Cushing's Syndrome

In healthy people, the hormone cortisol plays a vital role in dealing with stress, prepping the body to fight or flee from a tough situation. Our ancestors relied on it to escape wild animals; we get a surge of it whenever we are facing a deadline, fighting with our spouse, or dealing with rush-hour traffic. In people who have prolonged exposure to excess amounts of cortisol, the result is sometimes Cushing's syndrome, a rare disease that affects adults between the ages of twenty and fifty, mainly women.

People develop Cushing's for several reasons. The condition may occur in people who have taken steroids such as prednisone for the long-term treatment of asthma, lupus, or rheumatoid arthritis. In others, Cushing's is caused by the body's making too much cortisol. Tumors or illnesses affecting the pituitary or adrenals can wreak havoc on the adrenal gland's production of cortisol. In extremely rare cases, Cushing's is an inherited disorder that causes a tendency for tumors on one or more of the endocrine glands.

Some people may have a milder form of the disease called pseudo-Cushing 's, in which the patient has elevated cortisol as in Cushing's but has fewer signs and symptoms than someone with full-blown Cushing's.

Question

Can too much stress cause Cushing's?

No, but stress can cause a host of health problems — depression, insomnia, anxiety, and weight gain — that lead to other health problems such as heart disease. On its own, stress doesn't lead to full-blown Cushing's syndrome — or else we'd have a Cushing's epidemic.

Pseudo-Cushing 's is not caused by a tumor, but may be the result of myriad health problems, including depression, alcoholism, surgery- related stress, severe illness, and poorly controlled diabetes. Pseudo-Cushing 's doesn't cause the progressive problems associated with Cushing's, such as weakening bones, fractures, and thinning of the skin. But when the symptoms are mild and vague, it is easy to confuse pseudo-Cushing 's with a thyroid disorder.

Though symptoms vary, some cases of Cushing's disease do bear a resemblance to hypothyroidism. Many people may notice weight gain, especially in the upper body, and a rounding and reddening of the face. The skin may be fragile and thin, and there may be loss of muscle strength, high blood pressure, and high blood sugar. Patients may also develop purplish pink stretch marks on the arms, abdomen, thighs, buttocks, and breasts. Most people are severely fatigued and will experience irritability, anxiety, and depression.

Women with Cushing's may have menstrual irregularities and excess hair growth. Men may experience low libido and have problems with erections. Children with Cushing's may become obese and experience a slowdown in growth rate.

Diagnosing Cushing's can be difficult and involves an array of tests such as urine samples, CT scans, and MRIs. You will also need to undergo tests that measure levels of different hormones that affect the secretion of cortisol.

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