What is Cushing’s syndrome?
Cushing’s syndrome cases are quite rare, a complex hormonal condition. This happens when a person’s level of cortisol (cortisol / a type of hormone) is greatly increased. Its effects spread almost all over the body. It is a serious disorder, which can be fatal.
Its most common symptoms include increased skin thickness, gaining weight (obesity), skin scars or bruising, high BP, osteoporosis, sugar, bloated face, weakness and menstrual blockage (in women).
Those at high risk include those who take steroids for any other disease such as asthma or those who have tumors in the pituitary gland. In both of these conditions, steroids called cortisol are found in high amounts.
Under the treatment of Cushing’s syndrome, the amount of cortisol formation in the body is normalized and symptoms are improved. The sooner treatment starts, the greater the chances of becoming healthy.
Types of Cushing’s Syndrome –
How many types of Cushing’s syndrome are there?
Exogenous Cushing’s syndrome –
If the causes that develop Cushing’s syndrome are from outside the body, the condition is called exogenous Cushing’s syndrome.
Exogenous Cushing’s syndrome can also result from excessive intake of corticosteroid medicines. Corticosteroid medicines such as prednisone, dexamethasone or decadron and methylprednisolone.
For people who have a disease like arthritis, lupus asthma, or whose body part has been changed, high doses of medicines are needed for effective treatment. This also has similar effects on the body, Such as the increase in the amount of cortisol.
Corticosteroids given as injections are used for joint pain, backache, and bursitis. It can also cause Cushing’s syndrome.
Endogenous Cushing’s syndrome –
When the causes that develop Cushing’s syndrome originate from inside the body, it is called endogenous Cushing’s syndrome. For example, Producing excessive cortisol by the adrenal gland.
Many times a tumor causes an overproduction of adrenocorticotropic hormone (also called ACTH), which controls the production of cortisol.
Disorders of the adrenal glands, such as a cancer-free tumor, also increase the production of cortisol.
Symptoms of Cushing’s syndrome –
What are the symptoms of Cushing’s syndrome?
The symptoms and signs of Cushing’s syndrome can vary.
Common symptoms: including continuously increasing obesity and skin changes, such as:
- Weight gain and muscular tissue gathering, Especially in the middle and upper back of the back, on the face, in the waist between the two shoulders, which look like a hunch.
- Pink or light stretch marks on the skin of the abdomen, thighs, breasts and arms (Striae)
- Skin thinning and fragility
- Slow recovery of problems like injuries, insect bites and infections.
Women with Cushing’s disease: Those who may have the following problems:
- Thickening or overgrowth of body and facial hair (Hirsutism)
- Menstrual irregularity or discontinuation
Men with Cushing’s disease: who may have the following problems:
- Loss of libido
- Decreased fertility
- Erectile dysfunction
When should the doctor see?
Talk to a doctor if you are taking corticosteroid medications for diseases such as asthma, arthritis or intestinal inflammation and you feel symptoms and signs that indicate Cushing’s syndrome. Even if you are not using these medicines and you have any symptoms that are suspected of causing this disease, contact your doctor immediately.
Causes of Cushing’s syndrome –
Why does Cushing’s syndrome occur?
Exogenous Cushing’s syndrome –
The most common cause of Cushing’s syndrome is prolonged use of high doses of corticosteroid medicines (such as prednisone). Cushing’s syndrome caused by such causes is called exogenous Cushing’s syndrome. To prevention or avoidance internal organ transplantation, doctors can prescribe these medicines for the patient. These medicines are used to treat inflammatory diseases like lupus, arthritis etc. An overdose of steroid injection given for back pain can also cause Cushing’s syndrome.
Low doses of steroids as inhalants, such as medications used for asthma or creams used for eczema, etc., usually do not develop Cushing’s syndrome.
Endogenous Cushing’s syndrome –
Endogenous Cushing’s syndrome is caused by your body overproducing cortisol, which may cause
- A tumor in the pituitary gland releases a large amount of adrenocorticotropic hormone, also known as Cushing’s disease.
- Ectopic ACTH syndrome, which typically causes tumors in the lungs, pancreas, thyroid, or thymus gland.
- Adrenal gland abnormality or tumor.
- Cushing’s disease to someone else in the family is also a possible cause (Cushing’s syndrome is generally not hereditary, but there may be a hereditary tendency to develop tumors in the endocrine glands).
When is the risk of Cushing’s syndrome increased?
If your body is producing a high amount of cortisol, then you are at greater risk of developing Cushing’s syndrome. This can happen for various reasons, including:
- High levels of stress such as acute pain, illnesses, surgery, injuries, or pregnancy-related stress etc. (especially in the last trimester)
- Athletic training
- Diseases caused by drinking too much alcohol. (Alcoholism)
- High levels of stress, panic disorder or emotional stress
Cushing’s syndrome diagnosis –
How is Cushing’s syndrome tested?
Cushing’s syndrome develops for many different reasons. It is diagnosed on the basis of abnormality of cortisol level in the body. During the diagnosis, doctors conduct physical examination and try to gain information about previous medications and symptoms. Doctors may also order some laboratory tests. Which include
- 24-hour urine-free cortisol test
- Midnight plasma cortisol, measuring the late night salivary cortisol
- Low-dose dexamethasone suppression test
Even after the condition is diagnosed, doctors continue to find out the cause of excess cortisol formation. Some tests can be done to help determine its cause. Such as a corticotropin-releasing hormone stimulation test and a high-dose test of dexamethasone suppression. Doctors can also order some imaging tests, such as CT scan or MRI scan.
Treatment of Cushing’s syndrome –
How is Cushing’s syndrome treated?
The main goal of treatment is to decrease the increased level of cortisol, but the type of treatment depends on many factors. Which includes the causes of the syndrome.
If the cause of the syndrome is to use corticosteroids for the treatment of asthma, arthritis or any other condition. So the doctor may reduce the dose of this medicine or replace it with any other non-corticosteroid medicines.
Without a doctor’s supervision, the patient should not reduce the dose of corticosteroid medicines, as this can cause a dangerous reduction in cortisol levels.
The tumor may require surgery, the tumor of the pituitary gland is removed through the patient’s nose. Tumors in the adrenal gland, pancreas or lungs may require regular surgery or keyhole surgery.
After surgery, the patient needs to take alternative cortisol medicines until the production of hormones returns to normal.
Radiotherapy can be used as a part of treatment to remove the tumor. If the tumor is cancerous, chemotherapy may also be mandatory, for example cancerous tumors in the lungs.
Medicines such as Nizoral, Lysodren and Metopirone help to control the overproduction of cortisol.
If the tumor has decreased hormone production, doctors may suggest hormone replacement therapy (HRT).
If no further treatment works, the adrenal gland may need to be removed by surgery.
Cushing’s syndrome risks and complications –
What complications can occur in Cushing’s syndrome?
If Cushing’s syndrome is not treated quickly, the following complications can occur:
Bone damage (osteoporosis), which can cause abnormal fractures in bone. Such as rib fractures and bone fractures.
- High BP (High Blood Pressure)
- Sugar (diabetes)
- Recurrent or unusual infection
- Muscle loss etc.
What to eat in Cushing’s syndrome? –
What to eat when you have Cushing’s syndrome?
Eating well is a very important part of Cushing’s patients’ lives. A healthy diet can stop some symptoms of this disease and reduce some. Save your bones by consuming foods with calcium and vitamin D. Limit the intake of sodium and fatty food. Nutritionists can help you make sure that you are getting enough of the right nutrients or not.