BACK TOTOP Browse A-ZSearchBrowse A-ZABCDEFGHIJKLMNOPQRSTUVWXYZ0-9 E-mail FormEmail ResultsName:Email address:Recipients Name:Recipients address:Message: Print-FriendlyBookmarksbookmarks-menuCushing syndromeHypercortisolism; Cortisol excess; Glucocorticoid excess - Cushing syndromeCushing syndrome is a disorder that occurs when your body has a high level of the hormone cortisol. Causes The most common cause of Cushing syndrome is taking too much glucocorticoid or corticosteroid medicine. This form of Cushing syndrome is called exogenous Cushing syndrome. Prednisone, dexamethasone, and prednisolone are examples of this type of medicine. Glucocorticoids mimic the action of the body's natural hormone cortisol. These drugs are used to treat many conditions such as asthma, skin inflammation, cancer, bowel disease, joint pain, and rheumatoid arthritis.Exogenous Cushing syndromeExogenous Cushing syndrome is a form of Cushing syndrome that occurs in people taking glucocorticoid (also called corticosteroid, or steroid) hormone...ImageRead Article Now Book Mark Article Other people develop Cushing syndrome because their body produces too much cortisol. This hormone is made in the adrenal glands. Causes of too much cortisol are:Adrenal glands.The adrenal glands are two small triangle-shaped glands. One gland is located on top of each kidney.ImageRead Article Now Book Mark Article Cushing disease, which occurs when the pituitary gland makes too much of the hormone adrenocorticotrophic hormone (ACTH). ACTH then signals the adrenal glands to produce too much cortisol. A pituitary gland tumor can cause this condition. Cushing diseaseCushing disease is a condition in which the pituitary gland releases too much adrenocorticotropic hormone (ACTH). The pituitary gland is an organ of...ImageRead Article Now Book Mark Article Tumor of the adrenal gland Tumor of the adrenal glandCushing syndrome due to adrenal tumor is a form of Cushing syndrome. It occurs when a tumor of the adrenal gland releases excess amounts of the horm...ImageRead Article Now Book Mark Article Tumor elsewhere in the body that produces corticotropin-releasing hormone (CRH) Tumors elsewhere in the body that produce ACTH (ectopic Cushing syndrome) 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 Ectopic Cushing syndromeEctopic Cushing syndrome is a form of Cushing syndrome in which a tumor outside the pituitary gland produces a hormone called adrenocorticotropic hor...ImageRead Article Now Book Mark Article Symptoms Symptoms vary. Not everyone with Cushing syndrome has the same symptoms. Some people have many symptoms while others have hardly any symptoms. Symptoms usually get worse over time.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 can include:Skin infections Purple stretch marks (1/2 inch or 1 centimeter or more wide) called striae on the skin of the abdomen, upper arms, thighs, 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 (especially on the arms and hands) 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 collar bones 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) changes include:Type 2 diabetes mellitus High blood pressure (hypertension) Increased cholesterol and triglycerides (hyperlipidemia)Women with Cushing syndrome may have:Excess hair growth on the face, neck, chest, abdomen, and thighs 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 with this disease: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.Laboratory tests that may be done to diagnose Cushing syndrome and identify the cause are:Blood cortisol level 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 Blood sugar Blood sugarA 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 Saliva cortisol level Dexamethasone suppression test Dexamethasone suppression testDexamethasone suppression test measures whether adrenocorticotrophic hormone (ACTH) secretion by the pituitary can be suppressed.Read Article Now Book Mark Article 24-hour urine for cortisol and creatinine CortisolThe cortisol urine test measures the level of cortisol in the urine. Cortisol is a glucocorticoid (steroid) hormone produced by the adrenal gland. C...ImageRead Article Now Book Mark Article CreatinineThe creatinine urine test measures the amount of creatinine in urine. This test is done to see how well your kidneys are working. Creatinine can als...ImageRead Article Now Book Mark Article ACTH level ACTH levelThe 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 ACTH stimulation test (in rare cases) 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 Tests to determine