Cushing's syndrome can cause a range of symptoms. 1 , 2 The symptoms may also resemble those of other conditions. 3
Physically, someone with Cushing's syndrome can:
- Be heavy or obese above the waist, but have thin arms and legs
- Have a round, red face, also called a moon face
- Having a thick bump between the shoulders, also called a buffalo bump
- Have weak muscles or bones, including osteoporosis, bone pain, and fractures
- Has skin changes, including:
- New or worsening acne or skin infections
- Reddish-purple stretch marks called stretch marks (pronounced STRY-ee ). These are usually about an inch wide and can appear on the stomach, buttocks, thighs, arms and breasts.
- Thin, fragile skin that bruises easily and heals poorly
Additional symptoms can include the following:
- Children can gain weight, but grow more slowly than their peers.
- Women may have more hair on their face, neck, chest, stomach, and thighs. They can develop menstrual problems , such as irregular or stopped periods.
- Men may have a lower sex drive, experience impotence, and become less fertile.
The following less common symptoms may also occur:
- Mental changes such as depression, anxiety, moodiness or other behavior
- Severe fatigue
- Headache
- Thirst and increased urge to urinate
- High bloodpressure
- High blood sugar
- High cholesterol and triglycerides
In general, the symptoms most strongly suggestive of Cushing's syndrome are fat deposits on the upper back / neck, fat around the abdomen, weakness in the muscles closest to the trunk (such as in the shoulders and hips), broad stretch marks (skin stripes), bruising without being bumped, unexplained osteoporosis and - in children - slower height and weight gain that could be mistaken for obesity. 2 , 3
Therapy
The treatment for Cushing's syndrome depends on the cause of the extra cortisol in the body.1 ,2 ,3
For cases of Cushing's syndrome caused by taking medications to treat another condition, your healthcare provider will slowly and gently lower the dose if possible and then administer another medication so that the body can regain its own can make cortisol.
In cases where it is not possible to stop the medication, the health care provider will monitor the patient closely and treat any symptoms that may develop, such as high blood sugar, high cholesterol, bone thinning, or osteoporosis .
If a tumor is the cause of Cushing, treatments can include medication, surgery, radiation, chemotherapy, or a combination of these treatments. Treatment depends on the location and type of the tumor.
Pituitary tumors
The most common treatments for pituitary tumors are:
- Surgery. In most cases, a surgeon removes the tumor through a cut under the upper lip or at the bottom of the nose, between the nostrils. In rare cases, the surgeon may cut the skull to reach the pituitary tumor.
- Radiation therapy. Radiation therapy uses X-rays to kill or prevent tumor cells from growing. It can be used if some tumor cells remain after surgery.
- Chemotherapy. Chemotherapy uses drugs that kill or prevent tumor cells from growing. Some chemotherapy drugs are taken by mouth and some are injected.
- Drug therapy. Medicines can correct hormonal imbalances or replace cortisol after another treatment.
Go to the page of the National Cancer Institute of pituitary tumors for more information on pituitary tumor treatments.
Adrenal gland or other tumors
If the tumor is in one or both of your adrenal glands, you may need surgery to remove it. Providers will often remove the entire adrenal gland. After surgery to remove one adrenal gland, you may need to take medication for several months to keep your cortisol levels up until the other adrenal gland produces enough on its own. After surgery to remove both adrenal glands, you will need to take medication for the rest of your life to replace adrenal function and take additional precautions during illness or surgery.
If your healthcare provider cannot remove the tumor, medications can help block the release of cortisol. Radiation therapy isn't usually used for adrenal gland tumors.