June’s Monthly Topic: Cushing Disease/Cushing’s Syndrome

Resources Used: https://www.endocrine.org/ Author Disclaimer: I am in no a professional of any kind. I am strongly against self-diagnosis, and encourage my audience to please seek the professional advice of their own trusted medical professional and any other trusted professional depending on the topic at hand. The Abler Blog ONLY PROVIDES LIMITED GENERAL INFORMATION, and ALWAYS CITES WHERE THEY FIND THEIR RESOURCES AND OR INFORMATION. Jessica Niziolek, Founder Of The Abler Blog, and online community. What Is Cushing’s Syndrome? This is a physical disorder that effects the person, both mentally and physically. This happens because the person(s) has too much cortisol in their blood for a long period of time. Is There More Than One Type? Yes, There are two types.The first type is called, exogenous (caused by factors outside the body) and endogenous (caused by factors within the body). The symptoms for both are the same. The differences lie in their causes. Cushing Disease is rare, and only effects 10-15 million people per year. It is more common for women than men. More specifically, women between the ages of 20-50 years of age. What Is One Of The Most Common Causes For This Disorder? A pituitary adenoma is the most common cause of Cushing disease. An adenoma is a pituitary tumor that is almost always benign. The tumors can be hard to diagnose because they are quite small. Having the guidance of an endocrinologist can help in getting a proper diagnosis of this condition. What is The Endocrine Connection Between The Two Types? Cortisol What Is it? It is a hormone that produced by the adrenal glands. It is directly connected to the body’s stress response. Most cells within the body have cortisol receptors. Secretion of the hormone is controlled by the hypothalamus, the pituitary gland, and the adrenal gland, a combination gland often referred to as the HPA axis. In a healthy individual, it releases adrenocorticotropic hormone (ACTH), a hormone produced in the pituitary gland, and stimulates the production and release of cortisol by the adrenal glands. In normal amounts, cortisol helps the body:  Manage blood sugar levels  Regulate metabolism  Reduce inflammation  Assist with memory formulation  Maintain blood pressure and cardiovascular function  Develop the fetus during pregnancy (in women)  Balance salt and water intake  Convert fat, carbohydrates, and proteins into energy  When an individual faces a stressful situation, the body releases more cortisol. Sometimes the body is not able to properly regulate the production of cortisol and too much cortisol is produced. When too much cortisol is produced, it contributes to the development of Cushing syndrome.  
 Low cortisol levels can cause a condition known as primary adrenal insufficiency or Addison disease. While rare, primary adrenal insufficiency is an autoimmune disease that causes damage to the adrenal glands. Symptoms may start slowly, but they can be quite serious.  Exogenous Cushing Syndrome: The most common cause of exogenous Cushing syndrome is due to people taking cortisol-like medications such as prednisone. These drugs are used to treat inflammatory disorders such as asthma and rheumatoid arthritis. They also suppress the immune system after an organ transplant. This type of Cushing syndrome is temporary and goes away after the patient has finished taking the cortisol-like medications. 

Endogenous Cushing Syndrome: Endogenous Cushing syndrome, in which the adrenal glands produce too much cortisol, is uncommon. It usually comes on slowly and can be difficult to diagnose. This type of Cushing syndrome is most often caused by hormone-secreting tumors of the adrenal glands or the pituitary, a gland located at the base of the brain. In the adrenal glands, the tumor (usually non-cancerous) produces too much cortisol. Most tumors that produce ACTH originate in the pituitary gland but sometimes non-pituitary tumors, usually in the lungs, can also produce too much ACTH and cause ectopic Cushing syndrome. 

