Patient education: Cushing syndrome (The Basics)

What is Cushing syndrome? — Cushing syndrome is a condition that can cause lots of different medical problems. These can include high blood pressure, weight gain, muscle weakness, and thin skin.

Cushing syndrome happens when a person has too much of a hormone called "cortisol" in their body. Cortisol helps the body to work normally. But when people have too much cortisol, they can get symptoms.

Cortisol is made in the adrenal glands, which are small organs located on top of each kidney (figure 1). Normally, the adrenal glands make cortisol after they receive signals from the pituitary gland. The pituitary gland is a small organ located just below the brain.

What are the causes of Cushing syndrome? — Cushing syndrome can be caused by:

●Taking steroid medicines – Steroids are medicines that act like cortisol in the body. People might take high doses of these medicines for asthma or some types of arthritis.

●Abnormal growths in the pituitary gland or other parts of the body – These can signal the adrenal glands to make too much cortisol.

●Problems in the adrenal glands that cause them to make too much cortisol

What are the symptoms of Cushing syndrome? — People with Cushing syndrome can have 1 or more of the following symptoms:

●Weight gain in the face, neck, back, or belly

●Thin skin that bruises easily or has wide "stretch marks" (picture 1)

●Missed or irregular monthly periods (in females)

●Increased facial hair growth (in females)

●Oily skin or acne

●Weak muscles in the upper arms or legs. For example, it might be hard to get out of a chair.

●Bones that can break more easily than normal

●Diabetes (high blood sugar levels)

●High blood pressure and heart problems

●Changes in mood, such as feeling depressed, worried, or angry

●Problems with learning, attention, or memory

●Getting infections more easily

●Blood clots in the veins in the legs

Different people can have different symptoms. If symptoms are not treated, they can get worse over time and become life-threatening.

Is there a test for Cushing syndrome? — Yes. Your doctor or nurse will talk with you and do an exam. They will also do lab tests to measure the cortisol levels in your urine, blood, or saliva. If your cortisol levels are high, you will need more tests to figure out which treatment is right for you. These tests can include:

●Blood tests

●CT or MRI scans of your pituitary gland or adrenal glands, or other imaging tests – Imaging tests can create pictures of the inside of the body.

How is Cushing syndrome treated? — Treatment for Cushing syndrome depends on the cause. If you have symptoms because you take high doses of steroids, your doctor will slowly reduce your dose.

If you do not take steroids, treatment might include:

●Surgery – Doctors can do different types of surgery to remove:

•Abnormal growths in the pituitary gland or other parts of the body

•One or both of the adrenal glands

●Radiation therapy – Radiation can kill cells that are growing abnormally.

●Medicines – Different medicines can stop the adrenal glands from making too much cortisol.

What if I want to get pregnant? — Cushing syndrome can make it hard to get pregnant. This is because the extra cortisol often causes "infertility." This means trouble getting pregnant. If you want to try to get pregnant, tell your doctor or nurse. They can work with you to make a treatment plan.

If you have symptoms of Cushing syndrome and do get pregnant, talk with your doctor or nurse. Pregnant people with Cushing syndrome need treatment. Without treatment, Cushing syndrome can lead to problems like high blood pressure and diabetes during pregnancy.

What will my life be like? — Many people with Cushing syndrome can be cured with treatment. But some people will need to take medicine for the rest of their lives to stay healthy.

While most symptoms get better with treatment, some might not go away completely. If you had trouble with attention or memory, you might still have these problems. Talk to your doctor or nurse if you are worried about any of your symptoms or having a hard time coping.

More on this topic

Patient education: Acne (The Basics)
Patient education: Osteoporosis (The Basics)
Patient education: Absent or irregular periods (The Basics)
Patient education: Type 2 diabetes (The Basics)
Patient education: Depression in adults (The Basics)
Patient education: Deep vein thrombosis (blood clot in the leg) (The Basics)
Patient education: Addison disease (The Basics)
Patient education: Pituitary adenoma (The Basics)
Patient education: Cortisol test (The Basics)

Patient education: Cushing syndrome (Beyond the Basics)
Patient education: Cushing syndrome treatment (Beyond the Basics)
Patient education: Adrenal insufficiency (Beyond the Basics)