What is Cushing's syndrome?

Cushing's syndrome is a condition where your body is exposed to too much of the hormone called cortisol. This can be because your body is making too much cortisol, or because you have taken a lot of oral corticosteroid medicines. If you have Cushing's syndrome, it is treatable.

Cortisol is a hormone that is made by the adrenal glands. You have two adrenal glands, one sitting on the top of each kidney.

Cortisol is involved in many different parts of your body. It is produced all day, and especially during times of stress.

Cushing's syndrome is most often diagnosed in adults aged between 30 to 50 years. It affects 3 times as many women as men.

What are the symptoms of Cushing's syndrome?

The symptoms and signs of Cushing's syndrome can include:

• a rounded face
• weight around the torso, shoulders and neck, but thin arms and legs
• a hump between the shoulders
• high blood sugar or diabetes
• high blood pressure
• feeling tired or emotional
• skin problems like slow healing of wounds, bruising and stretch marks on the tummy, hips and thighs
• brittle bones (osteoporosis)

Other symptoms for women include more hair on the face and body and irregular periods. Men can have lower libido or erectile dysfunction.

What causes Cushing's syndrome and Cushing's disease?

Some people with Cushing's syndrome have a benign tumour in part of the brain. This tumour tells the adrenal glands to release cortisol. This condition is known as Cushing's disease. Cushing's syndrome can also be caused by:

• a tumour of the adrenal gland
• overgrowth of the adrenal glands
• occasionally, a tumour somewhere else in the body

Other people develop Cushing's syndrome from taking corticosteroid (steroid) medication for a long time.

If you have Cushing's syndrome because of taking steroid medicine, do not stop taking it suddenly, as you could become very unwell. Talk to your doctor.

When should I see my doctor?

You should see your doctor if you have any symptoms of Cushing's syndrome.

If you are diagnosed with Cushing's syndrome your doctor will organise regular check-ups with you. At these appointments, your doctor will monitor your condition and ensure that you're receiving the right treatment.

How is Cushing's syndrome diagnosed?

Cushing's syndrome can be hard to diagnose because it can look like other things.

Your doctor will talk to you, examine you and may arrange tests of your blood, urine and saliva.

If necessary, your doctor may recommend scans such as a CT scan or MRI scan.

You may also be referred to an endocrinologist (a doctor who specialises in problems with hormones).

How is Cushing's syndrome treated?

The treatment depends on the cause.

If you are taking steroids, then you and your doctor will need to talk about whether you can reduce the dose or not.

If there are other reasons as to why you have Cushing's syndrome, then you may be advised to have treatment such as:

• surgery
• radiotherapy
• chemotherapy
• medication to stop your body making too much cortisol

Can Cushing's syndrome be prevented?

The most common cause of Cushing's syndrome is the long-term use of high-dose corticosteroids. If you are taking corticosteroid medication, your doctor should monitor your cortisol levels closely.

Unfortunately, you can't prevent Cushing's syndrome when it is caused by a tumour.

Once you are diagnosed with Cushing's syndrome, eating a healthy diet can help to limit your symptoms.

What are the complications of Cushing's syndrome?

Cushing’s syndrome can usually be cured. However, it can be fatal if not treated.

Some health problems that can be caused by Cushing’s syndrome include:

• blood clots in the legs and lungs
• bone loss and fractures
• depression or other mood changes
• heart attack or stroke
• high blood pressure
• high cholesterol levels
• infections
• insulin resistance and prediabetes
• memory loss or trouble concentrating
• type 2 diabetes

Resources and support for Cushing's syndrome

Support and information for adults and children with pituitary conditions is available from the Australian Pituitary Foundation.

More information about hormones and how they affect the body is available from Hormones Australia.