Cushing’s Syndrome: Causes, Symptoms, Diagnosis and Treatment

It occurs due to increased cortisol levels, a steroid hormone made by the adrenal gland.

This may be caused by various reasons, but the most common cause is the excessive use of medications containing corticosteroids.

Cushing’s syndrome is also known as hypercortisolism.


The adrenal glands produce cortisol, which is a hormone produced by the body and helps its functioning in various ways; these include:

  • Regulate blood pressure levels and cardiovascular system functions.
  • Reduce the inflammatory response of the immune system.
  • Conversion of carbohydrates, fats, and proteins into energy.
  • Balance the effects of insulin.
  • Give a stress response.

The body can promote the production of high levels of hormones such as cortisol in response to several factors:

  1. Depression, panic disorders, or high levels of emotional stress, including stress caused by an acute illness, surgery, injury, or pregnancy, mainly in the last trimester.
  2. Athletic training
  3. The does nutrition.
  4. The alcoholism.
  5. But the most frequent cause of Cushing’s syndrome is the use of drugs that contain corticosteroids, such as prednisone, in high doses over a very extended period. This medicine can be recommended in cases of transplants to avoid rejection of the organ.

They also treat inflammatory diseases, such as arthritis and lupus. The high doses of steroids injected to treat pain can cause the appearance of this syndrome.

However, steroids with low doses in inhalers, such as those generally used for asthma, or creams, such as those prescribed for eczema, typically do not possess sufficient amounts to cause Cushing’s syndrome.

Other causes not related to the use of medications include:

  1. Tumors in the pituitary gland cause too many adrenocorticotropic hormones to be released, which also cause the onset of Cushing’s disease.
  2. Ectopic adrenocorticotropic hormone syndrome causes tumors that usually occur in the lung, pancreas, thyroid, or thymus gland.
  3. Abnormality or the presence of a tumor in the adrenal gland.
  4. Cushing’s syndrome is not a typically hereditary pathology, but it is possible to tend family type to develop tumors of the endocrine glands.


The most common symptoms of this condition are:


  • An increase in weight, with a tendency to abdominal obesity.
  • The appearance of fat deposits, especially in the middle section: of the face, causes the increase in the size of the face acquiring a rounded, plethoric, moon-shaped and on the shoulders and upper back.
  • Hyperpigmentation of folds and extensor surfaces in patients and purple striations on the arms, breasts, abdomen, and thighs.
  • Delicate and atrophic skin, spontaneous equipoise, and presence of skin lesions that take time to heal.
  • Neuropsychiatric disorders such as cognitive dysfunction, states of anxiety, increased irritability, and depressive symptoms.
  • Acne and hirsutism, as a consequence of activation in the pilosebaceous unit.
  • Appearance of fatigue.
  • Muscular atrophy and proximal myopathy.
  • I have impaired glucose tolerance.
  • An increase in the need to drink water.
  • An increase in urination.
  • High blood pressure
  • Headaches.
  • Menstrual disorders: Oligomenorrhea or amenorrhea due to the suppression of the gonadal axis due to hypercortisolism.
  • Osteopenia, your osteoporosis.
  • Increase in the incidence of infections.

In women, you can also notice the appearance of extra hair, both facial and body, and absent or irregular menstruation.

In the case of men, it can be observed:

  • Erectile dysfunction
  • The loss of sexual interest.
  • Decrease infertility.

Children with this condition are usually obese and have a prolonged growth rate.


The diagnosis of Cushing’s syndrome is based fundamentally on the appearance of abnormal levels of cortisol in the body.

A physical examination and a review of the medical history and symptoms will be performed.

For the differential diagnosis, laboratory tests are necessary, which include:

  • Urine cortisol test for 24 hours.
  • The Nugent test.
  • Salivary cortisol at night (23 hours).
  • The Liddle test or suppression test.

Imaging studies, such as computed tomography or magnetic resonance imaging may also be requested.


The treatment to recommend will depend on the cause.

Some drugs reduce the production of cortisol in the adrenal glands or decrease the production of adrenocorticotropic hormones in the pituitary gland.

Others block the effects of cortisol on tissues.

In the case of being caused by corticosteroids, the need for a change in treatment with the use of another drug or a variation in dosage may be imperative.

When the presence of tumors causes it, surgical removal may be necessary.

And in case of detecting malignancy, radiotherapy or chemotherapy can be recommended.