Cushing Syndrome | Endocrinology and Diabetes

Endocrinology and Diabetes

Cushing Syndrome

Too much of the hormone cortisol in your body can lead to serious problems. Our endocrinologists offer compassionate, expert care to cure Cushing Syndrome.

Medically reviewed by Jose Joaquin Lado Abeal, M.D. on Nov. 18, 2024.

Male endocrinologist talking to female patient about Cushing Syndrome.

Cushing Syndrome

At UC Davis Health, our Division of Endocrinology, Diabetes and Metabolism ranks among the top in the nation by the U.S. News & World Report and Becker’s Hospital Review. Our endocrinologists (hormone specialists) know how to identify Cushing syndrome and figure out the cause.

We offer the latest therapies for hypercortisolism if you need complex treatment. You can trust our team for expert care that helps you get back to feeling your best. 

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What Is Cushing Syndrome?

Cushing syndrome, also called Cushing’s syndrome or hypercortisolism, develops when you have too much cortisol in your body long-term.

Cortisol is a steroid hormone produced by your adrenal glands, which are located right above your kidneys. It is involved in many bodily functions relating to:

  • Blood glucose (sugar)
  • Blood pressure 
  • Inflammation 
  • Stress levels

Cushing syndrome is rare but can happen in children and adults. It occurs most often in women between 30 and 50 years old. 

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Symptoms of Cushing Syndrome

Cushing syndrome can cause a range of symptoms and health complications. Without diagnosis and treatment, Cushing syndrome can worsen and become life-threatening.

Common Symptoms

  • A hump on the upper back 
  • A round or swollen face 
  • Difficulty concentrating 
  • Extreme tiredness 
  • High cholesterol  
  • High blood pressure 
  • Muscle weakness 
  • Stretch marks 
  • Weight gain around the torso (abdomen and upper body) 

Serious Complications

Severe Cushing syndrome can lead to other serious health problems, including:

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Causes of Cushing Syndrome

Cushing syndrome can develop from taking too much cortisol-like steroid medication. It can also happen from tumors (growths) that lead to too much cortisol production in the body. Causes of Cushing syndrome include:

Steroid Medication

Cortisol-like steroid medication commonly causes Cushing syndrome when used for a long time in high doses. You may take steroids if you have asthma, joint pain or lupus or received an organ transplant.

Pituitary Adenoma

The pituitary gland releases adrenocorticotropic hormone (ACTH), which tells the adrenal glands to create cortisol. Some pituitary adenomas (noncancerous tumors) create too much ACTH. When a pituitary adenoma causes Cushing syndrome, the resulting condition is called Cushing disease.

Adrenal Tumors

Noncancerous and cancerous adrenal tumors can grow on the adrenal glands and produce hormones. Some adrenal tumors have overactive cells that make too much cortisol.

Other Tumors

Some tumors that grow in the lungs or on other hormone-producing glands can have overactive cells that create too much ACTH. The high amount of ACTH leads to hypercortisolism.

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Diagnosis and Testing for Cushing Syndrome

At UC Davis Health, our hormone specialists work with you to diagnose and cure Cushing syndrome early. We start with a physical exam and review your medical history to understand any other conditions that could cause your symptoms.

Several lab tests can give your care team more information about your cortisol levels. Your provider may request one or more tests, including a:

  • Blood test: We test the amount of ACTH and cortisol in your blood.
  • Low-dose dexamethasone suppression test (LDDST): This test involves taking a low dose of medication called dexamethasone followed by a blood test to measure cortisol levels.
  • Saliva test: We check whether the amount of cortisol in your spit decreases at night like it should. We collect and test a saliva sample.
  • Urine test: We measure the amount of cortisol in your urine throughout the day.

After your provider has diagnosed Cushing syndrome, you may undergo more testing to figure out the cause. You may need:

  • Additional blood tests: We further check levels of ACTH and cortisol in your blood.
  • High-dose dexamethasone suppression test (HDDST): This test works like LDDST but with a larger dose of medication.
  • Imaging tests: We look for tumors that cause Cushing syndrome using imaging tests, such as a CT scan or MRI.

Cushing Syndrome Treatments at UC Davis Health

Our endocrinologists offer several treatments to help cure Cushing syndrome. Your specific plan depends on the cause of too much cortisone in your body. We may recommend:

Steroid Reduction

If you regularly take cortisone-like steroids for other conditions, we look for alternatives where possible. We reduce your dosage or slowly wean you off the medication entirely.

Cushing Syndrome Surgery

Our skilled endocrine surgeons remove the tumor that causes Cushing syndrome. We offer minimally invasive procedures that help you recover faster.

Radiation Therapy

We use radiation therapy to treat tumors that we can’t safely remove with surgery. Radiation targets and destroys tumor cells that cause increased cortisol.

“Cushing’s Syndrome,” National Institute of Diabetes and Digestive Diseases, https://www.niddk.nih.gov/health-information/endocrine-diseases/cushings-syndrome 

Adults between

30-50Years old most commonly get Cushing syndrome

Cushing syndrome affects

3xMore women than men

Source: National Institute of Diabetes and Digestive and Kidney Diseases: Cushing’s Syndrome

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