Cushing’s disease is a condition in which the person suffering from it has high cortisol levels, the so-called stress hormone. The most common cause is that the pituitary gland secretes too much adrenocorticotropin hormone (ACTH), causing the adrenal glands to become overstimulated and increase the production of cortisol.
When this happens, it is called Cushing’s disease. However, Cushing’s syndrome is usually referred to because of characteristic symptoms and signs. It is a rare disease, and if left untreated, it can be very serious or even fatal. This FastlyHealarticle will look at Cushing’s disease’s possible causes, symptoms, and treatments.
Table of Contents
What is Cushing’s disease?
Cushing’s syndrome is a body disorder that occurs when high cortisol levels arise.
The pituitary gland, also called the pituitary gland, belongs to the endocrine system and is the most crucial gland. It regulates most of the body’s biological processes through the secretion of hormones. One of the hormones it secretes is adrenocorticotropin, responsible for handling stress and anxiety. In addition, this hormone stimulates the adrenal glands, producing other steroid hormones such as cortisol. Cortisol is released in response to stress and has various functions in the body, such as raising blood levels.
A person with Cushing’s syndrome or disease has a very high cortisol level because the pituitary gland secretes too much adrenocorticotropin hormone. This can cause other problems for the person, such as:
- Psychic disturbances
Excess cortisol is called hypercortisolism or hypercorticism and can be endogenous when the cause is in the body itself, as is the case with Cushing’s disease or syndrome, or exogenous when it is due to the intake of high doses of natural glucocorticoids or synthetics.
It is a sporadic disease, so it is considered a rare disease. It usually occurs more in women than in men and is prevalent in those who are between 20 and 40 years of age.
Causes of Cushing’s syndrome
Cushing’s syndrome has several causes, but the main one of all and the one that affects the most is a tumor in the pituitary gland. It is a benign adenoma or tumor, not cancerous. However, it causes an increase in cortisol. When it is caused by cancer, it is called Cushing’s disease.
As we have seen, endogenous Cushing syndrome can occur, that is, produced in the body or exogenous due to high doses of glucocorticoids. In addition, it must be taken into account that it is not only made by high doses of corticotropin (ACTH) that stimulate the adrenal glands inadequately, but it can also be due to alterations in the glands themselves without the need for an increase in ACTH.
Therefore, we can distinguish among the endogenous causes the ACTH-dependent and the non-ACTH-dependent, and on the other hand, the exogenous causes.
ACTH-dependent endogenous causes
- Adenoma in the pituitary: in this case, a small tumor produces large amounts of ACTH and therefore stimulates the adrenal glands and causes an increase in cortisol. It can also happen that there is an abnormal increase in the pituitary gland (hyperplasia), although the presence of a benign tumor is more common. It is the most common cause of all, and in this case, it is called Cushing’s disease.
- ACTH-secreting ectopic tumor: in this case, the cancer is found in another organ and affects the production of ACTH, causing the same effect as before, stimulating the adrenal glands. It is sporadic that tumors can secrete another hormone called CRH, which increases the pituitary release of ACTH. Therefore it is not usually a prevalent cause.
Non-ACTH dependent causes
- Adrenal adenoma: it may be that instead of the pituitary, the tumor is in the adrenal glands themselves, and an excess of cortisol is produced by itself. Without needing to be overstimulated.
- Adrenal carcinoma: in this case, there is also a tumor in the glands, but its cells are also cancerous.
- Nodules in the glands: it is called nodular hyperplasia, and it is a lesion, in this case benign, in which nodules form in the adrenal glands, which causes the increase in cortisol.
- Drugs: A particular group of medicines called glucocorticoids or corticosteroids with substances from the cortisol group has the same effects. They treat chronic severe inflammatory diseases such as asthma or arthritis and are very effective, but their prolonged use can cause Cushing’s syndrome. However, in this case, the syndrome may disappear as the administration of these drugs is reduced.
- Administration of ACTH may also be because a condition is being treated with ACTH since this hormone can also be prescribed as a drug. An excessive or prolonged intake can produce the same effects.
- Alcoholism: alcoholism itself does not cause Cushing’s syndrome. However, in those who suffer from chronic alcoholism, some very similar clinical characteristics or even high cortisol levels may appear. This is called pseudo Cushing’s syndrome.
Cushing’s syndrome: symptoms
The symptoms and signs of Cushing’s disease are:
- Obesity, although not in the whole body. It usually occurs in the trunk area, leaving legs and arms just as thin.
- Rounded and reddish face. It’s called a full moon face.
- Children can have much slower development.
- Acne or infections on the skin of the face.
- Stretch marks are very characteristic, especially in the abdomen, thighs, and breasts.
- The skin is usually thinner, so it is more common for bruises to be more noticeable in these people.
- They may feel back pain even in daily activities or pain and tenderness in the bones.
- Sometimes a hump can form from the accumulation of fat between the shoulders.
- Women may also have excessive hair on the face, neck, chest, and thighs. They can also have irregular menstrual cycles.
- For their part, men may feel a decreased sex drive or even impotence.
- Constant desire to pee and very thirsty.
- Mental changes such as depression or anxiety can occur.
Cushing syndrome: treatment
The treatment of Cushing’s syndrome depends on the cause. However, concerning Cushing’s disease, since the leading cause is the tumor in the pituitary gland, the treatment will begin by eliminating this adenoma.
The removal of the tumor may lead to full recovery. However, it can return to reappear over time, but that does not mean it always will happen.
Hospital surgery is performed to remove this tumor, and after this, the pituitary recovers and begins to function until it returns to normal.
Although it seems contradictory, a cortisol replacement treatment will be needed during the recovery from the surgery until the pituitary returns to its average production. It may take a while without it working correctly. This will allow you to produce ACTH again usually.
When the tumor has not been completely removed for some reason, it can be accompanied by radiation therapy to the pituitary. If neither surgery nor radiotherapy works, then pharmacological treatment will be used to avoid the production of cortisol in the body.
And if finally no treatment works or the problem has been caused in the glands, they will be removed so that they do not produce cortisol in high doses. However, eliminating these glands can cause an increase in the tumor in the pituitary gland, which is known as Nelson’s syndrome.
This article is merely informative. At FastlyHeal .com, we do not have the power to prescribe medical treatments or make any diagnosis. We invite you to see a doctor if you present any condition or discomfort.
If you want to read more articles similar to Cushing’s disease: symptoms, causes, and treatment, we recommend that you enter our Endocrine system category.
I am a Surgeon with a diploma in comprehensive ultrasound and surgical care residency, an area I am specializing in. During the exercise of my profession, I have realized the need for patients to know the diseases they suffer, and I can tell you that a large part of their complications is due to a lack of information. Being a health web writer allows me to transmit my experience, without borders, to all those readers eager for knowledge, educate them in the prevention of diseases and promote a healthy lifestyle.