Cushing's syndrome

Causes of Cushing’s syndrome

The most common cause of Cushing’s syndrome is taking high doses of steroid medicine, such as hydrocortisone or prednisolone for a long time.

Sometimes, a small, non-cancerous growth in the pituitary gland (near the brain) or adrenal glands (near the kidneys) can also cause too much cortisol to be released.

These glands help control the amount of certain hormones in your body, including cortisol.

If the problem is caused by the pituitary gland it’s called Cushing’s disease. If it's caused elsewhere in the body, it’s called Cushing's syndrome.

Symptoms of Cushing’s syndrome

Anyone can get Cushing’s syndrome, but it’s much more common in women than in men.

The symptoms often come on gradually and include:

• having more body fat on your neck, upper back, chest and tummy – your arms and legs may look thin compared to the rest of your body
• a red, round face – the redness may be harder to see on brown or black skin
• skin that bruises easily and stretch marks on your tummy, hips, breasts and under your arms
• muscle weakness, particularly at the top of your arms and legs
• low sex drive (loss of libido)
• changes in mood, such as feeling irritable, anxious or depressed
• irregular periods or periods stopping completely
• excessive hair growth (hirsutism)

Cushing's syndrome is rare in children. If a child does get it, the main symptoms are obesity and being short for their age.

What happens at your GP appointment

If a GP thinks you might have Cushing’s syndrome, they can arrange for the amount of cortisol in a sample of your blood, pee or spit (saliva) to be checked.

If you have high cortisol, you may be referred to a hormone specialist (an endocrinologist) for further tests to check for problems with your pituitary or adrenal glands.

These may include blood tests and scans of your brain and kidneys.

Treatments for Cushing's syndrome

Treatment for Cushing’s syndrome depends on what’s causing it and how severe your symptoms are.

Treatments can include:

• gradually reducing how much steroid medicine you take (if steroid medicine is causing Cushing’s syndrome)
• medicine to control the amount of cortisol your adrenal glands produce
• radiotherapy to get rid of a non-cancerous growth in the pituitary gland
• surgery to remove a growth in the pituitary gland or adrenal glands
• surgery to remove your adrenal glands – after surgery you’ll need to take medicines to replace hormones made by your adrenal glands for the rest of your life

After having treatment for Cushing’s syndrome, the amount of cortisol in your body will be checked. If it’s still high, you may need further treatment.

Complications of Cushing’s syndrome

If Cushing’s syndrome is not treated it can cause serious health problems including:

• heart attack and stroke
• high blood pressure
• type 2 diabetes
• an increased risk of blood clots
• weakened bones (osteoporosis)
• kidney stones

Help and support for Cushing's syndrome

The Pituitary Foundation provides help and support for people affected by pituitary conditions like Cushing’s syndrome.

Their services include:

• The Pituitary Foundation: helplines
• The Pituitary Foundation: Cushing’s syndrome online support group