Cushing's Disease (Cushing Syndrome)

What is Cushing syndrome?

Cushing syndrome is a hormonal disorder. It’s caused when you have high levels of the hormone cortisol over a long time. Cushing syndrome is fairly rare. It most often affects adults who are 20 to 50 years old. It is sometimes called hypercortisolism.

What causes Cushing syndrome?

Cushing syndrome happens when you have too many corticosteroids in your body. The disorder starts with the pituitary gland. The gland makes too much adrenocorticotropin hormone (ACTH). That causes the adrenal glands to make too many corticosteroids.

Another main cause is taking steroid medicines like prednisone for a long time. These are sometimes used to treat chronic diseases such as asthma. Other causes include:

  • Certain lung cancers
  • Benign or cancerous tumors on the adrenal glands
  • An inherited endocrine disorder

Who is at risk for Cushing syndrome?

You may be more likely to get Cushing syndrome if you:

  • Are overweight or obese
  • Have type 2 diabetes that is not under control and have high blood pressure

What are the symptoms of Cushing syndrome?

Each person may have symptoms in a different way. These are the most common signs and symptoms:

  • Upper body obesity
  • Round face
  • Increased fat around neck or a fatty hump between the shoulders 
  • Thinning arms and legs
  • Fragile and thin skin
  • Stretch marks on abdomen, thighs, buttocks, arms, and breasts
  • Bone and muscle weakness
  • Severe tiredness (fatigue)
  • High blood pressure
  • High blood sugar
  • Irritability and anxiety
  • Extra facial and body hair growth in women
  • Irregular or stopped menstrual cycles in women
  • Reduced sex drive and fertility in men

These symptoms may look like other health problems. Always see your health care provider for a diagnosis.

How is Cushing syndrome diagnosed?

Your healthcare provider will ask about your past health. You will also need an exam. These procedures may also help with a diagnosis:

  • 24-hour urinary test to measure the level of corticosteroid hormones
  • CT scan. This scan uses X-rays and computer technology to make images of the body.
  • MRI. This scan creates 2-D views of an internal organ or structure.
  • Dexamethasone suppression test. This test can tell whether the extra production of hormones is from the pituitary gland or from a tumor elsewhere in your body.
  • Corticotropin-releasing hormone (CRH) stimulation test. This test can tell whether the cause is a tumor on the pituitary gland or the adrenal gland.
  • Other laboratory tests

How is Cushing syndrome treated?

Your healthcare provider will figure out the best treatment for you based on:

  • How old you are
  • Your overall health and past health
  • How sick you are
  • How well you can handle specific medicines, procedures, or therapies
  • How long the condition is expected to last
  • Your opinion or preference

Treatment depends on what is causing Cushing syndrome. You may need surgery to remove tumors or the adrenal glands. Other treatments may include:

  • Radiation
  • Chemotherapy
  • Certain hormone-inhibiting medicines

When should I call my healthcare provider?

Tell your healthcare provider if your symptoms return or get worse. Also let him or her know if you get new symptoms.

Key points about Cushing syndrome

  • Cushing syndrome happens when pituitary gland makes too much adrenocorticotropin hormone. That causes the adrenal glands to make too many corticosteroids.
  • Cushing syndrome is fairly rare. It most often affects adults who are 20 to 50 years old.
  • Symptoms may include upper body obesity, round face, and thin skin.
  • Treatment depends on the cause. It may include surgery, radiation, chemotherapy, or medicines.

Next steps

Tips to help you get the most from a visit to your health care provider:
  • Before your visit, write down questions you want answered.
  • Bring someone with you to help you ask questions and remember what your provider tells you.
  • At the visit, write down the names of new medicines, treatments, or tests, and any new instructions your provider gives you.
  • If you have a follow-up appointment, write down the date, time, and purpose for that visit.
  • Know how you can contact your provider if you have questions.