Share this page

Health Library

Cushing's Syndrome(Cushing's Disease; Hypercortisolism)
Definition

Cushing's syndrome is a hormone disorder. Cortisol, in normal doses, helps the body manage stress and infection. However, these high levels over a long period of time can cause several health problems.

Causes

Cushing's syndrome is caused by extended exposure to a hormone called cortisol. 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's disease
    • Rarely, tumors of the lungs, thyroid, kidney, pancreas, or thymus gland.

Pituitary and Adrenal Glands

Nucleus factsheet image

Copyright © Nucleus Medical Media, Inc.

Risk Factors

Factors that increase your chances of getting Cushing's syndrome include:

Symptoms

Symptoms may include:

  • 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
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.

Tests for cortisol levels may include:

  • 24-hour urinary free cortisol level
  • Late-evening cortisol saliva/blood level
  • Dexamethasone suppression test

Tests to determine the cause of Cushing's Syndrome may include:

  • Blood test for adrenocorticotropin hormone (ACTH) level
  • High-dose dexamethasone suppression test

Other tests may help to see if there is a tumor on the pituitary or adrenal glands. Images may be taken with:

Treatment

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

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

RESOURCES:

American Academy of Family Physicians
http://familydoctor.org

Cushing's Support and Research Foundation
http://www.CSRF.net

CANADIAN RESOURCES:

The College of Family Physicians of Canada
http://www.cfpc.ca

Health Canada
http://www.hc-sc.gc.ca

References:

Arnaldi G, Angeli A, Atkinson AB, Bertagna X, et al. Diagnosis and complications of Cushing’s syndrome: a consensus statement. J Clin Endocrinolo Metabo. 2003;88:5593-5602.

Cushing disease. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed . Updated February 21, 2014. Accessed February 27, 2014.

Cushing's syndrome. National Endocrine and Metabolic Diseases Information Service website. Available at: http://endocrine.niddk.nih.gov/pubs/cushings/cushings.aspx. Updated April 6, 2012. Accessed February 27, 2014.

Diez JJ, Iglesias P. Pharmacological therapy of Cushing’s syndrome: drugs and indications. Mini Rev Med Chem. 2007;7(5):467-480.

Kirk LF Jr, Hash RB, Katner HP, Jones T. Cushing's disease: clinical manifestations and diagnostic evaluation. Am Fam Physician. 2000;62(5):1119-1127, 1133-1134.

Tritos NA, Biller BM, Swearingen B; Medscape. Management of Cushing disease. Nat Rev Endocrinol. 2011;7(5):279-289.

Makras P, Toloumis G, Papadoglas D, et al. The diagnosis and differential diagnosis of endogenous Cushing’s syndrome. Hormones. 2006;5:231-250.



Last reviewed February 2014 by Kim Carmichael, MD

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.

Baptist Flame

Healthy Life Podcasts

Find A Doctor

Services

Locations

Baptist Medical Clinic

Patients & Visitors

Learn

Contact Us

Physician Tools

Careers at Baptist

Employee Links

Online Services

At Baptist Health Systems

At Baptist Medical Center

close ×