Cushing Disease: Cushing disease is a form of Cushing syndrome. Cushing disease occurs when a benign tumor in the pituitary gland causes the pituitary gland to produce too much ACTH, the hormone responsible for cortisol production. Too much ACTH in the body causes the adrenal glands to produce cortisol in high levels. Cushing disease can also occur with diffuse growth of the pituitary gland, also called pituitary hyperplasia. Pituitary hyperplasia can lead to the release of too much ACTH, which then leads to over-production of cortisol by the adrenal glands.  For a proper diagnosis, the medical community use the following tests: Saliva Test Urine Test Steroid Test For Further details on how this test help the medical community properly diagnose someone with Cushing’s syndrome and or disease, please follow this link.https://www.endocrine.org/patient-engagement/endocrine-library/cushings-syndrome-and-cushing-disease What Are The Symptoms Of Cushing Syndrome? Weight gain, especially in the upper body  Rounded face and extra fat on the upper back and above the collarbones  High blood sugar (diabetes)  High blood pressure (hypertension)  Thin bones (osteoporosis)  Muscle loss and weakness  Thin, fragile skin that bruises easily  Purple-red stretch marks (usually over the abdomen and under the arms)  Depression and difficulties thinking clearly  Too much facial hair in women  Symptoms For Cushing’s Disease Cushing disease has many symptoms including changes in appearance, mood and thinking, and more.  Changes in appearance:  Wide, purple stretch marks on the skin (chest, armpits, abdomen, flanks)  Rapid and unexplained weight gain with a rounder face and abdomen  Increased fat in the neck and above the collarbone and upper back  Skin changes (bruising without injury, acne, hair growth) and red cheeks  Mood and thinking:  Memory loss or not being able to think clearly  Depression  Mood and behavior disorders  Other symptoms: Fatigue  Muscle weakness  Menstrual cycle disorders  Osteoporosis  High blood glucose (diabetes)  High blood pressure  Blood clots in leg veins  Heart attack  Stroke  Fracture  What Is Cushing’s Syndrome? This is a physical disorder that effects the person, both mentally and physically. This happens because the person(s) has too much cortisol in their blood for a long period of time. Is There More Than One Type? Yes, There are two types.The first type is called, exogenous (caused by factors outside the body) and endogenous (caused by factors within the body). The symptoms for both are the same. The differences lie in their causes. Cushing Disease is rare, and only effects 10-15 million people per year. It is more common for women than men. More specifically, women between the ages of 20-50 years of age. What Is One Of The Most Common Causes For This Disorder? A pituitary adenoma is the most common cause of Cushing disease. An adenoma is a pituitary tumor that is almost always benign. The tumors can be hard to diagnose because they are quite small. Having the guidance of an endocrinologist can help in getting a proper diagnosis of this condition. What is The Endocrine Connection Between The Two Types? Cortisol What Is it? It is a hormone that produced by the adrenal glands. It is directly connected to the body’s stress response. Most cells within the body have cortisol receptors. Secretion of the hormone is controlled by the hypothalamus, the pituitary gland, and the adrenal gland, a combination gland often referred to as the HPA axis. In a healthy individual, it releases adrenocorticotropic hormone (ACTH), a hormone produced in the pituitary gland, and stimulates the production and release of cortisol by the adrenal glands. In normal amounts, cortisol helps the body:  Manage blood sugar levels  Regulate metabolism  Reduce inflammation  Assist with memory formulation  Maintain blood pressure and cardiovascular function  Develop the fetus during pregnancy (in women)  Balance salt and water intake  Convert fat, carbohydrates, and proteins into energy  When an individual faces a stressful situation, the body releases more cortisol. Sometimes the body is not able to properly regulate the production of cortisol and too much cortisol is produced. When too much cortisol is produced, it contributes to the development of Cushing syndrome.  
 Low cortisol levels can cause a condition known as primary adrenal insufficiency or Addison disease. While rare, primary adrenal insufficiency is an autoimmune disease that causes damage to the adrenal glands. Symptoms may start slowly, but they can be quite serious.  Exogenous Cushing Syndrome: The most common cause of exogenous Cushing syndrome is due to people taking cortisol-like medications such as prednisone. These drugs are used to treat inflammatory disorders such as asthma and rheumatoid arthritis. They also suppress the immune system after an organ transplant. This type of Cushing syndrome is temporary and goes away after the patient has finished taking the cortisol-like medications. 

Endogenous Cushing Syndrome: Endogenous Cushing syndrome, in which the adrenal glands produce too much cortisol, is uncommon. It usually comes on slowly and can be difficult to diagnose. This type of Cushing syndrome is most often caused by hormone-secreting tumors of the adrenal glands or the pituitary, a gland located at the base of the brain. In the adrenal glands, the tumor (usually non-cancerous) produces too much cortisol. Most tumors that produce ACTH originate in the pituitary gland but sometimes non-pituitary tumors, usually in the lungs, can also produce too much ACTH and cause ectopic Cushing syndrome. 

Cushing Disease: Cushing disease is a form of Cushing syndrome. Cushing disease occurs when a benign tumor in the pituitary gland causes the pituitary gland to produce too much ACTH, the hormone responsible for cortisol production. Too much ACTH in the body causes the adrenal glands to produce cortisol in high levels. Cushing disease can also occur with diffuse growth of the pituitary gland, also called pituitary hyperplasia. Pituitary hyperplasia can lead to the release of too much ACTH, which then leads to over-production of cortisol by the adrenal glands.  For a proper diagnosis, the medical community use the following tests: Saliva Test Urine Test Steroid Test For Further details on how this test help the medical community properly diagnose someone with Cushing’s syndrome and or disease, please follow this link.https://www.endocrine.org/patient-engagement/endocrine-library/cushings-syndrome-and-cushing-disease What Are The Symptoms Of Cushing Syndrome? Weight gain, especially in the upper body  Rounded face and extra fat on the upper back and above the collarbones  High blood sugar (diabetes)  High blood pressure (hypertension)  Thin bones (osteoporosis)  Muscle loss and weakness  Thin, fragile skin that bruises easily  Purple-red stretch marks (usually over the abdomen and under the arms)  Depression and difficulties thinking clearly  Too much facial hair in women  To Find Further Information on treatment options for either condition, please visit this link There is a a link that follows below the page.It is a list of questions to ask your trusted medical professional if you have or believe that you or someone you love, has either conditions.