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Frequently asked questions about Cushing syndrome

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    What is cortisol, and why is it important?

    Cortisol, sometimes called the stress hormone, is an important hormone that helps regulate blood sugar, cardiovascular function, metabolism, inflammation, and memory formulation.

    Cortisol helps the body respond to stress or other external factors to maintain homeostasis.

    What is Cushing syndrome (hypercortisolism)?

    Cushing syndrome, also called hypercortisolism, is a serious condition that occurs when your body has excess cortisol (the stress hormone).

    Learn more about what causes excess cortisol.

    Why are there so many terms for Cushing syndrome (for example, Cushing disease, hypercortisolism)? Are they all the same?

    Cushing syndrome is an overarching term that describes the widespread signs and symptoms associated with having excess cortisol in the body. The state of having excess cortisol in the body can be described as hypercortisolism (hyper = too much).

    Depending on the source of excess cortisol in a person's body, the condition may have a more specific name. For example, Cushing disease is a form of Cushing syndrome caused by a nodule on the pituitary gland.

    Learn more about the causes of excess cortisol in the body and the terms associated with those causes.

    What are the signs and symptoms of Cushing syndrome

    Physical symptoms associated with more obvious cases of Cushing syndrome include a fatty hump between the shoulders (buffalo hump), weight gain around the abdomen, and reddish purple stretch marks (striae). However, not everyone will display these classic symptoms. In fact, many people will have a constellation of different symptoms. Some other common signs and symptoms include the following:

    • Diabetes
    • Hard-to-control or uncontrolled high blood pressure
    • Obesity
    • Depression
    • Irregular menstrual periods

    Learn more about the body systems affected by excess cortisol.

    Why is Cushing syndrome difficult to diagnose?

    No single sign or symptom of Cushing syndrome can be used to make a diagnosis. This is because Cushing syndrome may look different in each individual person. Depending on the cause and other individual factors, the symptoms of Cushing syndrome may vary in type and severity.

    Also, it is normal for cortisol levels to rise and fall throughout the day. Although there are several tests to measure cortisol levels, this normal fluctuation may make it challenging to determine whether a person has chronically elevated cortisol levels. Your doctor may recommend using multiple testing methods to measure your cortisol levels. The results of these tests will be considered along with a physical evaluation to confirm a diagnosis of Cushing syndrome.

    What are the consequences of Cushing syndrome?

    Excess cortisol may make day-to-day activities extremely difficult, as it may take a toll on the body. Keep in mind, everyone experiences these symptoms differently and at varying levels of severity.

    Excess cortisol may cause some of the following symptoms:

    • Physical symptoms, like weight gain around the center of the body, easy bruising, bone fractures, muscle weakness, reddish purple stretch marks, red or round faces (moon facies), fatty hump between the shoulders (buffalo hump), sexual dysfunction, uncontrolled blood sugar and blood pressure, and blood clots
    • Mental and emotional symptoms, like depression, irritability, trouble sleeping, severe fatigue, and problems thinking and remembering things

    Learn more about the symptoms of excess cortisol.

    What are the 3 common cortisol tests?

    The 3 common tests used to measure cortisol in the body are:

    • Overnight 1-mg dexamethasone suppression test (DST)
    • Late-night salivary cortisol (LNSC)
    • 24-hour urinary free cortisol (UFC)

    Learn more about the tests to measure cortisol levels.

    Can Cushing syndrome be treated, and how?

    Yes, there are several treatment options for Cushing syndrome, including surgery, radiotherapy, and medications.

    Learn more about the treatment options for people with Cushing syndrome.

    What do I do if I think I might have Cushing syndrome?

    Cushing syndrome can be difficult to diagnose. For this reason, the Endocrine Society recommends further evaluation by an endocrinologist. Endocrinologists are doctors specializing in diseases of the endocrine system, such as Cushing syndrome. Ask your primary care doctor if a consultation with an endocrinologist is right for you. This symptom checklist can help you prepare to have this conversation.