Cushing syndrome is the disorderliness of the hormone caused by the extended revelation of the tissues to the elevated levels of cortisol hormone. It is also known as ‘hypercortisolism’, it has a variety of causes, but main being the overutilization of corticosteroid medications.
It is not a life-threatening disorder and affects rarely to the adults between the age 20 – 50. There are several ways to treat this syndrome, but in most cases, medication helps to control cortisol levels.
Cushing Syndrome Causes
Extreme cortisol hormone levels are accountable for this disorder. Adrenal glands produce Cortisol which is crucial in the normal functioning of the cardiovascular syndrome and to regulate blood pressure. It also converts carbohydrates, proteins, and fats into usable energy, moreover, it regulates and responds to stress. But when the level of this hormone increases, one might develop Cushing syndrome. A person can increase this hormone in two ways, through medications and by over-production.
Cushing Syndrome Medications:
Oral Corticosteroid Medicines: Cushing syndrome can develop from a reason outside the body (exogenous Cushing syndrome). By taking high doses of oral medicines for a longer duration, a person increases the risk of developing this syndrome. Medicine like prednisone also has the same effect as the natural hormone. Hence, increasing levels of Cortisol hormone that results in various side effects. Moreover, oral corticosteroids are essential to prevent inflammatory diseases like asthma, lupus, rheumatoid arthritis etc. Doses of the medicines required are much higher than the body needs every day, making the body prone to Cushing syndrome.
Injections: For some people, it becomes essential to take injections for back pain, joint pain, and bursitis. Respired steroid medicines for asthma and steroid skin ointments used for eczema and other skin disorders are less probable to cause the syndrome, but some individuals might acquire the syndrome if they take these medicines in high doses.
Pituitary Adenoma: A pituitary gland tumor is noncancerous, it locates at the brain base and secrets ACTH in excess amount which instigates the adrenal glands to produce more cortisol resulting in Cushing disease. Mostly, women are affected by endogenous Cushing syndrome.
Ectopic ACTH-secreting tumor: Some organs do not excrete ACTH hormone, and if a tumor develops in these organs, the tumor starts to discharge excess ACTH hormones resulting in Cushing syndrome. These tumors are malignant (cancerous) or benign (noncancerous) and generally develop in thyroid, pancreas, thymus gland and lungs.
Primary Adrenal Gland Disease: Some people develop Cushing syndrome due to adrenal gland disorders that secrets cortisol excessively. The common disorder is the adrenal cortex tumor which is noncancerous and known as adrenal adenoma. Moreover, adrenocortical carcinomas (Adrenal cortex cancerous tumors) are rare but can cause this syndrome. Enlargement of both adrenal glands results in developing Cushing syndrome.
Inheritance: Some people rarely inherit a propensity of developing one or more endocrine glands tumor that affects the levels of cortisol hormone resulting in this syndrome.
Cushing Syndrome Symptoms
- Fatty tissue deposits and weight gain, specifically around the upper back, midsection, face and between the shoulders (buffalo hump)
- Striae (pink or purple) mars on the skin of thighs, breasts, arms and abdomen
- Fragile or thinning of the skin that easily bruises
- Gradual healing of infections, insect bites and cuts
Women might experience
- Absent or irregular menstrual periods
- More or thicker visible body and (hirsutism) facial hair
Men might experience
- Decreased fertility
- Decreased libido
- Erectile Dysfunction
- Muscle weakness
- Severe fatigue
- Deprived emotional control
- Irritability, anxiety or depression
- High blood pressure that can worsen sometimes
- Cognitive difficulties
- Impaired growth in children
- Fragile bones or bone loss that can lead to fractures overtime
Cushing Syndrome Diagnosis
Specifically, endogenous Cushing syndrome is difficult to diagnose as other conditions also share the same signs. Hence, diagnosing this syndrome can be an extensive process and it remains unclear even after a series of appointments. However, professionals ask for some tests to determine this syndrome.
Blood and Urine Tests: These tests help to measure the cortisol levels in urine and blood. Professionals might also recommend some other tests to evaluate the underlying cause of the excess production of cortisol. These tests include the measurement of the hormone levels before and after the suppression of other hormone medications.
Saliva Test: Hormone levels rise and fall various times in a day, but in this syndrome, cortisol levels fall significantly after sunset. Hence, by analysing the saliva sample collected at night, doctors can check the hormone levels.
Imaging Tests: Magnetic resonance imaging scans or Computerized tomography scans can come up with the pituitary images and adrenal glands to check for abnormalities like tumors.
Petrosal Sinus Sampling: This test helps to check the cause of the syndrome. Blood samples from the veins that lead to pituitary glands (petrosal tissues) are taken for this test.
Cushing Syndrome Treatment
Reducing Cortisol hormone: If the cause is related to the long-term use of hormone medications, a doctor might minimize the doses of medicines, for a certain time while checking other conditions. Professionals can also assign non-corticosteroid drugs which will not only minimize the dosage but also check the organs. Abrupt discontinuation can lead to a deficiency of the hormone, therefore, the doctors might change the doses gradually.
Surgery: If Cushing syndrome is related to a tumor, doctors might recommend a surgical removal. In such cases, pituitary tumors are removed through the nose, but if the tumor is present in pancreas, lungs or adrenal glands standard surgical techniques are followed. After the surgery, a patient should take cortisol replacement medicine to meet the regular requirement of the hormone for a certain time. But in rare cases, patients never experience normal adrenal function and require taking the medication lifelong.
Radiation Therapy: If the surgeon is unable to remove a pituitary tumor, they opt for a radiation therapy. Also, this therapy is applicable for people who are not suitable for surgery. Radiation is given in a technique named stereotactic radiosurgery or in small doses for over a six-week period. Stereotactic radiosurgery is a single treatment in which a large dose is released to a tumor that minimizes the surrounding tissues.
Medication: Medicines are used when the radiation and surgery don’t work. Doctor’s can also prescribe some medicines before surgery to minimize the risk. Some medicines control excessive cortisol production while some blocks the cortisol effects in the tissues. However, there some side effects that include vomiting, nausea, fatigue, high blood pressure, muscle ache, swelling and low potassium. Some medicines also have the serious effects like liver toxicity and neurological side effects.
Cushing Syndrome Complications
- Bone fractures
- Bone loss
- High Blood pressure
- Weakness and muscle loss
- Pituitary tumor enlargement
- Kidney Stones
Cushing Syndrome Prevention & Home Remedies
Activities: Due to muscle weakness, a patient should increase their activity gradually. Follow a low exercising schedule to rest muscles, prevent overdoing.
Eating Habits: Nutritious foods are ideal to helps a recovering body, it also help to lose extra pounds. Eat a diet that rich in vitamin D and calcium, it will to boost bone density.
Pains and Aches: Massage, hot baths exercise like tai chi and water aerobics can help to monitor joint and muscle pain.
Mental Health: Depression or anxiety is a side effect of this syndrome that requires early attention. Hence, it is advisable to seek medical help early to recover fast.