Cushing’s syndrome is a hormonal disorder caused by prolonged exposure to high levels of cortisol, a hormone produced by the adrenal glands. Cortisol helps regulate blood pressure, metabolism, and the body’s stress response, but too much of it can lead to serious health problems.
Cushing’s syndrome can be caused by the body making too much cortisol or by taking corticosteroid medications (like prednisone) for a long time.
Causes of Cushing’s Syndrome
- Long-term use of corticosteroid medications (most common cause)
- Pituitary tumor (Cushing’s disease) that increases ACTH and cortisol
- Adrenal tumors that directly produce excess cortisol
- Ectopic ACTH-producing tumors (often in the lungs or pancreas)
Symptoms of Cushing’s Syndrome
- Weight gain, especially in the face, upper back, and abdomen
- “Moon face” – rounded, puffy face
- “Buffalo hump” – fat pad on the upper back
- Thin arms and legs with muscle weakness
- Purple or pink stretch marks on the skin
- Thinning skin that bruises easily
- Acne or oily skin
- Slow healing of cuts or infections
- Fatigue and mood changes (anxiety, depression)
- High blood pressure
- High blood sugar or diabetes
- Irregular periods or infertility in women
- Reduced libido or erectile dysfunction in men
- Osteoporosis (weakened bones)
Diagnosis
- 24-hour urine cortisol test
- Late-night salivary cortisol test
- Low-dose dexamethasone suppression test (DST)
- Blood ACTH levels
- Imaging tests (CT or MRI scans) to look for tumors in the pituitary or adrenal glands
Treatment
Treatment depends on the cause of excess cortisol:
- Tapering or stopping steroid medications (under medical guidance)
- Surgery to remove a pituitary or adrenal tumor
- Radiation therapy if surgery isn’t possible or didn’t work
- Medications to block cortisol production or reduce ACTH levels
- Managing complications like diabetes, hypertension, or bone loss