Hypercortisolism or Cushing’s syndrome occurs due to abnormally high levels of the cortisol hormone. It may be caused by the use of oral corticosteroid medication.

In most cases, getting a proper treatment can help you manage your cortisol levels.

Cushing’s syndrome symptoms

The most common symptoms of Cushing syndrome are:

  • Weight gain
  • Muscle weakness
  • Purple stretch marks on the breasts, arms, abdomen, and thighs
  • Thinning skin that bruises easily
  • Acne
    • Skin injuries that are slow to heal
    • Fatigue
    • Fatty deposits (especially in the midsection, the face , between the shoulders and the upper back -causing a buffalo hump)

Some patients also show symptoms like;

  • Irritability
  • Increased thirst
  • Increased urination
  • Headache
  • Osteoporosis
  • More infections than usual
  • Mood swings
  • Anxiety
  • High blood sugar
  • High blood pressure (hypertension)
  • Depression

Symptoms In children:

In addition to the above mentioned symptoms, children with Cushing’s syndrome may also have:

  • Slower growth rate
  • Obesity
  • High blood pressure (hypertension)

Symptoms In women:

Cushing’s syndrome is more prevalent in women than in men. Women with Cushing’s syndrome may develop extra hair, mostly on

  • Face and neck
  • Abdomen
  • Chest
  • Thighs

Additionally, women with Cushing’s syndrome may also experience irregular or complete absence of menstruation.

Symptoms In men

In addition to the common symptoms, Men with Cushing’s syndrome may have:

  • Decreased fertility
  • Erectile dysfunction
  • Muscle weakness
  • Loss of sexual interest
  • Severe fatigue
  • Less control on emotions
  • Cognitive difficulties
  • Increased skin pigmentation
  • Bone loss ( leading to fractures over time)

Cushing’s syndrome causes

Cushing’s syndrome is caused by an excess of the hormone cortisol which is produced by adrenal glands. There can be several reasons of an abnormal functioning of adrenal glands and resulting high production of cortisol, including:

  • High stress levels ( mostly related to an acute illness, surgery, injury, or pregnancy)
  • Malnutrition
  • Alcoholism
  • Athletic training
  • Depression
  • Panic disorders
  • High levels of emotional distress

 

Cushing’s syndrome diagnosis

It is often very difficult to diagnose Cushing’s syndrome because the disease can have multiple causes and the symptoms in the patient (like weight loss, anxiety etc.) can be due to many reasons.

In the first step of diagnosis, your physician will take your medical history including your past medications. Then, he will perform a physical exam where he will search for symptoms like buffalo hump, stretch marks and bruises.

Next, He may suggest laboratory tests, including:

  • 24-hour urinary free cortisol test
  • Salivary cortisol measurement
  • Low-dose dexamethasone suppression test

Diagnosing the cause of Cushing’s syndrome

After being diagnosed with Cushing’s syndrome, you still need to find out the cause of the excess cortisol production for a more targeted treatment.

Your physician might suggest you one of the following Tests for determining the exact cause of the disease.

  • Blood adrenocorticotropin hormone (ACTH) test: Measures the levels of ACTH in the blood, Low levels of ADTH and high levels of cortisol could indicate the presence of a tumor on the adrenal glands.
  • Corticotropin-releasing hormone (CRH) stimulation test: A shot of CRH is given for raising the levels of ACTH and cortisol in people with pituitary tumors.
  • Petrosal sinus sampling: If results show High levels of ACTH in the blood near the pituitary, it indicates that you may have a pituitary tumor. Similar levels from both samples indicate an ectopic tumor.
  • High-dose dexamethasone suppression test: If the result shows increased levels of cortisol, you may have a pituitary tumor. Otherwise, you might be having an ectopic tumor.
  • Imaging studies (CT and MRI scans): They’re used to visualize the adrenal and pituitary glands to look for tumors.

Treatment

Treatment depends on the cause of the disease.

  • If caused by Steroid use, your doctor might recommend you to stop using the drugs (like prednisone) which will allow the body to go back to normal.
  • If caused by a Pituitary Tumor, you will need a surgery usually done through the nose (transsphenoidal surgery) by a neurosurgeon.
  • If caused by an Adrenal Tumor, you will need a laparoscopic or robotic surgery by a urologist. When laparoscopic surgery is not possible, an “open” surgery is performed.

Natural remedy

Dietary changes can help you in keeping your cortisol levels from rising more or preventing some complications.

Some dietary tips for those with Cushing’s syndrome include:

  • Since weight is a symptom of Cushing’s disease, you need to monitor your calorie intake.
  • Try to avoid drinking alcohol as it has been linked with increasing the cortisol levels in the body
  • Cushing’s syndrome can lead to high blood glucose. Try to avoid foods that can cause an increase in your blood sugar levels.
  • Cushing’s syndrome is associated with high blood pressure (hypertension). So try to limit your sodium intake by not adding salts while cooking your meals and reading labels of the products for measuring the amount of sodium they contain.
  • Cushing’s syndrome can weaken your bones, making you prone to fractures. Both calcium and vitamin D can help to strengthen your bones.

Prevention

Try to avoid long term usage of cortisol-containing medications. It can help you in preventing symptoms associated with Cushing’s syndrome.