Definition

Cushing 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.

Causes

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 disease
    • Rarely, tumors of the lung, thyroid, kidney, pancreas, or thymus gland.

Pituitary and Adrenal Glands

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Risk

Factors that may increase your chance of Cushing syndrome include using corticodsteroids to treat diseases, such as:

Symptoms

Cushing 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

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.

Blood tests, urine tests, and saliva tests may be done.

Imaging tests evaluate the pituitary and adrenal glands, and other internal structures. These may include:

Treatment

Treatment of Cushing syndrome depends on the cause. Talk with your doctor about the best treatment plan for you. Options include:

  • Gradual withdrawal of cortisone-type drugs under close medical supervision
  • Surgical removal of tumor
  • Surgical removal of part, all, or both adrenal glands
  • Radiation therapy for some persistent tumors
  • 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.