Skip to main content
Mother Nature AI
EndocrineICD-10: E24.9Endogenous Cushing's syndrome affects approximately 2-3 per million people per year; iatrogenic cases are much more common

Cushing's Syndrome

Cushing's syndrome is a hormonal disorder caused by prolonged exposure to high levels of the hormone cortisol, either from the body's own overproduction (endogenous) or from long-term use of corticosteroid medications (exogenous). When the syndrome is caused by a pituitary adenoma stimulating excess cortisol production, it is specifically called Cushing's disease. Cushing's syndrome affects multiple body systems and can lead to serious complications including diabetes, osteoporosis, hypertension, and cardiovascular disease if untreated.

Symptoms

Weight gain, particularly in the face (moon face), upper back (buffalo hump), and abdomen
Pink or purple stretch marks (striae) on the abdomen, thighs, breasts, and arms
Thinning, fragile skin that bruises easily
Slow wound healing
Muscle weakness, especially in the upper arms and thighs
High blood pressure
High blood sugar or new-onset diabetes
Bone loss (osteoporosis) and increased fracture risk
Mood changes including depression, anxiety, and irritability

Causes

  • Long-term use of oral corticosteroid medications (most common cause)
  • Pituitary adenoma producing excess ACTH (Cushing's disease)
  • Adrenal tumors (adenoma or carcinoma) producing excess cortisol
  • Ectopic ACTH syndrome from tumors in the lungs, pancreas, or other organs

Risk Factors

  • Chronic use of corticosteroid medications (prednisone, dexamethasone) for conditions like asthma, arthritis, or lupus
  • Female sex (endogenous Cushing's syndrome is 3-5 times more common in women)
  • Age 20-50 years at diagnosis
  • Type 2 diabetes that is difficult to control
  • Obesity with high blood pressure and unusual fat distribution

Diagnosis

  • 24-hour urinary free cortisol test
  • Late-night salivary cortisol test
  • Low-dose dexamethasone suppression test (1 mg overnight test)
  • Plasma ACTH levels to differentiate ACTH-dependent from ACTH-independent causes
  • MRI of the pituitary gland or CT of the adrenal glands to locate tumors
  • Inferior petrosal sinus sampling (IPSS) to confirm pituitary source of ACTH

Treatment

  • Gradual tapering and discontinuation of exogenous corticosteroids (if applicable)
  • Transsphenoidal surgery to remove pituitary adenomas (Cushing's disease)
  • Adrenalectomy (surgical removal of adrenal tumors)
  • Medications to control cortisol production (ketoconazole, metyrapone, osilodrostat, mifepristone)
  • Radiation therapy for residual or recurrent pituitary tumors
  • Treatment of associated conditions (diabetes, hypertension, osteoporosis)

Prevention

  • Use the lowest effective dose of corticosteroid medications for the shortest duration necessary
  • Explore steroid-sparing therapies when treating chronic inflammatory conditions
  • Regular monitoring during long-term corticosteroid therapy
  • No prevention for endogenous causes, but early recognition and diagnosis are key

When to See a Doctor

  • You develop unexplained weight gain with central obesity, skin changes, and muscle weakness
  • You are on long-term corticosteroids and develop cushingoid features
  • You have new-onset diabetes with high blood pressure and unusual body changes

Frequently Asked Questions

Related Conditions

Type 2 Diabetes

Endocrine

Obesity

Metabolic

High Blood Pressure

Cardiovascular

Depression

Mental Health

Have questions about Cushing's Syndrome?

Ask Mother Nature AI for personalized, evidence-based guidance.

Ask about Cushing's Syndrome

Medical Disclaimer: This content is for educational and informational purposes only. It is not a substitute for professional medical advice, diagnosis, or treatment. Always consult a qualified healthcare provider.

Content reviewed against peer-reviewed medical literature and clinical guidelines. Read our editorial standards.