Doctor's Notes on Cushing's Syndrome
Cushing syndrome (also termed Cushing's syndrome) is a disorder of over-administration or overproduction of corticosteroids. Signs and symptoms include unusual weight gain in the face, upper back, neck, and upper torso and skin changes like thinning, purple stretch marks, and easy bruising. Proximal muscle weakness (for example, difficulty climbing stairs), new onset of hypertension, and/or diabetes and other symptoms like depression and cognitive and emotional dysfunction may occur. Also, reduced bone mass, impaired wound healing, irregular periods, and increased hair production in women and decreased libido, infertility, and impotence in men can develop; other changes that can occur may depend on the source and rapidity of the corticosteroid excess. For example, if the pituitary gland is overproducing, headaches, polyuria, nocturia, visual problems, and galactorrhea (in non-pregnant women) may occur while virilization in women and feminization in men may occur with rapid corticosteroid excess happens with an adrenal cancer.
The causes of Cushing syndrome all are due to excess of corticosteroids. The main causes of excess corticosteroids are exogenous administration of them to treat other health problems and endogenous where the body's abnormal tissues (for example, adrenal gland tumors, pituitary tumors, and some lung tumors) make excess amounts of corticosteroids.
What Are the Treatments for Cushing Syndrome?
The key to treatment of Cushing syndrome is to lower the amount of cortisol in the body. Depending on the source of high cortisol, treatments vary from drug reduction to surgery. General treatments are as follows:
- Reduce corticosteroid use as a medicine (under a doctor's recommendation)
- Medications to reduce and/or control cortisol production
- Ketoconazole
- Mitotane
- Metyrapone
- Mifepristone (blocks cortisol effect on tissue)
- Radiation therapy (for pituitary tumor treatment or another tumor type)
- Surgery (for example, pituitary tumor removal; may require lifelong cortisol replacement therapy)
Your medical team can recommend the best protocol to use for your individual problem.
Must Read Articles:
-
High Blood Pressure (Hypertension)
High blood pressure (hypertension) may be present in an individual, without any symptoms. Thus, it is called the "silent killer." Causes of high blood pressure include heart disease, kidney disease, tumors, birth control, alcohol, thyroid dysfunction, and birth control pills.Treatment of high blood pressure is generally through diet, exercise, and medication if necessary. -
Obesity
More than two-thirds of Americans are overweight, including at least one in five children. Nearly one-third are obese. Obesity is on the rise in our society because food is abundant and physical activity is optional. The safest way to lose weight is to eat less and exercise more. Treatment may also include medications, surgery, and behavior modification.
REFERENCE:
Kasper, D.L., et al., eds. Harrison's Principles of Internal Medicine, 19th Ed. United States: McGraw-Hill Education, 2015.