Cushing's syndrome

Cushing's syndrome (CS) is a rare endocrinological disorder that occurs due to the excessive production of the stress hormone cortisol (also known as hypercortisolism) by adrenal glands for a prolonged time. Cortisol helps regulate the body's response to stress, blood sugar levels, blood pressure, and immune system. Cushing's syndrome usually affects individuals aged between 30 and 50 years. However, it can rarely occur in children. Cushing's syndrome is three times more prevalent in women than men.

Mainly there are two types of Cushing's syndrome: exogenous and endogenous.

  • Exogenous Cushing's syndrome is caused by the use of some medications which are similar to cortisol. Example: Glucocorticoids.
  • Endogenous Cushing's syndrome is caused due to functional and/or structural abnormalities found within the pituitary gland or adrenal glands, leading to excessive or abnormal cortisol production.

Causes of Cushing's Syndrome

The most common causes of Cushing's syndrome include:

  • Adrenal tumours
  • Long-term high-dose usage of cortisol-mimicking medications like glucocorticoids for treating autoimmune disorders (Eg: rheumatoid arthritis, lupus, etc.) and organ transplant immune rejections.
  • Pituitary tumours: Tumours in the pituitary gland release excessive amounts of adrenocorticotropic hormone (ACTH) that stimulate the adrenal gland to produce more cortisol.

Less commonly, Cushing syndrome can be caused by other factors such as:

  • Ectopic ACTH production: In rare cases, ACTH-producing tumours outside the pituitary gland, commonly in the lungs, thymus, and pancreas, can lead to excessive cortisol production.
  • Primary pigmented nodular adrenocortical disorder (PPNAD): A rare genetic condition that stimulates the adrenal glands to produce more cortisol.
  • Familial Cushing syndrome: This is an inherited disorder that causes the development of tumours in the pituitary gland or adrenal glands, leading to excess cortisol production.


The symptoms of Cushing's syndrome can vary from person to person, depending on the underlying cause. The common symptoms include:

  • Weight gain, especially in the upper body, neck, and face.
  • Rounded or moon-shaped face due to fat deposits.
  • Thin and fragile skin.
  • Slow healing: Wounds and infections may take longer to heal.
  • Acne: Excess cortisol production can lead to acne.
  • High blood pressure: As cortisol helps regulate blood pressure, excessive cortisol production in Cushing's syndrome can cause high blood pressure.
  • Mood swings: People with Cushing's syndrome may experience anxiety or depression.
  • Fatigue and muscle weakness.
  • Irregular menstrual cycles.
  • Increased thirst and urination.
  • Osteoporosis: Exposure to high cortisol levels for longer durations can lead to osteoporosis, making the bones brittle and weak.
  • Hyperglycemia: Excess cortisol can increase blood sugar levels, leading to hyperglycemia.

It is very important to note that not all people suffering from Cushing's syndrome will experience all the symptoms mentioned above. In fact, some individuals with Cushing's syndrome may not experience any significant symptoms.


Diagnosis of Cushing's syndrome is complex and involves several steps, as the condition can be challenging to diagnose. The diagnostic process typically involves the following:

Physical examination

Looking for signs of Cushing's syndrome, like weight gain, a rounded face, and thin skin that bruises easily.

Medical history

To look for risk factors and potential underlying causes of Cushing's syndrome.

Hormone testing

Blood and urine tests can measure cortisol levels and other hormones that are involved in the body's stress response.

LDDST (Low-dose dexamethasone suppression test)

This test involves giving a low dose of dexamethasone, a synthetic cortisol-like medication, and then measuring cortisol levels in the blood or urine to see how the body responds. Normally, levels of cortisol in the blood decrease after administering dexamethasone. Cortisol levels that don't decrease suggest Cushing's syndrome.

HDDST (High-dose dexamethasone suppression test)

This test is similar to that of the LDDST, except for administering higher doses of dexamethasone. If the cortisol levels in the blood drop after the administration of dexamethasone, it indicates the presence of a pituitary tumour. If cortisol levels don't drop, it indicates an ectopic tumour.

Corticotropin-releasing hormone (CRH) stimulation test

This test involves injecting a hormone called CRH, which stimulates the adrenal glands to produce cortisol. Then measure cortisol levels in the blood or urine to see how the body responds. CRH will increase the levels of ACTH and cortisol if the patient has pituitary tumours.

Imaging tests

Imaging tests, such as CT scans or MRIs, can be used to examine the adrenal glands or pituitary gland and look for any ectopic tumours.

