Cushing Syndrome

What is Cushing Syndrome?

Cushing Syndrome is a condition where you have increased levels of cortisol in your body. Cortisol is a hormone made in the adrenal glands, which are just above your kidneys. Cortisol helps your body deal with stress and helps keep blood sugar and blood pressure levels normal.

What increases my risk for Cushing syndrome?

A tumor on your adrenal glands may cause them to make too much cortisol. Another hormone, called adrenocorticotrophic hormone (ACTH), is made in the pituitary gland of your brain, and causes your adrenal glands to make cortisol. A pituitary gland tumor or certain cancers, such as lung cancer, can increase the levels of ACTH in your body. This will increase cortisol levels. Also, long-term use of steroid medicine may cause high cortisol levels and lead to Cushing syndrome.

What are the signs and symptoms of Cushing syndrome?

The most common symptoms are increased fat around your neck and collar area. You may also have extra fat around your abdomen, or you may lose weight in your arms and legs. Your face may become red, round, or puffy. Your skin can become thin and have purple stretch marks on the abdomen, thighs, buttocks, or breasts. You may also have any of the following:

• Fatigue and muscle weakness
• High blood sugar or high blood pressure
• Excess hair growth on the face, neck, chest, abdomen, and thighs of women
• An irregular monthly period, or no monthly period
• Mood swings, such as being irritable, depressed, or anxious
• Little to no interest in having sex, or trouble having an erection

How is Cushing syndrome diagnosed?

• Blood and urine tests measure the amount of cortisol in your body. For a urine test, you may need to save your urine for 24 hours and send the sample to a lab. This measures the amount of cortisol in your urine over 24 hours.
• A saliva test is done at 11 p.m. on two separate nights to measure the amount of cortisol in your saliva.
• A CT scan, or CAT scan, is a type of X-ray that is taken of your head, chest, abdomen, or pelvic area. The pictures may show the cause of your symptoms. You may be given a dye before the pictures are taken to help healthcare providers see the pictures better. Tell the healthcare provider if you have ever had an allergic reaction to contrast dye.
• An MRI takes pictures of your body to look for lung cancer or an adrenal or pituitary tumor. You may be given dye to help the pictures show up better. Tell the healthcare provider if you have ever had an allergic reaction to contrast dye. Do not enter the MRI room with anything metal. Metal can cause serious injury. Tell the healthcare provider if you have any metal in or on your body.

How is Cushing syndrome treated?

Treatment depends on what is causing increased cortisol in your body. Healthcare providers may change your steroid dose if you are on long-term steroid therapy. You may also have any of the following:

• Surgery is used to remove a tumor causing increased cortisol levels.
• Medicines may help decrease cortisol and block the adrenal glands from making cortisol. You may also need medicine to kill tumor or cancer cells.
• Radiation therapy uses high-energy X-rays to shrink a tumor or kill cancer cells.

When should I seek immediate help?

Seek care immediately or call 911 if:

• You always feel dizzy when you stand up from a sitting or lying position.
• You hear voices or see something that is not real.
• You have severe pain in your stomach, waist, or back.
• You have very dry skin, dry mouth and tongue, or feel more thirsty than normal.
• Your symptoms become worse, even after you take medicine.

When should I call my healthcare provider?

Call your healthcare provider if:

• You have a fever.
• You have diarrhea or constipation.
• You have nausea, vomiting, or stomach pain.
• You sweat or urinate more than usual.
• You have questions or concerns about your condition, treatment, or care.