BACK TOTOP Browse A-ZSearchBrowse A-ZABCDEFGHIJKLMNOPQRSTUVWXYZ0-9 E-mail FormEmail ResultsName:Email address:Recipients Name:Recipients address:Message: Print-FriendlyBookmarksbookmarks-menuExogenous Cushing syndromeCushing syndrome - corticosteroid induced; Corticosteroid-induced Cushing syndrome; Iatrogenic Cushing syndromeExogenous Cushing syndrome is a form of Cushing syndrome that occurs in people taking glucocorticoid (also called corticosteroid, or steroid) hormones.Cushing syndromeCushing syndrome is a disorder that occurs when your body has a high level of the hormone cortisol.ImageRead Article Now Book Mark Article Causes Cushing syndrome is a disorder that occurs when your body has a higher than normal level of the hormone cortisol. This hormone is normally made in the adrenal glands.Adrenal glandsThe adrenal glands are two small triangle-shaped glands. One gland is located on top of each kidney.ImageRead Article Now Book Mark Article Exogenous means caused by something outside the body. Exogenous Cushing syndrome occurs when a person takes man-made (synthetic) glucocorticoid medicines to treat a disease. These medicines act like cortisol in the body.Glucocorticoids are given for many diseases, such as lung diseases, skin conditions, inflammatory bowel disease, cancer, brain tumors, and joint disease. These medicines come in many forms, including pill, intravenous (IV), injection into a joint, enema, skin creams, inhalers, and eye drops. Symptoms Most people with Cushing syndrome have:Round, red, full face (moon face) Moon faceFacial swelling is the buildup of fluid in the tissues of the face. Swelling may also affect the neck and upper arms.ImageRead Article Now Book Mark Article Slow growth rate (in children) Weight gain with fat accumulation on the trunk, but fat loss from the arms, legs, and buttocks (central obesity) Skin changes that are often seen include:Skin infections Purple stretch marks (1/2 inch or 1 centimeter or more wide), called striae, on the skin of the abdomen, thighs, upper arms, and breasts StriaeStretch marks are irregular areas of skin that look like bands, stripes, or lines. Stretch marks are seen when a person grows or gains weight rapidl...ImageRead Article Now Book Mark Article Thin skin with easy bruising Muscle and bone changes include:Backache, which occurs with routine activities Bone pain or tenderness Bone pain or tendernessBone pain or tenderness is aching or other discomfort in one or more bones.ImageRead Article Now Book Mark Article Collection of fat between the shoulders and above the collar bone Rib and spine fractures caused by thinning of the bones Thinning of the bonesOsteoporosis is a disease in which bones become fragile and more likely to break (fracture).ImageRead Article Now Book Mark Article Weak muscles, especially of the hips and shoulders Body-wide (systemic) problems may include:Type 2 diabetes High blood pressure High cholesterol and triglyceridesWomen may have:Periods that become irregular or stop Men may have:Decreased or no desire for sex (low libido) Erection problemsErection problemsAn erection problem occurs when a man cannot get or keep an erection that is firm enough for intercourse. You may not be able to get an erection at ...ImageRead Article Now Book Mark Article Other symptoms that may occur include: Mental changes, such as depression, anxiety, or changes in behavior Fatigue FatigueFatigue is a feeling of weariness, tiredness, or lack of energy.Read Article Now Book Mark Article Headache Increased thirst and urination Exams and Tests The health care provider will perform a physical exam and ask about your symptoms and the medicines you are taking. Tell the provider about all medicines you have been taking for the past several months. Also, tell the provider about shots that you received at a provider's office.If you use cortisone, prednisone, or other corticosteroids, the following test results may suggest exogenous Cushing syndrome:Low ACTH level ACTHThe ACTH test measures the level of adrenocorticotropic hormone (ACTH) in the blood. ACTH is a hormone released from the pituitary gland in the brai...ImageRead Article Now Book Mark Article Low cortisol level (or high cortisol level) in the blood or urine, depending on the medicine you are taking Cortisol levelThe cortisol blood test measures the level of cortisol in the blood. Cortisol is a steroid (glucocorticoid or corticosteroid) hormone produced by th...Read Article Now Book Mark Article Abnormal response to a cosyntropin (ACTH) stimulation test Cosyntropin (ACTH) stimulation testThe ACTH stimulation test measures how well the adrenal glands respond to adrenocorticotropic hormone (ACTH). ACTH is a hormone produced in the pitu...Read Article Now Book Mark Article Higher than normal fasting glucose level Fasting glucoseA blood sugar test measures the amount of a sugar called glucose in a sample of your blood. Glucose is a major source of energy for most cells of the...ImageRead Article Now Book Mark Article Low blood potassium level Blood potassiumThis