If the tests revealed that a person has high cortisol levels, further testing would be required to determine the underlying cause. This may involve additional imaging tests or referral to an endocrinologist.


The treatment for Cushing's syndrome depends on the underlying cause. Sometimes, treatment may not be necessary if the condition is mild and does not cause significant symptoms. However, if the condition is severe, treatment is necessary. Treatment options include the following:


If a tumour is causing Cushing's syndrome, the primary treatment is usually surgery to remove the tumour. The type of surgical procedure will depend on the location of the tumour. If multiple tumours are present on the adrenal gland, the gland may need to be removed. If the tumour is on the pituitary gland, a procedure called transsphenoidal surgery may be used to remove the tumour.


If surgery is not an option or if the condition is caused by an overactive adrenal gland that cannot be removed, medications may be used to control cortisol production.

Radiation therapy

Radiation therapy may be used to shrink a tumour that is causing Cushing's syndrome. This treatment is often used in combination with surgery and/or medication.

Lifestyle changes

Lifestyle changes such as a healthy diet and exercise can help manage some of the symptoms of Cushing's syndrome, such as weight gain and high blood pressure.

Suppose the underlying cause of Cushing's syndrome is overusing glucocorticoids. In that case, the condition will be treated by gradually reducing the dose of glucocorticoids and shifting to non-glucocorticoid medications.

Individuals with Cushing's syndrome must work closely with their healthcare team to determine the most appropriate treatment plan based on their circumstances.

Care at Medicover

At Medicover Hospitals, we have the most experienced team of endocrinologists providing various treatment options to our patients for a better outcome. Healthcare providers at Medicover hospitals use a multidisciplinary approach to diagnose and treat Cushing syndrome with utmost precision. We provide various diagnostic and treatment procedures using the most advanced technologies and world-class equipment, bringing out the best possible outcomes.

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Frequently Asked Questions

1. What are the potential causes of Cushing's syndrome, and how do you determine the underlying cause at Medicover Hospital?

Cushing's syndrome can be caused by various factors, including adrenal gland tumors, pituitary gland tumors, or the use of corticosteroid medications. Our medical team conducts thorough evaluations, including imaging and hormone tests, to identify the specific cause.

2. Are there support groups or counseling services available for individuals dealing with Cushing's syndrome at Medicover Hospital?

Yes, we offer support groups and counseling services to help patients cope with the emotional and psychological aspects of Cushing's syndrome. Our team is dedicated to addressing not only the physical but also the emotional well-being of our patients.

3. Can I get a second opinion from specialists at Medicover Hospital if I've already been diagnosed or treated for Cushing's syndrome elsewhere?

Yes, you can seek a second opinion from our specialists at Medicover Hospital. We understand the importance of exploring all available options and ensuring the most accurate diagnosis and treatment plan.

4. Are there any potential side effects or risks associated with Cushing's syndrome treatments at Medicover Hospital?

As with any medical treatment, there may be potential side effects and risks. Our medical team will thoroughly discuss these with you before starting any treatment to ensure you are fully informed.

5. Do you offer telemedicine or virtual consultations for patients who are unable to visit Medicover Hospital in person?

Yes, we offer telemedicine services for initial consultations, follow-up appointments, and routine check-ups, making it more convenient for patients, especially those who may have difficulty traveling.

6. Can you provide information about the success rates of Cushing's syndrome treatment at Medicover Hospital?

Success rates can vary depending on individual cases and the chosen treatment approach. Our medical team will discuss expected outcomes and answer any specific questions during your consultation.

7. How can I stay informed about the latest developments in Cushing's syndrome research and treatment options offered at Medicover Hospital?

We regularly update our website with information about advancements in Cushing's syndrome treatment. You can also subscribe to our newsletter or follow us on social media for updates and educational resources.

8. What kind of specialists will be involved in my Cushing's syndrome treatment team at Medicover Hospital?

Your treatment team may include endocrinologists, neurosurgeons, radiologists, and nurses who specialize in Cushing's syndrome care. They work collaboratively to provide comprehensive treatment.

9. Can you explain the different types of tests and imaging studies used for diagnosing and monitoring Cushing's syndrome at Medicover Hospital?

Diagnostic tests may include cortisol level tests, dexamethasone suppression tests, ACTH tests, and imaging studies such as CT scans and MRI. These tests help in accurate diagnosis and monitoring of the condition.

10. Are there any experimental or cutting-edge treatments for Cushing's syndrome available at Medicover Hospital?

Our hospital participates in clinical trials and research studies to explore innovative treatments for Cushing's syndrome. Your medical team can discuss any available experimental options and their potential benefits.