Also known as: Cushing's Syndrome / Hypercortisolism
Cushing's syndrome results from prolonged exposure to high levels of cortisol, either from the body overproducing it or from long-term corticosteroid medications.
Cushing's syndrome has two main categories: exogenous (caused by corticosteroid medications — the most common cause) and endogenous (the body overproduces cortisol).
Endogenous Cushing's affects 10-15 per million people annually. Cushing's disease (pituitary adenoma causing ACTH overproduction) accounts for 70% of endogenous cases.
Untreated Cushing's causes significant morbidity including diabetes, hypertension, osteoporosis, and increased infection risk, with elevated mortality.
People with Cushing's Syndrome often experience the following symptoms.
Weight gain concentrated in the face (moon face), upper back (buffalo hump), and abdomen, with thin limbs.
Purple striae (stretch marks) wider than 1cm, easy bruising, thin fragile skin, and poor wound healing.
New-onset or worsening diabetes, hypertension, and osteoporosis from excess cortisol.
Depression, anxiety, cognitive impairment, and insomnia in up to 70% of patients.
Certain factors may increase your likelihood of developing Cushing's Syndrome.
Common approaches to managing cushing's syndrome. Always consult a healthcare provider for personalized treatment.
For exogenous Cushing's: gradual reduction of corticosteroid medication under medical supervision.
Transsphenoidal surgery for pituitary adenoma (Cushing's disease) or adrenalectomy for adrenal tumours.
Ketoconazole, metyrapone, or osilodrostat to block cortisol production when surgery is not possible.
Pituitary radiation for recurrent Cushing's disease after surgery.
24-hour urinary free cortisol, late-night salivary cortisol, overnight dexamethasone suppression test. MRI of pituitary and CT of adrenals to locate the source.
See a doctor if you develop unexplained central weight gain with thin limbs, easy bruising, purple stretch marks, or new-onset diabetes and hypertension.
Steps that may help reduce the risk of developing or worsening cushing's syndrome.
Use lowest effective dose of corticosteroids
Consider steroid-sparing alternatives
Regular monitoring during long-term steroid therapy
Cannot prevent endogenous Cushing's
If left untreated or poorly managed, cushing's syndrome may lead to:
Exogenous cases resolve with steroid tapering. Endogenous cases are often cured with surgery but may require ongoing management.
Yes, exogenous Cushing's from prescribed corticosteroids is the most common cause overall.
Adrenal recovery after surgery takes months to years. Full cortisol recovery may take 6-18 months.
This information is for educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.