Cushing's Syndrome

Cushing's syndrome, also known as hypercortisolism is a condition that occurs due to exposure to high cortisol levels for an extended period. Cushing syndrome is a rare condition and is mostly caused due to steroid drugs, but can also occur due to overproduction of cortisol. Most cases of Cushing syndrome are curable. 

Cushing Syndrome Causes

Cushing syndrome occurs when there is an excess amount of cortisol in the body for too long. Several reasons can result in Cushing syndrome. Some of these reasons include: 

• Steroid medications are one of the leading causes of this. These are powerful anti-inflammatory medications used to treat conditions like asthma, lupus etc. and taking too much of these medications for an extended period may lead to Cushing syndrome. 

• Tumor in the pituitary gland can also cause over secretion of cortisol.

• Similarly, a tumor in the adrenal glands can also cause over secretion of cortisol. 

• Though the condition is not passed on genetically, in some cases, a family history of Cushing syndrome increases the risk. 

Cushing Syndrome Symptoms

The symptoms of Cushing syndrome slightly vary from one person to another. Some of the most commonly observed symptoms of Cushing syndrome are: 

• A rounded face

• Weight gain and fatty deposit in the upper back, face, and shoulders

• Stretch marks on abdomen, thighs, arms etc.

• Thinning and fragile skin that bruises easily

• Slow healing of cuts or infections

• Getting tired easily

• Development of acne

• Development of kidney stones

• Sleep problems

• A headache

• Loss of emotional control

• Depression

• Impaired growth in children

Besides, there are a few symptoms particular to men and women.

Symptoms specific to men:

• Loss of libido

• Infertility

• Erectile dysfunction

Symptoms specific to women:

• Thicker and more visible body and facial hair

• Irregular periods

If the condition is left untreated some severe complications like the following may develop:

• Osteoporosis, leading to bone loss and frequent fractures

• High blood pressure

• Type 2 diabetes

• Loss of muscle mass and strength

• Recurrent infections

Cushing Syndrome Diagnosis

For the diagnosis of Cushing syndrome, the doctor will carefully examine the symptoms and ask about your mental and emotional health. If the doctor suspects Cushing syndrome, the following diagnostic tests may be recommended: 

• Dexamethasone suppression test: a low dose steroid pill is taken at night, and blood cortisol levels are measured in the morning.

• Late-night salivary cortisol level: the cortisol levels are measured in the saliva in the night time.

• 24-hour urinary test: in this test, your urine is collected for 24 hours to check the production of cortisol. 

• The doctor may also recommend imaging tests like an MRI scan or a CT scan. These tests provide detailed images of your adrenaline gland and help in detecting abnormalities like tumors. 

• Petrosal sinus sampling: this test helps determine if the cause of Cushing syndrome is in the pituitary gland or someplace else. 

Cushing Syndrome Treatment

The treatment is aimed at reducing cortisol levels in the body. The exact form of treatment depends on the cause of Cushing syndrome and other factors like health and age of patient etc. Some commonly adopted treatment procedures are:

• Limiting corticosteroid use: if the purpose of Cushing syndrome is corticosteroid drugs, then one of the first and foremost things to do is to restrict its use. The dosage of these drugs is slowly reduced, and over some time, the body’s cortisol levels resume to normal.

• In cases of tumors, surgical removal is always a preferred option. The doctor may remove the tumor along with some of the surrounding tissue. The doctor may prescribe cortisol replacement medications to provide the body with the correct amount of cortisol.

• Radiation therapy is also an option in case the condition is caused due to a tumor.
  

• The doctor may also prescribe medications for controlling cortisol production.

• In some rare cases, the doctor may remove the adrenal gland to cure the condition. In such cases, lifelong cortisol replacement medications are needed.

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