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About Cushing Syndrome

Cushing syndrome is a hormonal disorder in which the body has been exposed to high levels of cortisol for a long period of time. Treatments are available and depend on the cause of this disorder. Possible treatments include surgery, radiation therapy and medications.

Cortisol is a hormone naturally produced by the adrenal glands in response to stress; it fluctuates throughout the day according to the body’s circadian rhythm. Cortisol performs many essential functions, such as raising blood glucose, maintaining blood pressure and suppressing inflammation. However, a chronic high level of cortisol has detrimental effects on the body and can lead to Cushing syndrome.

Although it is produced by the adrenal glands, cortisol is regulated by the pituitary gland in the brain. The pituitary secretes adrenocorticotropic hormone (ACTH), which travels to the adrenal glands and stimulates them to grow and produce cortisol. Too much ACTH can cause high levels of cortisol in the body and, in turn, Cushing syndrome.

Cushing syndrome is divided into two categories, according to the cause of the disorder:

  • Exogenous Cushing syndrome is the classification when the source of excess cortisol is outside the body—namely, medications called glucocorticoids. Examples of glucocorticoid medications include prednisone, dexamethasone and cortisone.
  • Endogenous Cushing syndrome is the term used when the body itself produces excess cortisol. The underlying cause is known as either ACTH-dependent or ACTH-independent.
  • ACTH-dependent refers to an overproduction of ACTH that leads to high levels of cortisol. Usually, the cause of this is a pituitary tumor secreting ACTH, but sometimes the tumor is outside of the pituitary—for instance in the lung, thymus or thyroid.
  • ACTH-independent refers to normal ACTH levels accompanied by high cortisol levels. Either overactive adrenal glands or an adrenal tumor secreting cortisol may cause this condition.

Most often, Cushing syndrome can be attributed to an exogenous source, that is, glucocorticoids. Rarely is Cushing syndrome caused by an endogenous source, that is, by a tumor or by overactive adrenal glands.

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