Cushing’s Syndrome

Cushing’s Syndrome refers to a condition that occurs as a result of the high level of cortisol hormone in the blood. This could either be because the body produces a high amount of cortisol or the patient is taking corticosteroid medication. People suffering from this condition are at risk of developing hypertension and diabetes. The syndrome also causes bone loss, pinkish stretch marks and obesity.

Cushing’s Syndrome could possibly become life threatening if it is left untreated. Those who believe they have it should seek immediate medical advice so that treatment can be started right away and obtain a better prognosis. Treatment for this syndrome is planned individually based on the cause and level of cortisol hormone in the patient’s blood.

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Cushing’s syndrome – causes

The adrenal glands of those afflicted by the syndrome produce high amounts of cortisol. Cortisol is important in controlling the metabolism of fats, proteins and carbohydrates. It is also vital in suppressing the inflammatory response of the immune system as well as in maintaining cardiovascular function.

The brain stimulates the pituitary gland to produce ACTH (adrenocorticotropin hormone) by sending CRH (corticotropin-releasing hormone). The ACTH then triggers the adrenal glands to produce cortisol. Overproduction of cortisol hormone occurs when there is disruption in the production of cortisol. These disruptions could be set out by:

  • Steroid medications

These drugs are used in treating inflammatory disorders or illnesses like asthma, lupus and rheumatoid arthritis. It was found that prolonged intake of steroid medications results in high amount of cortisol in the blood.

  • Adrenal tumors

Cancerous and noncancerous tumor in the adrenal gland causes the cortisol level to go up.

  • Pituitary gland tumors

This typically noncancerous tumor, referred to as Cushing’s Disease, releases high amounts of adrenocorticotropin hormone (ACTH) resulting in an increased quantity of cortisol produced.

  • Ectopic tumor

Cancerous and noncancerous mass found in non-secreting ACTH organs like thyroid, pancreas and lungs, is another cause of Cushing’s Syndrome. The tumor often starts to produce excess amounts of ACTH, resulting in excessive levels cortisol hormone.

  • Inherited

Cushing’s syndrome is sometimes inherited by tumor or tumors in the endocrine glands.

Cushing’s Syndrome – statistics

It is estimated that the syndrome affects 2 to 4 individuals out of 1 million each year. Studies showed that the syndrome is more common in women who have pituitary or adrenal tumors; whereas in men, it is primarily due to lung tumors. The syndrome occurs more frequently in people between 25 and 40 years old. Psychological problems like irritability, depression, panic attacks, paranoia and insomnia are common among sufferers too.

Cushing’s Syndrome symptoms

The presence of an excessive amount of cortisol is evident in a number of ways. More often, the affected individual notices only a few manifestations during the disease’s early stage which get worse as the illness advances. It should be noted that each patient exhibits different symptoms based on the duration of the ailment, level cortisol, presence of tumors and other underlying causes. Some of the signs to look for are:

  • Weight gain

This is considered as the most prominent manifestation of the syndrome which is evident on the neck, face, abdomen and trunk. Fat deposits are also visible on the neck base and upper back.

  • Skin problems

The syndrome likewise causes various skin changes and problems like acne and pinkish stretch marks. Cushing’s syndrome also gives rise to skin sensitivity, making it prone to infections and bruises.

  • Irregular menstruation

Women suffering from the syndrome either have absent or irregular menstrual flow, which makes getting pregnant difficult.

  • Excess androgen

A high level of androgen is another problem that female patients face.  This leads to oily skin and growth of male-pattern body hair.

Complications are inevitable if the syndrome is left untreated, and some of these are:

  • Diabetes

This condition will likely occur due to glucose intolerance.

  • Hypertension

High cortisol increases the blood pressure, thus putting too much stress on the cardiovascular system.

  • Recurrent bouts of infections

This is attributed to the suppression of the immune system.

  • Osteoporosis

This will likely occur if the syndrome is not treated immediately, making the bone prone to fractures.

  • Blood clots

Sufferers are more susceptible to blood clots like DVT or deep vein thrombosis which is potentially deadly once it finds its way to the lungs.

Cushing’s syndrome diagnosis and treatment

There is no definitive lab test to diagnose the syndrome, so the doctor will order an array of tests and medical assessments to confirm the condition.  Some of these are:

  • · 24-hour urinary-free cortisol level test
  • · Midnight plasma cortisol/late-night salivary cortisol measurements
  • LDDST (Low-dose dexamethasone suppression test)
  • CRH (Dexamethasone-corticotropin-releasing hormone test)
  • · CRH stimulation test
  • HDDST (high-dose dexamethasone suppression test)
  • · Radiologic imaging
  • Petrosal sinus sampling

The chances of recovery from Cushing’s Syndrome vary with every individual depending on the underlying cause. Treating the syndrome may involve lowering the dosage of corticosteroid use, medication, surgery and radiation therapy.

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