Understanding Cushing's Syndrome

Cushing's Syndrome, also known as hypercortisolism, is a condition characterized by abnormalities produced by excessive amounts of the hormone cortisol - or by excessive use of cortisol or another similar sort of steroid hormones. While this used to be a naturally-occurring condition due to a malfunction of the adrenal glands, it is becoming increasingly common as a result of abuse of steroids.

Cortisol production in the body is actually regulated by adrenocorticotrophic hormone or ACTH, which is made in the pituitary gland. The pituitary gland is located just below the brain (the adrenal glands are located just above each kidney). Cushing's syndrome results when too much cortisol is produced in the adrenal glands, or too much is taken internally from external sources. This causes major changes and affects in the tissues and organs of the body.

Cortisol normally regulates the body's response to stress. Cortisol works to mobilize nutrients, stimulate the liver to raise blood sugar, help control the amount of water in the body and to help modify the body's response to inflammation.

When abnormalities result from Cushing's syndrome, some people may show dramatic changes in health and appearance. There is a tendency to gain weight and "bulk up" especially around the trunk and abdomen. The face may become round and "moon-like," there may be a thinning and weakness of the muscles of the upper arms and/or legs and the skin may appear thin and bruise easily. There may also be increased acne, facial hair growth and both men and women may look more masculine. Symptoms may also include weariness and fatigue, depression, mood swings, increased thirst and need for urination and a lack of menstrual cycles in women.

A doctor will perform tests, screenings and a physical exam to confirm the presence of Cushing's syndrome, and rule out other disorders. This is a rather rare disease, occurring in only about 25 people per 1,000,000 each year, so the doctor will be testing for other conditions as well. Evaluation will likely take several days and will involve testing for excess cortisol via blood and urine tests, as well as a variety of other tests and procedures.

Upon a positive diagnosis of Cushing's syndrome, treatment will depend on the severity and the cause of the disease. If it is caused by taking steroid hormones, treatment will involve withdrawal and management of this condition. In some cases, the best treatment will be the surgical removal of the pituitary tumor, or sometimes the entire pituitary gland.

Recovery also depends on the severity of the disease. Treatment is usually a long, slow process taking months, and potentially, years. The outcome will depend on the degree of the syndrome and the cortisol excess, how long the disease has been present, the overall health of the person affected, and why the type of syndrome and symptoms each case of Cushing's syndrome presents. A person will be working with an endocrinologist, in addition to his or her regular doctor. An endocrinologist is a doctor who specializes in hormonal diseases.