Cushing syndrome is a group of symptoms when your body produces too much cortisol. It’s caused by either an overactive adrenal gland (pituitary gland) or by taking corticosteroids, which are medications that mimic cortisol. Cushing syndrome can lead to severe health issues if not diagnosed and treated early enough.
Common signs and symptoms of Cushing syndrome
- Weight gain.
- Increased fat around the waist.
- Thin arms and legs.
- Round face.
- Darkening of the skin on your upper back, neck, armpits, and areas under your eyes (called “acromegaly”). This can make it hard to see if you have dark skin; ask someone else to look for signs of acromegaly if you’re concerned about it yourself!
Signs and symptoms women with Cushing syndrome may experience
Signs and symptoms of Cushing syndrome vary from person to person. Some people have only a few symptoms, while others have many. The most common signs and symptoms are:
- Weight gain (especially around the waist)
- Fatigue or tiredness
- Irritability, agitation, and anxiety
- Depression or mood swings
- Sleep disturbances such as insomnia or excessive daytime sleepiness
- Increased appetite with overeating; cravings for sweet foods like chocolate; increased thirst; urination at night
Muscle weakness that may cause you to feel unsteady when walking; joint pain (arthralgia) in your hands and feet
Hair growth on the face and body (hirsutism) in women who don’t normally have facial hair growth
Signs and symptoms men with Cushing syndrome may experience
- Weight gain.
- Muscle weakness.
- Sleep problems, such as insomnia or excessive daytime sleepiness.
- Depression and mood swings are common in people with Cushing syndrome because of the excess cortisol in their bodies, which can also lead to anxiety or panic attacks if left untreated for too long.
- Hair loss on the scalp or body (including facial hair) is often noticed first by women who notice thinning underarm hair while shaving; men may notice this around their temples and thinning pubic hair on their genitals (if they have enough left!). This is usually reversible once treatment begins but may take several months before regrowth occurs.
Elevated levels of the hormone cortisol in your body cause Cushing syndrome. A tumor can cause it on the pituitary gland that secretes excess amounts of adrenocorticotropic hormone (ACTH), leading to increased production of cortisol.
Other causes include adrenal gland tumors or adrenal gland hyperplasia. Some medications can also cause Cushing syndromes, such as prednisone and other corticosteroids.
The role of corticosteroid medications (exogenous Cushing syndrome)
The overuse of corticosteroid medications causes exogenous Cushing syndrome. It can be caused by taking more than the recommended dose or taking them longer than recommended. For example, if you’re prescribed prednisone to treat asthma and take it every day instead of just on days when your symptoms are bad, this could lead to exogenous Cushing syndrome. Steroids like prednisone are not meant to be taken long-term; they’re only meant as short-term solutions until your body heals itself naturally (or with other treatments).
So what happens when we take too many steroids? Well, over time, our bodies become desensitized to their effects–meaning that we need more and more steroids for their work properly. Eventually, this leads to full-blown Cushing syndrome: too much cortisol circulating through our systems causes unpleasant side effects like weight gain around our waistline (the “buffalo hump”), high blood pressure, and headaches.
Symptoms usually develop slowly over time, so early diagnosis is key to preventing long-term complications from developing.
The symptoms of Cushing syndrome can be subtle and easily mistaken for other conditions, such as obesity or depression. If you suspect you have Cushing syndrome, it’s important to seek medical attention immediately so your doctor can determine if this is the case.
There are several ways to get a diagnosis:
- Your doctor may order blood tests and MRI scans to help determine if the condition is present.
- You may also be referred to an endocrinologist (a specialist who treats disorders involving hormones) who can perform additional tests on tissue samples from your adrenal glands or pituitary gland. Suppose these tests show high levels of cortisol in the bloodstream but normal amounts produced by these organs themselves. In that case, excess cortisol production has likely been triggered somewhere else in the body (for example, by tumors).
Your body’s overproduction (endogenous Cushing syndrome)
The most common cause of Cushing syndrome is your body’s overproduction (endogenous) of cortisol. The adrenal glands produce this hormone, which helps regulate blood pressure and metabolism. Cortisol also acts as an anti-inflammatory agent; it can reduce swelling in the body by causing water retention and suppressing immune responses that might otherwise damage tissue during an infection or injury.
When you experience stress, your hypothalamus gland releases a chemical called corticotropin-releasing hormone (CRH), which triggers the pituitary gland to produce another chemical called adrenocorticotropic hormone (ACTH). ACTH travels through your bloodstream to reach its destination–the adrenal glands –and stimulates them into producing more cortisol than usual.
As you can see, Cushing syndrome is a complex condition that requires careful diagnosis and treatment. While there are many possible causes for this syndrome, the most common is exogenous steroid use (meaning the patient takes medications like prednisone or hydrocortisone). In cases where endogenous Cushing syndrome is suspected (which means an excessive amount of cortisol is produced by the body), testing for adrenal adenomas may be necessary before making an official diagnosis. If you are experiencing symptoms of Cushing syndrome, it’s important to talk with your doctor about what could be causing them.
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