Cushing Syndrome

(Cushing Disease; Hypercortisolism)

Definition

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

Causes    TOP

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 disease
    • Rarely, tumors of the lung, thyroid, kidney, pancreas, or thymus gland.

Pituitary and Adrenal Glands

Nucleus factsheet image
Copyright © Nucleus Medical Media, Inc.

Risk Factors    TOP

Factors that may increase your chance of Cushing syndrome include using corticodsteroids to treat diseases, such as:

Symptoms    TOP

Cushing syndrome may cause:

  • 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
  • Bone loss—osteoporosis

Diagnosis    TOP

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.

Blood tests, urine tests, and saliva tests may be done.

Imaging tests evaluate the pituitary and adrenal glands, and other internal structures. These may include:

Treatment    TOP

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

  • Gradual withdrawal of cortisone-type drugs under close medical supervision
  • Surgical removal of tumor
  • Surgical removal of part, all, or both adrenal glands
  • Radiation therapy for some persistent tumors
  • Drugs that decrease cortisol production or block the functioning of other adrenal products

Prevention    TOP

Work with your doctor to keep your use of corticosteroid drugs to a minimum.

RESOURCES:

Cushing's Support and Research Foundation
http://www.CSRF.net
Family Doctor—American Academy of Family Physicians
http://familydoctor.org

CANADIAN RESOURCES:

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

References:

Arnaldi G, Angeli A, Atkinson AB, et al. Diagnosis and complications of Cushing’s syndrome: a consensus statement. J Clin Endocrinolo Metabo. 2003;88(12):5593-5602.
Cushing disease. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T127665/Cushing-disease. Updated June 15, 2017. Accessed March 5, 2018.
Cushing's syndrome. National Institute of Diabetes and Digestive and Kidney Disorders website. Available at:
...(Click grey area to select URL)
Updated April 2012. Accessed March 5, 2018.
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.
Tritos NA, Biller BM, Swearingen B. Management of Cushing disease. Nat Rev Endocrinol. 2011;7(5):279-289.
Makras P, Toloumis G, Papadogias D, Kaltsas GA, Besser M. The diagnosis and differential diagnosis of endogenous Cushing’s syndrome. Hormones. 2006;5(4):231-250.
Last reviewed March 2018 by EBSCO Medical Review BoardAlan Drabkin, MD
Last Updated: 2/17/2016

EBSCO Information Services is fully accredited by URAC. URAC is an independent, nonprofit health care accrediting organization dedicated to promoting health care quality through accreditation, certification and commendation.

This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.

To send comments or feedback to our Editorial Team regarding the content please email us at healthlibrarysupport@ebsco.com. Our Health Library Support team will respond to your email request within 2 business days.