the cause or complications may include:Abdominal CT Abdominal CTAn abdominal CT scan is an imaging method. This test uses x-rays to create cross-sectional pictures of the belly area. CT stands for computed tomog...ImageRead Article Now Book Mark Article Pituitary MRI Pituitary MRIA head MRI (magnetic resonance imaging) is an imaging test that uses powerful magnets and radio waves to create pictures of the brain and surrounding...ImageRead Article Now Book Mark Article Bone mineral densityBone mineral densityA 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 Making the diagnosis of Cushing syndrome is complicated. Usually, you will be asked to see a hormone specialist (endocrinologist). Treatment Treatment depends on the cause.Cushing syndrome caused by corticosteroid use:Your provider will instruct you to slowly decrease the medicine dosage. Stopping the medicine suddenly can be dangerous. If you cannot stop taking the medicine because of disease, your high blood sugar, high cholesterol levels, and bone thinning or osteoporosis should be closely monitored and treated. OsteoporosisOsteoporosis is a disease in which bones become fragile and more likely to break (fracture).ImageRead Article Now Book Mark Article With Cushing syndrome caused by a pituitary or a tumor that releases ACTH (Cushing disease), you may need:Surgery to remove the tumor Radiation after removal of a pituitary tumor (in some cases) Cortisol replacement therapy after surgery Medicines to replace pituitary hormones that become deficient Medicines to prevent the body from making too much cortisol With Cushing syndrome due to a pituitary tumor, adrenal tumor, or other tumors:You may need surgery to remove the tumor. If the tumor cannot be removed, you may need medicines to help block the release of cortisol or the ability of cortisol to signal. Outlook (Prognosis) Removing the tumor may lead to full recovery, but there is a chance that the condition will return.Survival for people with Cushing syndrome caused by tumors depends on the tumor type. Untreated, Cushing syndrome can be life threatening. Possible Complications Health problems that may result from Cushing syndrome include any of the following: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 Enlargement of pituitary tumor Bone fractures due to osteoporosis Bone fracturesIf more pressure is put on a bone than it can stand, it will split or break. A break of any size is called a fracture. If the broken bone punctures...ImageRead Article Now Book Mark Article High blood pressure Kidney stones Kidney stonesA kidney stone is a solid mass made up of tiny crystals. One or more stones can be in the kidney or ureter at the same time.ImageRead Article Now Book Mark Article Serious infections When to Contact a Medical Professional Call your provider if you have 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; Endocrine Society. 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/.AllVideoImagesTogEndocrine glands - illustration Endocrine glands release hormones (chemical messengers) into the bloodstream to be transported to various organs and tissues throughout the body. For instance, the pancreas secretes insulin, which allows the body to regulate levels of sugar in the blood. The thyroid gets instructions from the pituitary to secrete hormones which determine the rate of metabolism in the body (the more hormone in the bloodstream, the faster the chemical activity; the less hormone, the slower the activity).Endocrine glandsillustrationEndocrine glands - illustration Endocrine glands release hormones (chemical messengers) into the bloodstream to be transported to various organs and tissues throughout the body. For instance, the pancreas secretes insulin, which allows the body to regulate levels of sugar in the blood. The thyroid gets instructions from the pituitary to secrete hormones which determine the rate of metabolism in the body (the more hormone in the bloodstream, the faster the chemical activity; the less hormone, the slower the activity).Endocrine glandsillustrationRelated Information ACTH blood test(Medical Test)Adrenal glands(Special Topic)Pituitary tumor(Condition)Tumor(Condition)Rheumatoid arthritis(Condition)Asthma(Condition)Cushing disease(Condition)Exogenous Cushing syndrome(Condition)Ectopic Cushing syndrome(Condition)Cushing syndrome due to adrenal tumor(Condition)Rheumatoid arthritis(In-Depth)Asthma in adults(In-Depth)Diabetes - type 1(In-Depth) 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. 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