Cortisol is a hormone that helps govern how your body uses fat and sugar. Everyone needs this hormone for normal metabolic activity. However, if levels get too high, health problems can be a result.

What is Cushing’s syndrome?

Cushing's syndrome, also known as hypercortisolism, occurs when there is too much cortisol in the body. This hormone, which regulates how the body uses energy, can cause damage when it is present in higher than normal levels.

Causes of Cushing's syndrome

The most common cause of Cushing's syndrome is an overuse of corticosteroid medications. These medications are prescribed for their anti-inflammatory properties and to aid healing. For instance, someone who is suffering from pneumonia may be prescribed Prednisone, a common corticosteroid medicine, to aid healing.

Cushing's syndrome can also occur when the adrenal glands are producing too much cortisol. Triggers can include malnutrition, high levels of stress, athletic training, alcoholism, and depression. In some cases, Cushing's may be caused by an adrenal gland tumor or overgrowth. It can also be caused by a tumor on the pituitary gland.

Cushing's syndrome is not hereditary. However, people can inherit a tendency to develop tumors on their endocrine glands.

Symptoms of Cushing’s syndrome

The most common symptoms of Cushing's syndrome include:

  • weight gain and obesity.
  • diabetes
  • fatty deposits, especially around the face, midsection and between the shoulders and upper back. These fatty deposits cause the characteristic round face shape associated with Cushing's.
  • thin skin that bruises easily.
  • acne.
  • fatigue and muscle weakness.
  • increased thirst.
  • bone loss and osteoporosis.
  • headaches.
  • high blood pressure.
  • injuries that are slow to heal.
  • anxiety, irritability, and depression.

Women with Cushing's syndrome may notice irregular or absent periods and extra body and facial hair. Men may experience a loss of sex drive, erectile dysfunction and decreased fertility.

When Cushing's is left untreated, it can cause a number of complications. These can include bone fractures, bone loss, infections and chronic conditions like type 2 diabetes.

Diagnosing Cushing's syndrome

Your doctor will review your personal and family medical history, then perform a physical examination. You may also have lab tests such as a 24-hour urinary free cortisol test. Your doctor will also seek to determine the cause of your high cortisol levels in order to create an effective treatment plan. Imaging tests such as CT or MRI can determine if a tumor of the adrenal or pituitary glands is the source of the problem.

Cushing’s syndrome treatment

How Cushing's syndrome is treated depends on the cause. A medication may be prescribed to decrease cortisol production in your adrenal glands. You may also get medication to decrease ACTH production in your pituitary gland. A third option is medication that blocks the effect of cortisol on the tissues in your body.

If you are regularly prescribed corticosteroids, your doctor may need to change your medication or adjust your dose.

If your Cushing's syndrome is caused by tumors, it may be necessary to perform surgery. Surgical removal of a gland will stop the overproduction of cortisol. Your doctor may also recommend chemotherapy or radiation therapy if tumors are malignant.

If Cushing's syndrome is left untreated, it can cause other conditions like type 2 diabetes, kidney stones, and high blood pressure. Prompt treatment is necessary to get cortisol levels back to normal and to get you back to full health.