Cushing’s syndrome is a rare but serious condition. It occurs when the body is exposed to high levels of cortisol over a prolonged period. Cortisol is a hormone produced by the adrenal glands. It’s an important part of bodily functions that helps regulate metabolism, blood pressure, and stress responses. However, excess cortisol can cause serious health complications. Cushing’s syndrome is often difficult to diagnose as it is relatively rare and some of its symptoms appear within many other health conditions. Uncovering the condition with a diagnosis requires expert care from an endocrinologist.
The symptoms of Cushing’s syndrome can be varied and affect different parts of the body. One of the most recognizable signs is weight gain, particularly in the face, upper back, and abdomen, while the arms and legs may remain thin. Patients often develop purple stretch marks (striae) on their abdomen, breasts, or thighs, as well as bruising due to the thinning of the skin.
Other common symptoms include high blood pressure, muscle weakness, and fatigue. Many people with Cushing’s also experience mood changes, including anxiety, irritability, or even depression. Women may notice irregular periods, while men may suffer from decreased libido and erectile dysfunction. Additionally, Cushing’s syndrome can lead to osteoporosis and an increased risk of fractures due to weakened bones, so doctors will pay special attention to bone issues that present with other symptoms.
The complexity of Cushing’s syndrome makes it essential to seek care from an endocrinologist, a specialist trained in diagnosing and treating hormone-related conditions. Endocrinologists understand the body at the metabolic level, and can spot the hormonal imbalances that cause Cushing’s and can provide targeted treatment options. An endocrinologist will perform specific tests to measure cortisol levels, they may also order imaging studies, such as a CT scan or MRI, to locate the source of excess cortisol production. The production could be caused by a tumor on the pituitary or adrenal gland, or in rare cases, elsewhere in the body.
Treatment for Cushing’s syndrome depends on the underlying cause of the condition. In cases where a tumor is causing the excess cortisol, surgery to remove the tumor is often the most effective option. The endocrinologist will typically refer their patient to an endocrine surgeon for removal of either pituitary tumors or adrenal gland tumors, both of which require specialized techniques and experience.
If surgery is not an option or is unsuccessful, medication may be used to reduce cortisol production or block its effects. Drugs like mifepristone can help manage symptoms. In some cases, radiation therapy may also be considered, particularly if the patient has a tumor that cannot be fully removed through surgery. Because Cushing’s syndrome affects multiple systems in the body, ongoing monitoring by an endocrinologist is crucial to ensure treatment is effective and the patient can experience an optimal quality of life.
Dr. Brian Fertig is a renowned endocrinologist and author with extensive experience in treating complex hormonal disorders, including Cushing’s syndrome. In addition to his clinical expertise, Dr. Fertig is the author of “Quantum Body: The New Science of Living a Healthier, Longer, and Happier Life,” which explores the intersection of medicine, science, and holistic well-being. His approach to patient care emphasizes the importance of personalized medicine and lifestyle changes in improving long-term health outcomes. For patients facing conditions like Cushing’s syndrome, the guidance of a skilled endocrinologist like Dr. Fertig can make all the difference in managing the disorder.