Cushing's syndrome is a condition where your body is exposed to too much of the hormone called cortisol. This can be because your body is making too much cortisol, or because you have taken a lot of oral corticosteroid medicines. If you have Cushing's syndrome, it is treatable.
What causes Cushing's syndrome? The most common cause of Cushing's syndrome is the long-term, high-dose use of the cortisol-like glucocorticoids.
Cushing's syndrome can be caused by overuse of cortisol medication, as seen in the treatment of chronic asthma or rheumatoid arthritis (iatrogenic Cushing's syndrome), excess production of cortisol from a tumor in the adrenal gland or elsewhere in the body (ectopic Cushing's syndrome) or a tumor of the pituitary gland ...
Cases due to a pituitary adenoma are known as Cushing's disease, which is the second most common cause of Cushing's syndrome after medication. A number of other tumors, often referred to as ectopic due to their placement outside the pituitary, may also cause Cushing's.
Cushing disease is a rare condition, only affecting 10 to 15 people per million every year. It is more common in women and occurs most often in people between the ages of 20 and 50. A pituitary adenoma is the most common cause of Cushing disease. An adenoma is a pituitary tumor that is almost always benign.
People with Cushing's syndrome may see their face get round ("moon face"), they gain weight in unusual ways, bruise easily or feel weak, tired and sad. Women and men may also notice fertility and other problems. CS is most often found in adults between the ages of 20 and 50.
Cushing's disease is fatal without treatment; the median survival if uncontrolled is about 4.5 years, Melmed said. “This truly is a metabolic, malignant disorder,” Melmed said. “The life expectancy today in patients who are not controlled is apparently no different from 1930.”
According to Mayo Clinic, signs and symptoms associated with excess cortisol levels can include: Rapid weight gain mainly in the face, chest, and abdomen. A flushed and round face. High blood pressure.
Symptoms of Cushing's syndrome
One of the main signs is weight gain and more body fat, such as: increased fat on your chest and tummy, but slim arms and legs. a build-up of fat on the back of your neck and shoulders, known as a "buffalo hump" a red, puffy, rounded face.
Fortunately, most people with the syndrome are treated and cured. However, after successful treatment of the syndrome, some health problems may continue. For instance, your bones may continue to be weak.
Slow down with the salt
Excess cortisol from Cushing's syndrome can increase blood pressure, leading to hypertension. Avoid processed foods packed with sodium, which contributes to high blood pressure. Focus on fruits, vegetables, and reduced-sodium soups, dressing, and spreads.
These data demonstrate that patients with Cushing's are significantly more likely to gain at least 2kg (4.4 lbs) over a six-month period compared to a similarly overweight/obese population without clinical Cushing's, independent of the use of insulin in the setting of diabetes mellitus.
Despite a person having developed many of the symptoms, signs and outward appearance of Cushing's disease, many patients may go undiagnosed for years as their condition worsens.
People with Cushing's disease have a high risk of being deficient in vitamin D, but taking supplements can improve those levels, a new study indicates. Results also showed that lower vitamin D levels are associated with higher levels of cortisol, a stress hormone that is elevated in Cushing's.
Cushing disease may be caused by an overuse of corticosteroids, such as prednisone, or may be due to an underlying condition, such as an adrenal tumor, lung tumor, or pituitary tumor. Chronic stress and poor stress management can cause Cushing disease, as cortisol is the hormone we produce when we're stressed.
Symptoms of Cushing's syndrome
Wasting of the limbs. A 'buffalo' hump of fat high on the back. Round, red and puffy-looking face ('moon face') Thin skin, easily bruised, slow healing and ulcers.
Surgical resection of the causal lesion(s) is generally the first-line approach. The choice of second-line treatments, including medication, bilateral adrenalectomy, and radiation therapy (for corticotrope tumors), must be individualized to each patient.
Too much cortisol can cause some of the main symptoms of Cushing syndrome — a fatty hump between the shoulders, a rounded face, and pink or purple stretch marks on the skin.
However, several at-home cortisol tests are available to purchase. A person can take these tests at home by providing a urine, blood, or saliva sample. Once a lab analyzes the test, people usually receive their results within a few days. Individuals should follow up on any test results with a healthcare professional.
Medicines to control cortisol production at the adrenal gland include ketoconazole, osilodrostat (Isturisa), mitotane (Lysodren), levoketoconazole (Recorlev), and metyrapone (Metopirone). Mifepristone (Korlym, Mifeprex) is approved for people with Cushing syndrome who have type 2 diabetes or high blood sugar.
Cushing disease is caused by a tumor or excess growth (hyperplasia) of the pituitary gland. The pituitary gland is located just below the base of the brain. A type of pituitary tumor called an adenoma is the most common cause. An adenoma is a benign tumor (not a cancer).
Cushing's disease often causes psychiatric symptoms. The most common are cognitive impairment, irritability, anxiety, and depression. Psychotic disorders and delusions are less common, but also occur.
The causes of premature death in untreated Cushing's syndrome are vascular disease (myocardial infarction/stroke), uncontrolled diabetes mellitus and complications and infections.