Cushing's Syndrome and Cushing's Disease

Cushing's syndrome is the name for what happens when your body makes too much cortisol. Cortisol is also sometimes called a "stress hormone" and is a natural steroid hormone that's like the "cortisone" in some medicines. Cushing's syndrome can be caused by the body making too much cortisol or it can be caused by taking too much cortisone-like drugs.

The most common cause of Cushing's syndrome is taking cortisone-like medicines orally (by mouth) every day for weeks to months. Prednisone is the most common medicine that's taken this way.

Inhaled steroid medicines for asthma and steroid skin creams for eczema and other skin conditions don't cause Cushing's syndrome. Even oral medicines taken every day for short periods of time or every other day for longer periods don't often cause Cushing's syndrome.

The next most common cause of Cushing's syndrome is Cushing's disease. Tumors in the adrenal glands or somewhere else in the body can also cause Cushing's syndrome.

Cushing's disease is the name doctors use when Cushing's syndrome is caused by a tumor in the pituitary gland. The pituitary gland is on the bottom of the brain and controls the body's production of cortisol. These small tumors can cause the adrenal glands, which are near the kidneys, to make too much cortisol.

The tumors on the pituitary gland in Cushing's disease aren't usually cancerous. However, if these tumors get too big, they can cause problems with your eyesight.

The following are some of the signs and symptoms of Cushing's syndrome and disease:

Your doctor may start by asking you questions and doing a physical exam. If the cause is a medicine you are taking, no tests are needed. If your doctor thinks that you have Cushing's syndrome or disease, but no medicines are causing it, you may need to have some blood and urine tests.

You may be asked to collect your urine for 24 hours. Your doctor will explain how to do this test. You may also be given a medicine called dexamethasone before your blood or urine is collected. This tests your body's response to steroids.

At some point, you may need a CT scan or an MRI. These tests show a "picture" of your insides. Looking at these pictures, your doctor will be able to tell whether there are tumors on the pituitary gland or in other parts of your body.

If you have Cushing's disease, a doctor will remove the tumor from your pituitary gland. This type of surgery is usually successful. Radiation treatments are sometimes used after surgery to lower the risk that the tumor will come back. You'll need to take cortisone-like medicines for several months after the tumor is removed and follow your treatment plan very carefully.