Cortisol, which is commonly known as “the stress hormone”, is needed for our bodies to be able to react to stressful situations and keep us safe. Many people with Cushing’s disease don’t know that they have it, and they can go undiagnosed for a long time. But untreated Cushing’s syndrome can impact your quality of life and cause uncomfortable symptoms.
If you want to learn more about Cushing’s syndrome, its causes, signs and symptoms, and treatment, just keep reading.
What is Cushing’s syndrome?
Cushing’s syndrome or Cushing’s disease happens when your body is exposed to high levels of the hormone cortisol over a long period of time. Under normal circumstances, cortisol plays an important role in many processes happening inside your body. According to the Cleveland Clinic, the functions of cortisol include:
- Increasing your heart rate, blood pressure, and muscle tension
- Managing your blood sugar and respiration
Many people have never even heard of Cushing’s syndrome, and it’s difficult to estimate exactly how many cases there are. It’s not uncommon for patients to delay seeking medical attention for a long time, even as they deal with uncomfortable symptoms in their everyday lives.
Causes of Cushing syndrome
So what causes Cushing syndrome? As the National Center for Health Research explains, Cushing’s syndrome isn’t caused by stress. According to the Mayo Clinic, high cortisol levels can happen because you’re taking oral corticosteroids, or because your body is producing too much cortisol on its own.
Cushing’s syndrome and Cushing’s disease aren’t exactly the same. According to the Oregon Health & Science University, the cause of Cushing syndrome can come from taking oral corticosteroids, or a tumor in your pituitary or adrenal glands that trigger cortisol production. Cushing’s disease can also be caused by tumors in your lungs, pancreas, thyroid, or thymus. Tumors can be benign or malignant.
But the cause of Cushing’s disease itself is more specific. Cushing’s disease is caused by a type of pituitary tumor that causes your body to produce excess quantities of cortisol. Cushing’s disease causes up to 70% of all cases of Cushing’s disease.
People who have Cushing’s disease have a pituitary adenoma, which is a benign non-cancerous tumor. But this tumor can trigger the production of adrenocorticotropic hormone (ACTH), which travels to the adrenal or suprarenal glands where it stimulates the production of cortisol. The adrenal glands are located above each kidney. Not all pituitary adenomas lead to Cushing’s disease.
Cushing’s syndrome signs and symptoms
Since the syndrome is closely related to your cortisol levels, the severity of your Cushing disease symptoms will also vary depending on how much cortisol you’re producing. According to UCLA Health, the signs of cushing syndrome can include:
- Moon face or rounding of the face
- “Buffalo hump” or accumulation of a fatty hump between your shoulders
- Easy bruising of the skin
- Excessive weight gain, especially around the abdomen
- Red cheeks or “plethora”
- Slow healing of cuts or lesions
- Purplish abdominal stretch marks
- High blood pressure that’s difficult to manage
- Diabetes mellitus
- Mood and behavior alterations
- Depression, anxiety, and/or irritability
- Cognitive difficulties
- Loss of bone density and fractures
- Skin darkening
- Impaired growth in children
Patients with Cushing’s disease who have large pituitary adenomas can develop additional symptoms, including:
- Vision loss
- Inability to perceive colors correctly
- Blurry vision
Cushing’s syndrome in men
In addition to the symptoms mentioned above, men with Cushing syndrome can also experience these signs:
Cushing’s syndrome in women
In addition to the symptoms mentioned above, women with Cushing syndrome can also experience these signs:
- Irregular or absent periods (this could also be a sign of STDs, which you can rule out using an at-home STD test)
- Thicker, more visible facial and body hair or hirsutism
- Decreased breast milk production
Cushing’s syndrome prevention
Unfortunately, you can’t prevent the formation of a tumor that leads to Cushing’s syndrome or Cushing’s disease.
If you have a different health condition that requires prolonged treatment with oral corticosteroids, you may want to discuss the risk of Cushing’s syndrome. In most cases, taking oral corticosteroids as prescribed by your physician won’t lead to any health complications, but it’s very important to follow their recommendations.
How to diagnose Cushing’s syndrome
So how can we test for Cushing’s disease? If you’re taking oral corticosteroids and develop signs of high cortisol, your doctor could suspect Cushing syndrome right away. Diagnosing a pituitary tumor can be trickier, since its symptoms are largely nonspecific and it’s a rare condition.
According to the NHS, different Cushing disease tests can be used to measure your cortisol. Cortisol can be measured in your:
Treatment will depend on the cause of the issue. If you have Cushing’s syndrome caused by taking oral corticosteroids, your dosage will be reduced gradually or stopped. But if you have a tumor causing the disease, surgery or radiotherapy may be necessary to remove it. You could also need to take medications to reduce the effects that cortisol has on your body.
Cushing’s Syndrome: A Tale of Frequent Misdiagnosis - center4research.org
Cushing syndrome - mayoclinic.org
Cushing’s Syndrome - my.clevelandclinic.org
Cushing Disease / Cushing Syndrome - ohsu.edu
Cushing’s Disease - pituitary.ucla.edu
Cushing’s syndrome - nhs.uk