(Cushing Disease; Hypercortisolism)
Cushing syndrome is too much cortisol in the blood. Cortisol is a hormone. In normal doses, it helps the body manage stress and infection. High levels over a long period of time can cause health problems.
High levels of this hormone may be caused by:
- Long-term use of corticosteroid hormones—such as cortisone or prednisone
- Excess production of cortisol from a:
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This problem is more common in women. It is also common in people who use corticosteroids to treat problems, such as:
Symptoms may be:
- Weight gain in the upper body and trunk
- Rounded face
- Severe tiredness or muscle weakness
- Easy bruising, thin skin, or purple stretch marks
- Excess hair growth or acne in women
- Menstrual problems, especially irregular or absent periods
- Low fertility and interest in sex
- Personality changes or mood swings
The doctor will ask about symptoms and past health. A physical exam will be done.
Tests will be done to check levels of cortisol. They include blood tests, urine tests, and saliva tests.
Images will look at the pituitary and adrenal glands and at other structures. They may be done with:
Treatment of Cushing syndrome depends on the cause. Options are:
- Stopping or changing corticosteroids
- Surgical removal of a tumor
- Surgical removal of part, all, or both adrenal glands
- Radiation therapy to treat lasting tumors
- Drugs that decrease the body's cortisol—or block the way other adrenal products work
The risk of this problem may be reduced by limiting long-term corticosteroid use.
- Cushing disease. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/cushing-disease.
- Cushing's syndrome. National Institute of Diabetes and Digestive and Kidney Disorders website. Available at: https://www.niddk.nih.gov/health-information/endocrine-diseases/cushings-syndrome?dkrd=hispt0295.
- Nieman LK, Biller BM, et al. Treatment of Cushing's Syndrome: An Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab. 2015;100(8):2807-2831.
- Daniel A. Ostrovsky, MD
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