Cushing Syndrome

If your body releases too much cortisol it may cause a health condition called Cushing Syndrome. This hormone is released in an increased amount directly in your bloodstream when you are stressed. However, it contributes to many processes in your body. Fortunately, several treatment options are available to treat this condition.

What is Cushing Syndrome?

This is an uncommon health condition that usually occurs when in your bloodstream is too much cortisol hormone. Some people call this condition hypercortisolism. Cortisol also known as stress hormone is released in increased amounts when you are stressed. It helps to:

  • Increase heart rate and blood pressure
  • Manage glucose levels in the blood
  • Increase your tension in the muscles
  • Manage your breath

This hormone may shut down some functions that you do not need while experiencing elevated stress (such as reproduction and digestion). This hormone is also vital to:

  • Decrease inflammation
  • Keep under control your blood pressure and sugar
  • Forming memories
  • Managing respiration
  • Balance salt in the body
  • Transform food into energy

The hypothalamus, pituitary gland, and adrenal glands keep under control cortisol levels.

There are two main causes of Cushing syndrome. For example:

  • Exogenous – In such cases, this syndrome occurs as a side effect of medicines used in the treatment of other health conditions.
  • Endogenous–Cushing syndrome appears due to increased cortisol levels produced in your body.

Anyone can develop this condition (including children, teenagers, and adults). Additionally, those who use cortisol medicines to treat rheumatoid arthritis and asthma are more vulnerable. Approximately 70% with Cushing syndrome are women and 30% are men. In any case, this is a very rare condition because it affects 40 to 70 people out of 1 million every year.

Is There a Difference Between Cushing Syndrome and Disease?

Cushing disease is a type of Cushing syndrome and it is a benign tumor located in the pituitary gland. In this condition, the pituitary gland releases too much Adrenocorticotropic hormone (ACTH).

Can Cushing Syndrome be Fatal?

If you leave this condition untreated you may notice some complications. For example:

  • Blood clots (especially in the legs and lungs)
  • Myocardial infarction
  • Infections
  • Mental disorders (such as depression)
  • Weight gain (which may lead to obesity or overweight)
  • Broken bones
  • Type 2 diabetes mellitus
  • Memory problems or concentrating problems
  • In some cases, this disease may cause death

Symptoms

This syndrome has some distinctive symptoms that are different from other syndromes. Anyway, the following symptoms are not the same for all people. Examples include:

  • Red and round face
  • Hypertension (high blood pressure)
  • Excessive hair growth (especially on the face, neck, chest, abdomen, and thighs) or balding
  • Diabetes
  • Would that heal poorly
  • Increased weight gain in the face, abdomen, back of the neck, and chest

Check below other symptoms of Cushing syndrome:

  • Easy bruising on the arms and legs
  • Purple stretch marks over the abdomen
  • Fatigue and weakness
  • Blurred vision
  • Dizziness
  • Muscle weakness and thinner legs and arms
  • Changes in sex drive and erectile dysfunction (ED)
  • Stunted growth in children

Commonly, people who suffer from hypercortisolism recover after several weeks of treatment. The condition may last for a longer time if your body does not respond to the treatment. In such cases, it is advised to see a doctor for some treatment changes.

Causes

High cortisol levels provoke this health condition. There are different causes that increase cortisol levels. For example:

  • Glucocorticoid Medications (such as Prednisone) – These medicines are usually used in the treatment of autoimmune diseases including rheumatoid arthritis, chronic asthma, lupus, and others.
  • Pituitary Tumors – In such cases, your pituitary gland produces more ACTH that provoke an increased cortisol production. Thus, Cushing syndrome may happen.
  • Adrenal Cortical Tumors – A tumor on the adrenal gland makes elevated levels of cortisol. In rare cases, it may lead to adrenal cortical carcinoma (adrenal cancer).
  • Lung, Pancreas, Thyroid, and Thymus Tumors – In case tumors that develop outside the pituitary gland produce ACTH, it may lead to Ectopic ACTH syndrome. Therefore, these tumors are commonly malignant and the most common type is small cell lung cancer.

Diagnosis

Your physician will ask you about your medical history, and symptoms, perform a physical examination, certain laboratory tests, and others. All these questions and tests are done to determine if you have Cushing syndrome or not. In some cases, diagnosing this condition may be difficult because fatigue and weight gain are symptoms similar to other diseases. Sometimes, healthcare providers mistake Cushing syndrome for polycystic ovary syndrome or metabolic syndrome.

What Tests are Used to Diagnose Cushing Syndrome?

Check below some examples:

  • High or Low-dose dexamethasone suppression test
  • Midnight salivary cortisol test
  • Blood test
  • A 24-hour urinary cortisol test

In addition, after your doctor identified that you have Cushing syndrome, it is needed to determine why. That’s why your physician may recommend the following imaging tests. They will help to identify the location of the tumor. Examples include:

  • CT scan chest
  • Bilateral inferior petrosal sinus sampling (BIPPS)
  • Magnesium resonance imaging (MRI) pituitary
  • CAT scan (CT scan) or MRI abdomen

For more details, talk with your healthcare provider.

Treatment

How Cushing syndrome will be treated depends on the cause of increased cortisol levels. In case your disease is provoked by a tumor, your doctor may suggest radiation or surgery. Healthcare professionals may prescribe some medicines such as Ketoconazole to decrease cortisol production. Furthermore, you may work with several physicians to manage Cushing syndrome symptoms. Check the treatment options below in detail:

  • Chemotherapy – This medical procedure is needed when cancerous tumors spread throughout the body. Talk with your doctor about the benefits and risks before this procedure.
  • Radiation – If surgery on a pituitary tumor is not possible, you may have several weeks of radiation. To decrease cortisol levels to normal may last for years.
  • Medications – Physicians may prescribe some drugs to reduce cortisol levels or take away those that provoke Cushing syndrome.
  • Surgery – This medical procedure is considered effective in removing pituitary tumors, adrenal tumors, and ectopic tumors. Ask your doctor if you have any questions.

If you receive a suitable treatment, Cushing syndrome should go away after 2 to 18 months. Regular checkups during treatment with your healthcare professional are recommended.

Frequently Asked Questions

Can Cushing syndrome cause hypokalemia or osteoporosis?

Unfortunately, yes, this health condition may weaken bones, which increases the risk of bone fractures. Additionally, hypokalemia (low potassium levels in your blood) also may occur due to Cushing syndrome. Discuss with your doctor for more details.

Can Cushing’s syndrome get worse?

Yes, if left untreated, it may lead to some serious complications or even death. Inform your doctor if you experience new or worsening symptoms regularly, to avoid unpleasant results.

Is Cushing syndrome genetic?

No, because most cases diagnosed with this health condition are not genetic. Discuss with your healthcare provider for more details.

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