Cushing syndrome: symptoms, causes, and medications. Hello healthy

Definition

What is Cushing syndrome (Cushing syndrome)?

Cushing syndrome or hypercortisolism is a disease caused by increased levels of the hormone cortisol in the body. Cortisol is a type of hormone produced by the adrenal glands.

The adrenal glands are located on top of each of your kidneys. Its main function is to regulate the balance of hormones in the body. One of the hormones produced is cortisol, and its levels are controlled by the pituitary gland, which is located in the lower brain.

Generally, Cushing syndrome is a condition caused by tumor growth in the pituitary gland. However, it does not rule out tumors also grow in the adrenal glands.

If this condition occurs, there will be many problems and disorders in the body system, such as imbalanced blood sugar levels, deteriorating immune system, affected blood pressure, problems with the heart and blood vessels, and central nervous system disorders.

Fortunately, this condition is curable. Usually, it takes 2 to 18 months to recover after treatment.

How common is Cushing syndrome (Cushing syndrome)?

This syndrome is more common in female than male patients. This condition is also more common in patients aged 25-40 years.

Cushing syndrome is a condition that can be treated by controlling the existing risk factors. To find out more information about this condition, you can consult a doctor.

Signs & symptoms

What are the signs and symptoms of Cushing syndrome (Cushing syndrome)?

The signs and symptoms of Cushing syndrome can vary from person to person. The severity and duration also varies.

However, the main symptom that this disease generally shows is weight gain. Increased cortisol levels cause fat to accumulate in several parts of the body, especially the face, stomach and chest.

Other symptoms that may appear in people with Cushing syndrome are:

• Obesity
• Fat deposits, especially on the midsection of the face (causing a round, moon-like face)moon-shaped face), between the shoulders and the top of the back (causing a buffalo hump-like shape /buffalo hump)
• Bruises on the breasts, arms, stomach and thighs
• Thinning skin and bruising easily
• Skin injuries that are difficult to heal
• Acne
• Fatigue
• Muscle weakness
• Glucose intolerance
• Increased thirst
• Increased urine
• Bone loss
• High blood pressure
• Headache
• Cognitive dysfunction
• Anxiety
• Get irritated easily
• Depression
• Easy to get infected

In women, there may be the following signs and symptoms:

• Excess hair growth on the face and some parts of the body
• Irregular menstruation
• In some cases, menstruation stops for some time

In addition, male patients may also experience symptoms such as:

• Erectile dysfunction
• Loss of sexual desire
• Decreased fertility

Children with this condition are usually obese and have a slower growth rate.

There may be signs and symptoms not listed above. If you have concerns about a particular symptom, consult your doctor.

When should I see a doctor?

If you have any signs or symptoms above or any other questions, please consult your doctor.

Each sufferer's body shows signs and symptoms that vary. To get the most appropriate treatment and according to your health condition, make sure you always check any symptoms you experience to the doctor or the nearest health service center.

Cause

What causes Cushing syndrome (Cushing's syndrome)?

The main cause of Cushing syndrome is elevated levels of the hormone cortisol. As previously explained, cortisol is a hormone produced by the adrenal glands.

Cortisol has various roles in the human body. Some of them are regulating blood pressure, reducing inflammation or inflammation, and maintaining the function of your heart and blood vessels.

In addition, cortisol also affects how your body responds to stress. This hormone also controls the process of converting protein, carbohydrates and fats into energy. This process is called metabolism.

However, if the cortisol levels in your body are too high, you may be suffering from this syndrome. The main causes of this condition are corticosteroid drugs and abnormalities in the cortisol production system.

1. Corticosteroid drugs

One of the main causes of Cushing syndrome is the consumption of corticosteroid drugs in high doses and over a long period of time.

Corticosteroid drugs, such as prednisone, are commonly used to treat inflammation in the body. Some of these include rheumatoid arthritis, lupus, and asthma. This medicine is also usually used to prevent your body from rejecting the transplanted organ.

Because the doses given to the treatment of these diseases are higher than the normal amount of cortisol in the body, side effects may arise.

Corticosteroid drugs that can cause this syndrome are not only oral drugs, but also injectable drugs (injections) that are given to treat joint pain, bursitis, and back pain.

In addition, steroid drugs for asthma and eczema can also increase the risk of developing these diseases.

2. Excess cortisol production in the body

Not only corticosteroid drugs, this syndrome can also occur due to excessive production of the hormone cortisol in the body.

This condition usually results from a problem with one or both of the adrenal glands, or an increase in levels of adrenocorticotropic hormone (ACTH), a hormone that regulates cortisol production.

