Cushing's Syndrome Facts and Symptoms

Jun 24, 2011
Kimberly McRae

Adrenal Gland - National Cancer Institute

Learn about the cause, symptoms and treatment of Cushing's Syndrome, an endocrine disorder caused by prolonged exposure to high cortisol.

Homeopathic medicine professionals have been educating people on the effects of prolonged stress causing a syndrome known as adrenal fatigue. Endocrine disorder specialists have been treating low and high cortisol created by this adrenal hormonal imbalance. These two extreme forms of adrenal fatigue are Addison's Disease (low cortisol) and Cushing's Syndrome (high cortisol).

What is Cushing's Syndrome?

During times of stress our bodies produce a hormone known as cortisol to help manage the effects of stress. Cortisol is used by the body to regulate blood sugar, metabolism, inflammation, and the immune system.

When a person is exposed to high levels of cortisol over an extended period of time it can cause Cushing's Syndrome. The Cushing's Support and Research Foundation reports that only 10 - 15 people per million each year are affected by Cushing's. Due to the rare nature of this endrocrine disorder it can be difficult to find a doctor that is well informed on the testing and treatment options.

Causes of Cushing's Syndrome

Cushing's Syndrome can be caused by the body's overproduction of cortisol, excess production of ACTH (adrenocorticotropic hormone), or from medications.

ACTH is used to regulate cortisol production. Some patients with Cushing's Syndrome may have a tumor that excretes excess ACTH. These tumors can be found on the pituitary gland or adrenal glands. They may also be found in the lungs, pancreas, thyroid, or thymus glands. The tumors can be either benign or cancerous. Tumors found on the adrenal or pituitary glands are typically benign.

Additionally, patients can develop Cushing's Syndrome through disorders of the adrenal glands and, on rare occasions, it can be genetic.

Lupus and Rheumatoid Arthritis sufferers are often exposed to high levels of prednisone on a daily basis during treatment. Prolonged use of glucocorticoid hormones can cause Cushing's Syndrome.

Symptoms of Cushing's Syndrome

There are a number of symptoms that can be a sign of Cushing's Syndrome. Not all patients will display the entire list of symptoms. Some may have many while others may show only a few.

Perhaps three of the most common visual signs of Cushing's Syndrome are a hump that forms on the upper back below the nape of the neck known as a "buffalo hump," a round puffy moon shaped face, and purple stretch marks on the stomach or breasts. Other visual signs are weight gain, acne, facial hair growth on women, loss of hair, and poor wound healing.

Additional symptoms of Cushing's Syndrome include fatigue, menstrual irregularities, mood changes (depression and anxiety), unstable blood glucose levels, water retention, easy bruising, and muscle weakness. The National Adrenal Diseases Foundation also reports that untreated Cushing's Syndrome can cause osteoporosis of the spine and an increased risk of getting pneumonia and TB.

Testing for Cushing's Syndrome

Some doctors may not be well informed on the testing procedures for Cushing's Syndrome. These doctors will run a simple cortisol test to get the level of cortisol at the time of testing. This is inaccurate as it can be normal in a Cushing's patient.

Their are four tests that are typically used to accurately diagnose Cushing's Syndrome:

Late-night Salivary Cortisol
24-Hour Urine Free Cortisol
Low-Dose Dexamethasone Suppression
CRH Stimulation Test

Patients being tested using the Late-Night Salivary Cortisol test will have saliva collected between 11:00 pm and midnight. Research performed by doctors J.W. Findling, H. Raff, and J.L. Raff showed that Cushing's Syndrome patients tested at 11:00 pm had elevated levels of cortisol.

Patients tested using the 24-Hour Urine Free cortisol methods will be given a collection jug by their physician. Urine is collected beginning in the morning and each urination following for 24 hours.

For the Low-Dose Dexamethasome Suppression test the patient is given a steroid that can inhibit the production of the hormones CRH and ACTH. During this test cortisol production should be suppressed. If high levels of cortisol are shown in the sample it could be an indication of Cushing's Syndrome.

The CRH Stimulation Test uses the same principle as the Low-Dose Dexamethasone test by injecting CRH (Corticotrophin Releasing Hormone).

If Cushing's Syndrome is suspected additional tests may be run such as CT, Ultrasound, and MRI tests to look for adrenal, pituitary or ectopic tumors.

Treating Cushing's Syndrome

For patients who have been found to have a tumor that is causing Cushing's Syndrome, the tumor is typically surgically removed. This can be followed up by radiation therapy. Some physicians recommend radiation therapy for patients who are unable to undergo surgery. The Mayo Clinic indicates that radiation is given for a six-week period using a technique called stereotactic radiosurgery or gamma-knife radiation.

If surgical removal of a portion of the gland that is affected by the tumor is recommended, often the patient will remain on hormone replacement following surgery. These levels will need to be monitored and adjusted by a physician over time.

Patients who have Cushing's Syndrome due to steriod usage may be given alternative medications or a reduction in their medication to address the excess cortisol production.

Naturopaths have begun treating Cushing's Syndrome sufferers with a variety of natural supplements to adjust the imbalance of adrenal hormones. Marcelle Pick, OB/GYN NP works with women at the Women's Clinic in Yarmouth, Maine, to treat adrenal extremes using herbal medicine.

A general practitioner or physician specializing in endocrine disorders can test and diagnose Cushing's Syndrome or Adrenal Fatigue as well as recommend treatment options.

Disclaimer: The information contained in this article is for educational purposes only and should not be used for diagnosis or to guide treatment without the opinion of a health professional. Any reader who is concerned about his or her health should contact a doctor for advice.