Hypercortisolism; Cortisol excess; Glucocorticoid excess - Cushing syndrome
Cushing syndrome is a disorder that occurs when your body has a high level of the hormone cortisol.
The most common cause of Cushing syndrome is taking too much glucocorticoid or corticosteroid medicine. This form of Cushing syndrome is called exogenous Cushing syndrome. Prednisone, dexamethasone, and prednisolone are examples of this type of medicine. Glucocorticoids mimic the action of the body's natural hormone cortisol. These drugs are used to treat many conditions such as asthma, skin inflammation, cancer, bowel disease, joint pain, and rheumatoid arthritis.
Other people develop Cushing syndrome because their body produces too much cortisol. This hormone is made in the adrenal glands. Causes of too much cortisol are:
Symptoms vary. Not everyone with Cushing syndrome has the same symptoms. Some people have many symptoms while others have hardly any symptoms. Symptoms usually get worse over time.
Most people with Cushing syndrome have:
Skin changes can include:
Muscle and bone changes include:
Body-wide (systemic) changes include:
Women with Cushing syndrome may have:
Men may have:
Other symptoms that may occur with this disease:
The health care provider will perform a physical exam and ask about your symptoms and the medicines you are taking. Tell the provider about all medicines you have been taking for the past several months. Also, tell the provider about shots that you received at a provider's office.
Laboratory tests that may be done to diagnose Cushing syndrome and identify the cause are:
Tests to determine the cause or complications may include:
Making the diagnosis of Cushing syndrome is complicated. Usually, you will be asked to see a hormone specialist (endocrinologist).
Treatment depends on the cause.
Cushing syndrome caused by corticosteroid use:
With Cushing syndrome caused by a pituitary or a tumor that releases ACTH (Cushing disease), you may need:
With Cushing syndrome due to a pituitary tumor, adrenal tumor, or other tumors:
Removing the tumor may lead to full recovery, but there is a chance that the condition will return.
Survival for people with Cushing syndrome caused by tumors depends on the tumor type.
Untreated, Cushing syndrome can be life threatening.
Health problems that may result from Cushing syndrome include any of the following:
Call your provider if you have symptoms of Cushing syndrome.
If you take a corticosteroid, know the signs and symptoms of Cushing syndrome. Getting treated early can help prevent any long-term effects of Cushing syndrome. If you use inhaled steroids, you can decrease your exposure to the steroids by using a spacer and by rinsing your mouth after breathing in the steroids.
Newell-Price JDC, Auchus RJ. The adrenal cortex. In: Melmed S, Auchus RJ, Goldfine AB, Koenig RJ, Rosen CJ, eds. Williams Textbook of Endocrinology. 14th ed. Philadelphia, PA: Elsevier; 2020:chap 15.
Nieman LK, Biller BM, Findling JW, et al; Endocrine Society. Treatment of Cushing's syndrome: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab. 2015;100(8):2807-2831. PMID: 26222757 pubmed.ncbi.nlm.nih.gov/26222757/.BACK TO TOP
Review Date: 5/13/2021
Reviewed By: Brent Wisse, MD, Board Certified in Metabolism/Endocrinology, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
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