(Cushing's Disease; Hypercortisolism)
Cushing's syndrome is a hormone disorder. Cortisol, in normal doses, helps the body manage stress and infection. However, high levels over a long period of time can cause several health problems.
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
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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Factors that may increase your chance of Cushing's syndrome include:
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
- 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:
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
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
Work with your doctor to keep your use of corticosteroid drugs to a minimum.
Cushing's Support and Research Foundation
Family Doctor—American Academy of Family Physicians
The College of Family Physicians of Canada
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- Reviewer: EBSCO Medical Review Board
Kim Carmichael, MD
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