• Tumor of the pituitary gland

If there is a tumor in the pituitary gland that grows, it has the potential to overproduce ACTH. This can cause cortisol levels to exceed reasonable limits.

• ACTH producing tumors

In rare cases, tumors that grow in other organs of the body can also produce ACTH, both malignant and benign tumors.

• Diseases of the adrenal glands

Some patients have adrenal glands that are not functioning properly. Generally, this is caused by the growth of a benign tumor in the adrenal cortex, which is called an adrenal adenoma.

Risk factors

What increases my risk for Cushing syndrome (Cushing syndrome)?

Cushing syndrome is a condition that can occur in almost anyone, regardless of age group and race group. However, there are several factors that can increase a person's risk for developing this condition.

It is important for you to know that having one or more risk factors does not mean that you will definitely be exposed to a disease or health condition. In some cases, it is possible that you may suffer from certain diseases or health conditions without any risk factors.

The following are factors that can trigger the appearance of Cushing's syndrome:

1. Age

This disease is more common in patients in the age range of 25 to 40 years. If you fall into this age range, your risk for suffering from this disease is much greater.

2. Gender

Apart from the age factor, gender can also influence. This disease is more common in female patients than in men.

3. Suffering from type 2 diabetes

If you have type 2 diabetes, your chances of getting this syndrome are much greater.

4. Have excess weight or obesity

Being overweight or obese can also increase your risk for developing Cushing's syndrome.

5. Having a family member who has Cushing's syndrome

If in your family there are family members who suffer from this disease, there is a possibility that this disease can be passed on to you.

Diagnosis & treatment

The information provided is not a substitute for medical advice. ALWAYS consult your doctor.

How is Cushing syndrome diagnosed?

Cushing syndrome is a disease that is quite difficult to diagnose. This is because the symptoms resemble other diseases.

In the process of diagnosis, the doctor will perform a physical examination by noting symptoms such as a round face, accumulation of fatty tissue in the shoulders and neck, as well as thinning of the skin accompanied by bruises and stretch marks.

Several additional tests will be performed to get an accurate diagnosis:

1. 24 hour urine test

In this test, the medical team will measure the levels of the hormone cortisol in your urine. Urine examination is performed on urine that has been collected for 24 hours. Patients with Cushing's syndrome will experience an increase in cortisol levels in the urine 24 hours.

2. Low dose Dexamethasone suppression test(DST)

DST is a test done specifically to diagnose Cushing's syndrome. This test is done by calculating the levels of the hormone cortisol with a low dose of dexamethasone.

This test also aims to find out how the adrenal glands respond to the ACTH hormone.

Generally, this test is done by giving a low dose of 1 mg of dexamethasone at 11:00 p.m. and then the serum cortisol in the blood is examined in the morning. Under normal conditions, the cortisol levels checked will be low, whereas if you have Cushing's syndrome the cortisol levels will increase.

3. Saliva test

Cortisol levels increase and decrease throughout the day. In healthy people, cortisol levels drop significantly at night. Meanwhile, people with Cushing's syndrome will experience an increase in cortisol in saliva at night.

3. Test shooting

CT scans and MRI scans can produce detailed images of the adrenal and pituitary glands. With this test, the doctor can see if there are any abnormalities in the two glands.

4. Petrosal sinus sampling

This test is done by inserting a thin tube through your groin while being sedated. Then, the doctor will take a blood sample from the petrosal sinuses, which are blood vessels connected to the pituitary gland.

If the level of the ACTH hormone in the blood sample taken is high, it is possible that this syndrome is caused by an abnormality in the pituitary gland.

How to treat Cushing syndrome?

Treatment for Cushing syndrome depends on the cause. If the syndrome is caused by a pituitary or a tumor that produces excess ACTH, the following treatments will be needed:

• Surgical removal of tumors
• Radiation after pituitary tumor removal
• Cortisol replacement therapy after surgery, and possibly throughout life
• If the tumor can't be removed, you may need medication to help block cortisol

Home remedies

What are some lifestyle changes or home remedies that can be done to treat Cushing syndrome?

Some of the lifestyle and home remedies that can help you deal with Cushing syndrome include the following:

• Increase daily activities slowly to protect weakened muscles from damage from pushing too hard.
• Have a healthy diet with nutritious foods to help increase strength and strengthen bones.
• Maintain mental health: keep yourself relaxed and manage stress well.
• Try therapy to relieve aches and pains, such as hot baths, massage and exercise.

If you have any questions, consult your doctor for the best solution to your problem.