians of Canada http://www.cfpc.ca
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