Cushing’s Disease: Symptoms, Diagnosis and Treatment

Cushing’s disease is caused by extended exposure to high levels of cortisol, a hormone. It can occur if the body releases too much of the hormone naturally or if the person is taking oral corticosteroid medication. There are treatments that can help return the body’s cortisol products to a safe level. The sooner the disease is diagnosed and treated, the more likely a person is to recover.

Causes of Cushing’s Disease

Cushing’s disease is caused by a buildup of cortisol in the body. Cortisol is produced naturally, but some people also take cortisol medication to treat various illnesses, such as arthritis and asthma. Over time, this can lead to too much cortisol in the body. Cortisol is produced by the adrenal glands, and it plays a role in how the body responds to stress and how the metabolism works.

Symptoms of Cushing’s Disease

The symptoms of Cushing’s disease can vary by individual. The cortisol levels and the length of time the person has been suffering from the disease can also play a role in the symptoms and their severity. Some of the most common symptoms of the disease include:

• Weight gain
• Stretch marks
• Thinning skin
• Bruising
• Slow healing
• Acne
• Increase in facial and body hair in women
• Irregular or missed menstrual cycles in women
• Decreased libido in men
• Decreased fertility in men
• Erectile dysfunction in men
• Fatigue
• Muscle weakness
• Headaches
• Depression
• Anxiety
• Mood changes
• Bone loss
• High blood pressure
• Impaired growth in children

Diagnosis of Cushing’s Disease

Cushing’s disease can be hard to diagnose because many other illnesses have the same symptoms. It can sometimes take months or even years for Cushing’s disease to be diagnosed. Doctors use a variety of tests to diagnose it, including:

• Urine Tests: Urine tests are used to measure the hormone levels in the body.
• Blood Tests: Blood tests check hormone levels and can help rule out other diseases and illnesses.
• Saliva Tests: People with normal cortisol levels usually experience drops in those levels at night. Saliva tests can be taken at night to check for a change in these levels.
• Imaging Tests: Imaging tests can determine if the adrenal glands are enlarged or if there are any tumors present.

Treatment of Cushing’s Disease

Cushing’s disease can be treated. The sooner it is treated, the more likely a person is to recover from it. Some of the most common treatments used include:

• Reducing corticosteroid use
• Surgery to remove enlarged adrenal glands
• Radiation therapy to shrink the adrenal glands
• Oral medications that control the production of cortisol

Prognosis of Cushing’s Disease

The prognosis for people with Cushing’s disease is good as long as they seek treatment. In addition to medical treatment, people who have Cushing’s or who are at risk for it should focus on staying active, eating healthy, and getting regular checkups to monitor cortisol levels and symptoms. If undiagnosed or diagnosed too late, Cushing’s disease can be fatal.

Additional Resources:

• https://www.aace.com/publications/guidelines