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You may known cortisol primarily as a stress hormone, but this natural steroid hormone actually plays a big role in the functioning of many body systems. Produced by the adrenal glands that sit on top of your kidneys, cortisol production is stimulated by another hormone called ACTH, which is produced by the pituitary gland.
In Cushing syndrome, sometimes called either hypercortisolism or Cushing's Syndrome, cortisol levels are elevated, setting off all the systems the hormone usually plays a role in. Cortisol increases blood glucose, stores fat and breaks down muscle protein.
What Causes Cushing Syndrome?
Cushing syndrome most commonly occurs as the result of an overdose or side effect of medications containing corticosteroids. Synthetic corticosteroids like Prednisone, dexamethasone and prednisolone mimic the action of cortisol. Corticosteroid drugs are commonly prescribed for a number of conditions, including asthma, inflammatory bowel disease, rheumatoid arthritis, lupus and many other autoimmune diseases.
There are other causes of Cushing syndrome in which body itself produces too much cortisol. This can be caused by a tumor of the adrenal glands or there may be a tumor of the pituitary gland producing excess ACTH, which in turn over-stimulates the adrenal glands — resulting in increased cortisol production. This condition is called Cushing “disease”
Cushing syndrome can also occur when a tumor outside of the pituitary gland produces ACTH. This is called Ectopic Cushing syndrome and is very rare.
Signs And Symptoms Of Cushing Syndrome
The symptoms of Cushing syndrome are brougt on by increased cortisol levels. Patients with Cushing syndrome usually present with:
- A red, rounded and full face caused by the deposition of fat (" full moon face").
- Central obesity, which means an overall weight gain with deposition of fat in the central part of the body (trunk), but a loss of fat from the limbs and buttocks.
- A hump between the shoulders due to collection of fat. It is called a “Buffalo hump”.
- Purple or pink stretch marks on the skin of abdomen, thigh or breasts called “striae”. Easy bruising of skin and skin infections are also seen. Slow healing of cuts and minor injuries.
- Osteoporosis, which means brittle bones. It is also associated with bone pains, especially backache. Weak bones — like the ribs and spine — are fractured easily.
- Muscle weakness is a very common symptom. This occurs because cortisol increases the rate of muscle protein breakdown.
- Behavioral and psychological changes like anxiety, irritability and depression.
- Other symptoms include headache, fatigue, high blood pressure and increased urination.
- In women, Cushing syndrome is associated with menstrual irregularities and hirsutism which is excessive growth of hair on the face, chest, neck, thighs and abdomen.
- In men, it is associated with a decreased libido. Cushing syndrome may also cause impotence or erectile dysfunction.
- Children with Cushing syndrome are usually obese and have stunted growth
Please tell your doctor about any medications you are taking, and about all the symptoms you have and for how long you've had them. The best way is to make a list of all the symptoms and medications. This will help the doctor in reaching a final diagnosis.