test measures the amount of potassium in the fluid portion (serum) of the blood. Potassium (K+) helps nerves and muscles communicate. It also ...ImageRead Article Now Book Mark Article Low bone density, as measured by bone mineral density test Bone mineral density testA bone mineral density (BMD) test measures how much calcium and other types of minerals are in an area of your bone. This test helps your health care...ImageRead Article Now Book Mark Article High cholesterol, particularly high triglycerides and low high-density lipoprotein (HDL) A method called high performance liquid chromatography (HPLC) can show a high level of the suspected medicine in the urine. Treatment Treatment is to decrease and eventually stop taking any corticosteroids. This may be done slowly or quickly, depending on why you are being treated with corticosteroid. Do not stop taking any medicine without first talking to your provider. Suddenly stopping corticosteroids after taking them for a long time (usually more than 2 weeks) can result in a life-threatening condition called adrenal crisis. Adrenal crisisAcute adrenal crisis is a life-threatening condition that occurs when there is not enough cortisol. This is a hormone produced by the adrenal glands...ImageRead Article Now Book Mark Article If you cannot stop taking the medicine because of disease (for example, you need glucocorticoid medicine to treat severe asthma), follow your provider's instructions on how to reduce the possibility of developing complications, including:Treating high blood sugar with diet, oral medicines, or insulin. Treating high cholesterol with diet or medicines. Taking medicines to prevent bone loss. This can help reduce the risk for fractures if you develop osteoporosis. Taking other medicines to decrease the amount of glucocorticoid medicine that you need. Outlook (Prognosis) Slowly tapering the medicine that is causing the condition can help reverse the effects of adrenal gland shrinkage (atrophy). This may take months to as long as a year. During this time, you may need to restart or increase the dosage of your steroids in times of stress or illness. Possible Complications Health problems that may result from exogenous Cushing syndrome include any of the following:Low immune system, which may lead to frequent infections Damage to the eyes, kidneys, and nerves due to untreated high blood sugar Diabetes DiabetesDiabetes is a long-term (chronic) disease in which the body cannot regulate the amount of sugar in the blood.ImageRead Article Now Book Mark Article High cholesterol levels High cholesterolCholesterol is a fat (also called a lipid) that your body needs to work properly. Too much bad cholesterol can increase your chance of getting heart...ImageRead Article Now Book Mark Article Increased risk for heart attack from untreated diabetes and high cholesterol Increased risk for blood clots Weak bones (osteoporosis) and increased risk for fracturesOsteoporosisOsteoporosis is a disease in which bones become fragile and more likely to break (fracture).ImageRead Article Now Book Mark Article These complications can generally be prevented with proper treatment. When to Contact a Medical Professional Call for an appointment with your provider if you are taking a corticosteroid and you develop symptoms of Cushing syndrome. Prevention If you take a corticosteroid, know the signs and symptoms of Cushing syndrome. Getting treated early can help prevent any long-term effects of Cushing syndrome. If you use inhaled steroids, you can decrease your exposure to the steroids by using a spacer and by rinsing your mouth after breathing in the steroids.Open ReferencesReferencesNewell-Price JDC, Auchus RJ. The adrenal cortex. In: Melmed S, Auchus RJ, Goldfine AB, Koenig RJ, Rosen CJ, eds. Williams Textbook of Endocrinology. 14th ed. Philadelphia, PA: Elsevier; 2020:chap 15.Nieman LK, Biller BM, Findling JW, et al. Treatment of Cushing's syndrome: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab. 2015;100(8):2807-2831. PMID: 26222757 pubmed.ncbi.nlm.nih.gov/26222757/.AllVideoImagesTogHypothalamus hormone production - illustration The controlling hormones from the hypothalamus regulate hormone production by the pituitary. These hormones regulate body processes such as metabolism and control the release of hormones from glands like the thyroid, the adrenals, and the gonads (testes or ovaries).Hypothalamus hormone productionillustrationHypothalamus hormone production - illustration The controlling hormones from the hypothalamus regulate hormone production by the pituitary. These hormones regulate body processes such as metabolism and control the release of hormones from glands like the thyroid, the adrenals, and the gonads (testes or ovaries).Hypothalamus hormone productionillustrationRelated Information Cushing syndrome(Condition) Review Date: 5/13/2021 Reviewed By: Brent Wisse, MD, Board Certified in Metabolism/Endocrinology, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. 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