Cushing Syndrome, medically termed hypercortisolism, is a rare but serious hormonal disorder triggered by prolonged exposure to high levels of the hormone cortisol in the body. While cortisol plays a crucial role in managing blood pressure, metabolism, blood sugar, and the body's stress response, its chronic elevation leads to a cascade of health complications.
What Exactly is Cushing Syndrome?
The condition stems from a disruption in the body's finely tuned hormonal system. Normally, the hypothalamus in the brain signals the pituitary gland, which then instructs the adrenal glands to produce cortisol. Any fault in this chain can cause an overproduction. Cushing Syndrome manifests in two primary forms. Endogenous Cushing syndrome occurs when the body itself produces excess cortisol, often due to tumours. Exogenous Cushing syndrome is more common and results from long-term use of high-dose corticosteroid medications like prednisone.
Who is at Risk and What are the Symptoms?
This disorder can affect individuals of any age, including children. However, it is most frequently diagnosed in adults aged between 25 and 50 years and is more prevalent in women than in men. People on long-term steroid therapy for conditions such as asthma, rheumatoid arthritis, or autoimmune diseases are at a higher risk. Despite the attention, it remains uncommon, with an incidence of roughly 40 to 70 cases per million people annually.
The symptoms of Cushing Syndrome are distinct and often progressive:
- Rapid weight gain, particularly in the face (creating a "moon face"), abdomen, and upper back ("buffalo hump").
- A swollen, reddish face and the appearance of purple stretch marks on the skin.
- Muscle weakness, especially in the limbs, alongside easy bruising and slow healing of wounds.
- High blood pressure and elevated blood sugar, which can lead to diabetes.
- Mood disturbances like depression, anxiety, and problems with memory and concentration.
- Weakened bones (osteoporosis), increasing fracture risk, and reduced libido.
- In children, a noticeable slowing or impairment of growth.
Causes, Prevention, and Living with the Condition
The leading cause of high cortisol is the therapeutic use of glucocorticoid medicines. Other causes include benign tumours of the pituitary gland (secreting excess ACTH) or the adrenal glands themselves. In rarer cases, malignant tumours elsewhere in the body (like the lungs) can produce ACTH. Most cases are not inherited and appear spontaneously.
Prevention is challenging, especially for tumour-related cases. For those on necessary steroid treatments, doctors recommend using the lowest effective dose for the shortest possible duration under close medical supervision.
Living with Cushing Syndrome involves managing both physical changes and psychological impacts, where support from healthcare and mental health professionals is vital. The prognosis is positive with early diagnosis. Effective treatments are available, and many individuals successfully regain their health after addressing the root cause of the excess cortisol.
