General characteristics
Cushing's syndrome is a condition caused by an excess of the hormone cortisol which is produced in the body by the adrenal glands. Cortisol has several vital functions in the body including regulating blood pressure, regulating the immune response, helps balance blood sugar levels and helps the body cope with the effects of stress. The amount of cortisol in the blood is normally regulated by a feedback system...when levels are too high a signal is sent to the pituitary gland to stop its release and allow levels to normalise. When this feedback system is interrupted then Cushing's syndrome can result.
In the majority of cases it occurs as a result of prolonged steroid medications which mimic the action of natural cortisol but it can also occur as an effect of prolonged stress, depression or anxiety, excessive alcohol consumption, often benign tumours of the pituitary or adrenal glands, diabetes or from other conditions that cause the excessive secretion of cortisol such as certain malignant cancers.
Symptoms usually develop gradually and include sudden weight gain (especially around the trunk), fatigue, joint pains, low immunity, stretch marks suddenly appearing, high blood pressure, excessive hair growth on the face and chest in women, irregular periods, water retention, excessive thirst, diabetes, mood swings, acne, poorly healing wounds, erectile dysfunction, developing a 'moon' shaped face, a fatty hump developing at the back of the neck and thinning of the skin with bruising.
Tumours of the pituitary are generally benign and after removal the cushing's syndrome usually resolves. Tumours in the adrenals can be more complex and result in removal of the entire glands which results in the opposite condition... adrenal insufficiency or low adrenal output. Often the person is then prescribed artificial adrenal hormones for life. If the cushing's is caused from excessive steroid use then the steroids should be gradually stopped and adrenal output should eventually return to normal after a brief dip in output.