Cushing's Syndrome
1 medicine
Cushing's syndrome is a hormonal disorder caused by prolonged exposure to high cortisol levels, producing weight gain, skin changes, and metabolic problems. It is managed by treating the underlying cause and, when needed, cortisol-lowering medicines.
Key facts
- Cushing's syndrome develops when the body is exposed to abnormally high cortisol levels over a prolonged period, disrupting fat distribution, skin integrity, blood pressure, and blood sugar.
- The most common cause worldwide is long-term corticosteroid medication; when it arises from within the body, a pituitary tumour secreting ACTH (Cushing's disease) is the usual culprit, and less often the adrenal glands or another tumour produce cortisol directly.
- Central weight gain with a rounded face, wide purple stretch marks, thinning skin that bruises easily, muscle weakness, and raised blood pressure or blood sugar are the hallmark signs.
- When surgery is not possible or needs bridging, medicines such as ketoconazole suppress cortisol production.
What drives excess cortisol
The most common cause worldwide is long-term corticosteroid medication. When the syndrome arises from within the body itself, a pituitary tumour secreting ACTH is the usual culprit (called Cushing's disease); less often, the adrenal glands or a tumour elsewhere produce cortisol directly.
Recognising the pattern
Central weight gain with a rounded face and fat pad at the upper back, stretch marks that are wide and purple, thinning skin that bruises easily, muscle weakness in the thighs and upper arms, and elevated blood pressure or blood sugar are the hallmark signs. Mood changes and irregular periods occur in many women. If several of these are present together, investigation for cortisol excess is warranted.
Reducing cortisol medically
When surgery on the underlying tumour is not possible or needs to be bridged, medicines that suppress cortisol synthesis are used. Ketoconazole, an antifungal agent, inhibits key enzymes in the adrenal steroid pathway and has been used for decades as a cortisol-lowering treatment in this setting.
When to see a doctor
See a doctor if several of these changes appear together, particularly unexplained central weight gain, new stretch marks, or muscle weakness. Diagnosis usually needs blood or urine tests to confirm cortisol excess before treatment starts.
This page is educational and does not replace advice from a doctor or pharmacist who knows your health history.