Cushing’s syndrome refers to a hormonal disorder that occurs due to the overproduction of cortisol hormone by the adrenal glands. Some of the ways to spot this rare hormonal disorder are purple stretch marks and a fatty hump between the shoulders. In an interview with HT Lifestyle, Dr. Pranav A Ghody, Endocrinologist, Wockhardt Hospital, Mumbai Central, explained how cortisol can lead to Cushing’s syndrome. Also read | Common reasons of hormonal imbalance in women
“Cortisol has effects on almost every organ in our body; it is essential for maintaining blood pressure, blood sugar, energy metabolism and inflammation control. This hormone is often called the stress hormone as the adrenal glands produce more cortisol to regulate the stress response. Excessive cortisol levels over a period cause a complex disorder called Cushing’s syndrome,” the doctor explained.
Cushing syndrome: Types
Exogenous: When the body is exposed to excess cortisol from outside, it can lead to exogenous Cushing’s syndrome. This is the most common form of Cushing’s syndrome and occurs as steroids are often used to treat multiple medical conditions such as rheumatoid arthritis, asthma, lupus, joint problems, avoiding transplant rejection, etc. The body can get exposed to excess cortisol from a variety of sources including tablets, injections, creams, inhalers, etc. Also read | Menopause and hormonal changes: Doctor shares tips to manage symptoms naturally
Endogenous: This happens when the body produces too much cortisol from within. This is often due to a tumor in the pituitary gland, adrenal gland or from another source called ectopic tumor such as lungs, pancreas, thymus. Endogenous Cushing’s syndrome is less frequent and occurs at a reported frequency of 10 to 15 people per million every year. It is more common in women and occurs most often in people between the ages of 20 and 50. When the excess cortisol comes due to a pituitary gland tumor, it is called Cushing’s disease.
Early warning signs of Cushing’s syndrome:
- Excess weight around belly (central obesity)
- Rounded or puffy face (moon face)
- Excess hair growth on face, neck, chest, abdomen, and thighs (hirsutism)
- Significant upper back fat (buffalo hump)
- Thin arms and legs
- Dark red-purple stretch marks on chest and belly
Cushing’s syndrome: Diagnosis
“Diagnosis of endogenous Cushing’s syndrome can be challenging, it involves first identifying excess cortisol levels in blood/urine/saliva and then locating the source (pituitary gland, adrenal gland, ectopic). This is done by checking ACTH levels, using MRI/CT and advanced diagnostic techniques such as nuclear medicine Octreotide scanning, Inferior Petrosal Sinus Sampling (IPSS). Once the source is identified, first line treatment often involves surgery to remove the culprit tumor. Often patients with Pituitary related Cushing’s disease may require repeat surgery or gamma knife radiosurgery or medical therapies to control excess cortisol levels,” Dr. Pranav A Ghody explained. Also read | Do you have a hormonal imbalance? Signs to know and natural remedies for relief
Prevention tips:
Medication management: Since glucocorticoids given from outside are the most common source of Cushing’s syndrome, using the smallest dose of glucocorticoids and for the shortest possible time under the supervision of a healthcare provider is advisable.
Genetic counseling: For individuals with a family history of pituitary tumors or adrenal gland abnormalities, genetic counseling can help identify people that would need frequent monitoring. While genetic predisposition exists, tumor formation cannot be definitively prevented. Also read | Why is cortisol your frenemy? Here’s how to keep this stress hormone in check
Note to readers: This article is for informational purposes only and not a substitute for professional medical advice. Always seek the advice of your doctor with any questions about a medical condition.
