April 8th is Cushing syndrome awareness day.
What is Cushing syndrome?
Cushing syndrome, also called Cushing’s syndrome or hypercortisolism, is a rare hormonal disorder which causes a variety of symptoms and physical abnormalities due to an abnormally high amount of the hormone cortisol.
Annually, about 10 to 15 million people are detected with Cushing syndrome.
What is cortisol?
Cortisol is a vital glucocorticoid hormone. It is the body’s main stress hormone. It works with part of your brain to control your mood, motivation and fear.
Adrenal glands, small glands at the top of your kidneys, produce cortisol. Cortisol is like the body’s own alarm clock.
What does cortisol do in your body?
It manages different functions of your body.
· Manages how your body uses carbohydrates, proteins and fats
· Keeps inflammation in check
· Regulates your blood pressure
· Increases your blood sugar/glucose levels
· Controls your sleep/wake cycle
· Curbs functions that may be non-essential or harmful during a fight or flight situation
· Boosts your energy so you can handle stress and restores balance when the stress is over.
What causes the abnormally high blood cortisol levels?
Too much stress
After the pressure or danger has been evaded, the cortisol level should calm down. Your heart beat, blood pressure etc should come down to normal values.
However, when you are under constant pressure, the alarm button stays on and the blood cortisol level remains high. This can lead to a number of health problems.
Too much cortisol intake
Many people develop abnormally high cortisol levels due to the long-term use of steroids for different ailments such as asthma, arthritis, etc.
Too much cortisol production
Your brain has a tiny gland called the pituitary gland. It produces a hormone called adrenocorticotropic hormone (ACTH) that regulates the production of cortisol by adrenal glands. If there is tumor or mass in the pituitary gland (most often a benign pituitary adenoma), this hormone may be produced in excess and it may trigger an increase in production of cortisol by the adrenal glands.
Some benign or cancerous tumors arising outside the pituitary gland can also produce ACTH. This is called ectopic ACTH syndrome. Benign tumors in the lung or thyroid may produce ACTH and increase the blood cortisol levels.
Cushing syndrome in multiple endocrine neoplasia type I (MEN I) may be due to hormone secreting tumors of the pituitary, pancreas or adrenal gland.
A mass located only in your adrenal glands can also increase the production of cortisol. Most of these masses are non-cancerous. Adrenal cancers are the least common cause of Cushing syndrome.
What are the signs and symptoms associated with Cushing syndrome?
Weight gain due to fat deposits
Moon face – fat deposits in the face
Fat deposits above the collar bone
Fat deposits between the shoulder blades
Central obesity – weight gain over the chest and abdomen with thin arms and legs
Changes in the skin
Easy bruising in the limbs
Purplish stretch marks mainly over the abdomen and near the armpits
Red, round face (plethora)
Changes in the hair
Hirsutism (excessive hair growth) over the face, neck, chest, abdomen, and thighs
Female balding
Generalized weakness and fatigue
Blurry vision
Vertigo – a sensation that everything around you in spinning in circles
Muscle weakness
Menstrual disorders in women
Decreased sex drive
Decreased fertility
High blood pressure
Diabetes mellitus
Poor wound healing
Extreme mood swings
How is Cushing syndrome treated?
Well, it depends on what caused it.
If it is due to a mass or tumor anywhere, it may be treated with surgery, radiation therapy, or chemotherapy or a combination of these.
If it is due to long-term administration of cortisol in the form of oral or injectable medications for another disease, then the physician will gradually reduce the dose of the externally administered steroid to the lowest dose needed for control of that disorder. Once control of the disorder is established, the steroid may be given at lower frequency to lessen its side effects.
Read more about Cushing syndrome here: https://www.webmd.com/a-to-z-guides/cushing-syndrome#1