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.

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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Risk Factors

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

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

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:

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

Prevention

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