Hollywood actor Amy Schumer recently revealed that she has been diagnosed with Cushing’s syndrome.
What is Cushing’s Syndrome?
Cushing’s syndrome, also known as hypercortisolism, is a hormonal disorder characterized by abnormally high levels of cortisol in the body. Cortisol, produced by the adrenal glands, is a vital hormone involved in various functions, including blood sugar regulation, stress response, and immune system function. When cortisol levels remain elevated for an extended period, it disrupts several bodily processes, leading to a range of symptoms and potential health complications.
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Causes of Cushing’s Syndrome:
Exogenous Cushing’s: This is the most common cause and arises from the prolonged use of corticosteroid medications (prednisone, hydrocortisone) for various conditions like asthma, arthritis, or autoimmune diseases.
Endogenous Cushing’s: This form arises from abnormal cortisol production within the body itself. It can further be categorized into:
Cushing’s disease: A tumour in the pituitary gland, a small gland at the base of the brain, causes this type. The tumour secretes an excess of ACTH (adrenocorticotropic hormone), which stimulates the adrenal glands to produce more cortisol.
Adrenal Cushing’s: A tumour on one or both adrenal glands directly produces excessive cortisol, independent of ACTH.
Ectopic ACTH syndrome: Rare tumours outside the pituitary gland (e.g., lung cancer) can release ACTH, leading to Cushing’s syndrome.
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Symptoms:
1. Weight Gain: Particularly in the abdomen, face (moon face), and upper back (buffalo hump).
2. Muscle Weakness and Wasting: Thinning of the arms and legs.
3. Skin Changes: Thin, fragile skin that bruises easily, purple stretch marks (striae) on the abdomen, thighs, and breasts.
4. Facial Features: Rounded, red face with fullness in the cheeks and increased facial hair (in women).
5. High Blood Pressure: Often difficult to control.
6. Osteoporosis: Weak, brittle bones.
7. Mood Changes: Irritability, anxiety, or depression.
8. Irregular Menstruation in women and decreased libido in men.
9. Increased Thirst and Urination due to high blood sugar levels.
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Diagnosis and Treatment
1. Medical History and Physical Examination: A doctor may suspect Cushing’s syndrome based on symptoms and physical signs.
2. Blood and Urine Tests: These tests measure cortisol levels and other hormone levels.
3. Imaging Tests: CT or MRI scans can identify tumours in the pituitary or adrenal glands.
4. Dexamethasone Suppression Test: A test to determine how the body responds to cortisol suppression.
Management of Cushing’s syndrome requires a multidisciplinary approach involving endocrinologists, neurosurgeons, and other specialists to address the underlying cause and manage associated symptoms and complications. Regular follow-up care is essential to monitor hormone levels and overall health.
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