What is Cushing's syndrome?

Cushing's syndrome is a condition where your body is exposed to too much of a hormone called cortisol. This can be because your body is making too much cortisol or because you have taken a lot of oral corticosteroid medicines.

Cortisol is a hormone that is made by the adrenal glands. You have two adrenal glands, one sitting on the top of each kidney.

Cortisol affects many different bodily functions. It is produced in different amounts throughout the day — levels are generally highest in the morning and lowest in the evening. Higher amounts are produced during times of stress. However, in Cushing's syndrome, cortisol levels remain high all the time.

Cushing's syndrome is rare. It affects more females than males.

What are the symptoms of Cushing's syndrome?

Symptoms of Cushing's syndrome include:

• a rounded face
• weight gain, especially around the torso
• a hump between the shoulders
• feeling tired or moody
• skin problems such as slow healing of wounds, bruising and stretch marks on the tummy and thighs
• lower libido (sex drive)

Females may also have more hair on the face and body and irregular periods. Males may have erectile dysfunction. Children with Cushing's syndrome may have problems with growth.

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What causes Cushing's syndrome?

Some people with Cushing's syndrome have a tumour (growth) in a part of the brain called the pituitary gland. This tumour tells the adrenal glands to release cortisol. This condition is known as Cushing's disease.

Cushing's syndrome can also be caused by:

• a tumour in the adrenal gland
• overgrowth of the adrenal glands
• a tumour somewhere else in the body
• taking corticosteroid (steroid) medicine for a long time

If you have Cushing's syndrome because of taking steroid medicine, do not stop taking it suddenly, as you could become very unwell. Talk to your doctor about what to do next.

When should I see my doctor?

You should see your doctor if you have any symptoms of Cushing's syndrome. It can make you very unwell if it is not treated.

If you have been diagnosed with Cushing's syndrome, you should see your doctor regularly so they can monitor your condition and ensure that you're receiving the right treatment.

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How is Cushing's syndrome diagnosed?

Cushing's syndrome can be hard to diagnose, because it causes symptoms that can occur in many other health conditions.

Your doctor will talk to you, examine you and check your blood pressure. They may refer you for blood tests, urine tests and saliva tests to measure your cortisol levels.

If your cortisol levels are high, your doctor may recommend a CT scan or MRI scan of your brain or adrenal glands to identify the cause.

You may also be referred to an endocrinologist (a doctor who specialises in problems with hormones).

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How is Cushing's syndrome treated?

The treatment depends on the cause.

If you are taking steroid medicines, then you and your doctor will need to talk about whether you should reduce the dose.

If you have a tumour causing Cushing's syndrome, your doctor may recommend treatment such as:

• surgery to remove the tumour
• radiotherapy — if your tumour cannot be fully removed with surgery
• medicine to stop your body making too much cortisol

After surgery, it may take some time for your body to make the right amount of cortisol. You might need to take corticosteroid medicines to boost your cortisol levels while you recover.

Cushing's disease can come back after treatment. After you have recovered, you should have your cortisol levels checked regularly to make sure you stay healthy.

Can Cushing's syndrome be prevented?

Cushing's syndrome can be caused by long-term use of high-dose corticosteroids to treat conditions such as asthma or rheumatoid arthritis. If you are taking a corticosteroid medicine, see your doctor regularly for monitoring.

Unfortunately, you can't prevent Cushing's syndrome caused by a tumour.

What are the complications of Cushing's syndrome?

Cushing's syndrome can often be cured, but untreated, it can make you very unwell.

Some health problems that can be caused by Cushing's syndrome include:

• high blood pressure
• high blood sugar and type 2 diabetes
• osteoporosis and fractures
• depressionor other mood changes
• heart attack,stroke or blood clots
• higher risk of infections
• fertility problems

Resources and support

Support and information for adults and children with pituitary conditions is available from the Australian Pituitary Foundation.

More information about hormones and how they affect the body is available from Hormones Australia.