By Dr. Hanish Gupta, Endocrinology
Also known as hypercortisolism, Cushing’s syndrome is a disorder resulting from prolonged exposure to high levels of cortisol. Cushing syndrome occurs when your body is exposed to high levels of the hormone cortisol for a long time.
Too much cortisol can produce some of the hallmark signs of Cushing syndrome — a fatty hump between your shoulders, a rounded face, and pink or purple stretch marks on your skin. This condition can result in high blood pressure, bone loss and Type 2 Diabetes.
Overexposure to high levels of the “cortisol” hormone over an extended period of time is the primary reason behind Cushing’s syndrome. Excessive use of oral corticosteroid medications and overproduction of cortisol in the body bring about this condition. Other reasons that result in excess cortisol include:
- Strenuous athletic training
- Alcoholism and excess smoking
- Depression and panic disorders
- Subject to high levels of stress
In addition to the various signs listed above, the other symptoms include:
- Weight gain
- Acne breakouts, primarily on the face
- Increased urination
- Skin injuries that heal slowly
- Increased occurrence of infections
- Glucose intolerance
Men may also have erectile dysfunction, diminished or no sexual interest, and decreased fertility. Women may find absent or irregular menstrual periods and extra hair growth on their faces, chests, necks, abdomens, and thighs. Children with Cushing’s usually have a slower rate of growth and may be overweight to obese.
Your adrenal glands produce cortisol. It helps with a number of your body’s functions, including:
- regulating blood pressure and the cardiovascular system
- reducing the immune system’s inflammatory response
- converting carbohydrates, fats, and proteins into energy
- balancing the effects of insulin
- responding to stress
Your body may produce high levels of cortisol for a variety of reasons, including:
- high-stress levels, including stress related to an acute illness, surgery, injury, or pregnancy, especially in the final trimester
- athletic training
- depression, panic disorders, or high levels of emotional stress
The most common cause of Cushing’s syndrome is the use of corticosteroid medications, such as prednisone, in high doses for a long period. Doctors can prescribe these medications to prevent rejection of a transplanted organ. They also use them to treat inflammatory diseases, such as lupus and arthritis. High doses of injectable steroids for treatment of back pain can also cause this syndrome.
With effective treatment, cortisol levels will gradually stabilize and symptoms will eventually improve. It should be noted that the earlier you receive treatment, the better the outcome.
Depending upon the causes of the syndrome, treatment may vary accordingly. The design, however, of all treatment methods is to help lower excessive levels of cortisol hormone in your body. Here are a few possible treatment options:
- Reducing the Use of Corticosteroids: Long term usage of corticosteroid medications is the primary reason behind Cushing’s syndrome. Hence, symptoms can be improved by either decreasing the dosage over a period of time or by taking prescribed non-corticosteroid drugs.
- Surgery: Cushing’s syndrome resulting from tumours would require a complete surgical removal. If the tumour forms in the lungs, pancreas or adrenal glands, it can be surgically removed either by standard surgery methods or using minimally invasive surgical techniques with relatively smaller incisions.
- Radiation Therapy: This form of treatment is recommended only if your pituitary gland cannot be removed completely or if you are not eligible for a surgery.
- Medication: Specific medications that help control cortisol production should be administered if surgery and radiation therapy prove to be ineffective.