Cushing’s Syndrome (Hypercortisolism)
Cushing’s syndrome refers to a condition in which your body is exposed to high levels of cortisol over a long period of time. Cortisol, also known as stress hormone, is produced by adrenal gland that is situated above the kidneys. Hypercortisolism is a result of either excessive production of cortisol by your body (endogenous Cushing’s syndrome) or exposure to external sources (exogenous Cushing’s syndrome) such as corticosteroid medications. Cortisol plays an important role in regulation of body functions such as conversion of proteins and carbohydrates into energy, maintaining blood pressure levels, reducing inflammations and responding to stress.
The causes differ depending on the type of Cushing’s syndrome.
Exogenous Cushing’s syndrome:
- Oral corticosteroids
- Injectable corticosteroids
Endogenous Cushing’s syndrome:
- Pituitary tumours
- Adrenal gland diseases or tumours
- Adrenocorticotropic hormone – secreting tumour
Adrenocorticotropic hormone stimulates the adrenal glands to produce steroid hormones including cortisol.
Signs and symptoms of Cushing’s syndrome can vary depending on the excess cortisol levels produced. Some of the symptoms include:
- Weight gain particularly in the face, between shoulders (buffalo hump) and back
- Weak muscles
- Depression, anxiety, losing emotional control
- Thinning of skin
- Rounding of face (moon face)
- Easy bruising due to fragile skin
- Purple stretch marks on abdomen, thighs, breasts or arms
- Appearance of acne
- Slow healing of wounds
- Erectile dysfunction, decreased sex drive and fertility in males
- Irregular menstrual cycles and thickening of body and facial hairs in females
Diagnosis of Cushing’s syndrome can be time taking and a difficult procedure as the symptoms can also occur in other conditions such as poly cystic ovary syndrome and depression. Hence, various tests might be needed to differentially diagnose Cushing’s syndrome or hypercortisolism. Some of the diagnostic procedures include:
- Review of signs and symptoms
- Medical history
- Physical examination
- Urine tests
- Saliva tests
- Blood tests
- LDDST – low dose dexamethasone suppression test
- Petrosal sinus sampling
Prevention of Cushing’s syndrome involves preventing the causes of the condition. Tumours and other factors may not be preventable.
- Avoiding intake of corticosteroids can prevent exogenous Cushing’s syndrome.
- Awareness about the condition can help in early identification and treatment that can prevent the condition from getting worsened.
Treatment for Cushing’s syndrome depends on the cause of the condition.
- Reducing corticosteroid intake is a measure if excessive exposure to corticosteroid is the cause
- Surgery may be required for conditions like pituitary or adrenal gland tumours, in order to remove the tumour cells
- Radiation therapy can also be used to treat tumours which uses high energy beams to destroy tumour cells
- Medications may also be prescribed by your doctor to control levels of cortisol
- Healthy diet is also an important part of living with Cushing’s syndrome.
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