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Medical Therapy for Hypercortisolism (Cushing Syndrome)

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By, Dr. Jagruti Parikh, Endocrinology

Cushing syndrome occurs when your physique is unprotected to high levels of a hormone cortisol for a prolonged time. Cushing syndrome infrequently called hypercortisolism, might be caused by a use of verbal corticosteroid remedy in conditions like asthma, inflammatory bowel disease, eczema etc.

The condition might also be due to your body’s possess overproduction of cortisol (endogenous Cushing syndrome). This might start from additional prolongation by one or both adrenal glands, or overproduction of a adrenocorticotropic hormone (ACTH), that routinely regulates cortisol prolongation like in pituitary tumours, adrenal tumours, ectopic ACTH tumours. Too many cortisol can furnish some of a hallmark signs of Cushing syndrome — a greasy mound between your shoulders, a dull face, and pinkish or purple widen outlines on your skin. Cushing syndrome can also outcome in high blood pressure, bone detriment and, on occasion, form 2 diabetes.

The signs and symptoms of Cushing syndrome can change depending on a levels of additional cortisol.

Common signs and symptoms engage on-going plumpness and skin changes, such as:

  • Weight benefit and greasy hankie deposits, quite around a midsection and top back, in a face (moon face), and between a shoulders (buffalo hump)
  • Pink or purple widen outlines (striae) on a skin of a abdomen, thighs, breasts and arms
  • Thinning, frail skin that bruises easily
  • Slow recovering of cuts, insect bites and infections


Women with Cushing syndrome might experience:

  • Thicker or some-more manifest physique and facial hair (hirsutism)
  • Irregular or absent menstrual periods

Men with Cushing syndrome might experience:

  • Decreased libido
  • Decreased fertility
  • Erectile dysfunction

Other signs and symptoms include: 

  • Severe fatigue
  • Muscle weakness
  • Depression, stress and irritability
  • Loss of romantic control
  • Cognitive difficulties
  • New or worsened high blood pressure
  • Headache
  • Bone loss, heading to fractures over time
  • In children, marred growth

With effective treatment, cortisol levels will gradually stabilise and symptoms will eventually improve. It should be remarkable that a progressing we accept treatment, a improved a outcome.

Depending on a means of a syndrome, diagnosis might change accordingly. The design, however, of all diagnosis methods is to assistance reduce extreme layers of cortisol hormone in your body. Here are a few probable diagnosis options:

  1. Decreasing a Use of Corticosteroids: A long-term use of corticosteroid drugs is a heading means in causing Cushing’s syndrome. If this is a case, we can assistance urge symptoms possibly by shortening a dose over a duration of time or by holding prescribed non-corticosteroid drugs.
  2. Surgery: If tumors are a cause, your alloy will many substantially suggest a finish surgical removal. If a growth originates in a lungs, pancreas or adrenal glands, it can be surgically private possibly by customary operation or by regulating minimally invasive surgical techniques with comparatively smaller incisions.
  3. Radiation Therapy: Radiation therapy is recommendable usually if your pituitary gland can't be private totally or if we are not authorised for surgery.
  4. Medications: If conjunction medicine nor deviation therapy works, we might have to review to holding specific drugs to assistance control cortisol production.
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