Cushing syndrome is a condition caused by too much of the hormone cortisol in the body. The excess may happen because of medications or because your body produces too much of the hormone. There are treatments for Cushing syndrome. Treatment may last for some time.
Cushing syndrome is an uncommon condition that happens when your body has too much of a hormone called cortisol. Another word for Cushing syndrome is hypercortisolism. A syndrome is a medical term that refers to a group of signs and symptoms that happen together. You may see some people call this condition Cushing’s syndrome.
Cortisol is a steroid hormone commonly called the “stress hormone.” Your body releases extra cortisol during times of stress. Cortisol helps by:
Cortisol also helps by temporarily shutting down systems that your body doesn’t need during times of increased stress, such as digestion and reproduction.
Cortisol is essential to:
The adrenal glands (two small glands on top of your kidneys), pituitary gland (in your brain) and the hypothalamus (the part of your brain above the pituitary gland) control cortisol levels.
A tumor typically causes the cortisol levels found in Cushing syndrome.
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The people most commonly affected by Cushing syndrome are children, teenagers and adults, mostly those ages 25 to 50. People who take cortisol medication (for example, to treat asthma and rheumatoid arthritis) are especially vulnerable. Some 70% of people with Cushing syndrome are women or people assigned female at birth (AFAB) and 30% are men or people assigned male at birth (AMAB).
Cushing syndrome is rare. It affects 40 to 70 people out of 1 million each year.
Cushing disease is a type of Cushing syndrome. A benign tumor located in the pituitary gland that secretes too much ACTH (adrenocorticotropic hormone) causes Cushing disease. This increases cortisol secretion from the adrenal glands.
Out of all the people who have Cushing syndrome, Cushing disease accounts for more than 70% of cases in adults and about 60% to 70% of cases in children and adolescents.
Your healthcare provider will consult a specialist called an endocrinologist for evaluation and treatment.
Cushing syndrome can possibly be fatal if you don’t get treatment. Without treatment, hypercortisolism can cause health problems, including:
If left untreated, Cushing syndrome can also result in death.
Too much cortisol causes Cushing syndrome. There may be many underlying causes of high cortisol levels, including:
Generally speaking, no. Most cases of Cushing syndrome aren’t genetic.
Cushing syndrome has some unique symptoms as well as some that could point towards a variety of other syndromes. Not everyone has the same symptoms. Possible characteristics include:
Other signs and symptoms of Cushing syndrome include:
How long Cushing syndrome lasts depends on how you respond to treatment. Many people with hypercortisolism recover after several weeks of treatment.
No. Shortness of breath isn’t a characteristic symptom of Cushing syndrome.
Yes. Cushing syndrome can weaken bones. That can lead to fractures, especially if you have a long-standing case of Cushing syndrome. Weak bones can cause pain.
Hypokalemia is the medical term for having low levels of potassium in your blood. This may happen if you have Cushing syndrome.
When your healthcare provider suspects hypercortisolism, there are certain guidelines they may follow. They’ll ask questions, look at your medical history, perform a physical examination and then conduct some laboratory tests. They’ll likely continue to monitor you over time.
Cushing syndrome can sometimes be difficult to diagnose. If you tell your provider you have fatigue and weight gain, they might not immediately think of Cushing syndrome. These types of symptoms are common to many different kinds of diseases.
Cushing syndrome is also sometimes mistaken for polycystic ovary syndrome or metabolic syndrome. Your healthcare provider will have to go through a process of elimination to rule out other conditions.
Your healthcare provider is likely to request some of the following tests:
Once your healthcare provider has confirmed that you have Cushing syndrome, the next step is to determine why. Often it’s medication or a tumor. If you’re on glucocorticoids, that’s probably the cause, and your healthcare provider will likely decrease the dosage. If you’re not on glucocorticoids, that indicates there’s likely a tumor in your adrenal glands, pituitary gland or elsewhere. Your healthcare provider may recommend the following imaging studies to reveal the location of the tumor:
The type of treatment depends on the underlying cause of the high cortisol levels. If you use glucocorticoids, your healthcare provider will likely lower the dosage or prescribe a non-glucocorticoid medication.
If a tumor’s causing Cushing syndrome, your provider may suggest surgery or radiation.
Another option is for your healthcare provider to prescribe a medication such as ketoconazole that’ll slow down the production of cortisol. You may work with several healthcare providers to treat the tumor and Cushing syndrome symptoms.
If Cushing syndrome is properly treated, the disease may go away after two to 18 months. Be sure to stay in contact with your healthcare provider during and after this period.
You always need cortisol in your body. You need it to function. It manages your respiration, turns your food into energy, regulates your blood sugar, helps you cope with stress and more. Cortisol isn’t your body’s enemy, but too much of it can be. However, you can’t live without cortisol.
Have your healthcare provider monitor your cortisol levels closely if you’re on glucocorticoids or steroids. Unfortunately, there’s no way to prevent a tumor that causes Cushing syndrome (hypercortisolism).
Your provider can and should treat Cushing syndrome. If it’s not treated, it can be fatal. Get your symptoms checked by your healthcare provider as soon as possible.
There’s usually a cure for Cushing syndrome. Treatment may last for some time, even up to 18 months.
Cushing syndrome can get worse without proper treatment. Be sure to stay in contact with your healthcare provider and report any new or worsening symptoms or any other concerns you may have.
Cushing syndrome can be difficult to live with, but your quality of life doesn’t have to get worse. There are healthcare providers trained to help you and there are treatments available. Generally, these will be able to cure Cushing syndrome and improve symptoms caused by hypercortisolism.
You may find yourself dealing with some emotional and social issues due to Cushing syndrome. Some people may feel embarrassed by the balding, excessive hair and/or the weight gain in the face and back of the neck. “Moon face” and “buffalo hump” may make you hesitate to participate in social situations. With time, treatment can cure those symptoms. Cushing syndrome can also cause depression and other mental illnesses. If need be, consult a therapist for counseling and a psychiatrist for medication to help yourself deal with the emotional impact of hypercortisolism.
See your healthcare provider if you have the following symptoms of Cushing syndrome:
Symptoms that affect women and people AFAB specifically include:
Symptoms that affect everyone include:
A note from Cleveland Clinic
Cushing syndrome can be a difficult syndrome to endure. It causes weakness, hypertension, fatigue and more. The treatments — including surgery, medications, radiation and chemotherapy — may be uncomfortable. However, they’re worth it because, with the right treatment, there’s a cure for Cushing syndrome.
Stay in contact with your healthcare provider during every stage. Follow your healthcare provider’s instructions and don’t hesitate to ask them any questions.
Last reviewed by a Cleveland Clinic medical professional on 12/27/2022.
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