There are many diseases associated with abnormal levels of hormones. Cushing’s syndrome is a condition caused by having too much of a hormone called cortisol in your body. It can be serious if it’s not treated.
Who gets Cushing’s syndrome?
Cushing’s syndrome mostly affects people who have been taking steroid medicine, especially steroid tablets, for a long time. Steroids contain a man-made version of cortisol.
Very rarely, it can be caused by the body producing too much cortisol. This is usually due to:
• a growth (tumour) in the pituitary gland in the brain
• a tumour in one of the adrenal glands above the kidneys
The tumours are usually non-cancerous (benign). They are most common in young women.
What are some signs and symptoms of Cushing’s syndrome?
The signs and symptoms of Cushing’s syndrome can vary depending on the levels of excess cortisol. Increased weight gain and skin changes are common symptoms of this syndrome.
Common symptoms include the following:
• Weight gain and fatty tissue deposits particularly around the midsection and upper back, in the face (moon face), and between the shoulders (buffalo hump)
• Pink or purple stretch marks (striae) on the skin of the abdomen, thighs, breasts and arms
• Thinning, fragile skin that bruises easily
• Slow healing of cuts, insect bites and infections
• Acne
Women with Cushing’s syndrome may experience:
• Thicker or more visible body and facial hair (hirsutism)
• Irregular or absent menstrual periods
Men with Cushing’s syndrome may experience:
• Decreased libido
• Decreased fertility
• Erectile dysfunction
Other symptoms include:
• Severe fatigue
• Muscle weakness
• Depression, anxiety and irritability
• Loss of emotional control
• Cognitive difficulties
• New or worsened high blood pressure
• Headache
• Bone loss, leading to fractures over time
• In children, impaired growth
Cushing’s syndrome can also cause high blood pressure which can be serious if not treated.
Diagnosis
If you have symptoms suggestive of Cushing’s syndrome see you doctor for an evaluation. Diagnosis might be easy if you are known to be taking steroids.
If you are not taking steroids, it can be difficult to diagnose because the symptoms can be like other conditions. Various tests might be needed to confirm the diagnosis, and you may be referred to a specialist in hormone conditions (endocrinologist) to confirm or rule out Cushing’s syndrome.
Treatment
Once the diagnosis is made your doctor will discuss with you the different treatments available. Treatment will depend on what is causing it.
Complications
Without treatment, complications of Cushing’s syndrome may include:
• Bone loss (osteoporosis) which can result in unusual bone fractures such as rib fractures and fractures of the bones in the feet
• High blood pressure (hypertension)
• Type 2 diabetes
• Frequent or unusual infections
• Loss of muscle mass and strength
Conclusion
Cushing’s syndrome can cause serious complications if not diagnosed and treated correctly. If you have signs and symptoms suggestive of Cushing’s syndrome you should see your doctor. Treatment is usually successful, but it can often take a while to see the benefits of treatment.
Ask Your Doctor is a health education column and is not a substitute for medical advice from your physician. The reader should consult his or her physician for specific information concerning specific medical conditions. While all reasonable efforts have been made to ensure that all information presented is accurate, as research and development in the medical field are ongoing, it is possible that new findings may supersede some data presented.
Dr Brett Hodge MB BS DGO MRCOG is an Obstetrician/Gynaecologist and Family Doctor who has over thirty-five years in clinical practice. Dr Hodge has a medical practice in The Johnson Building in The Valley (Tel: 264 4975828).
