Life Before and After Cushing’s Syndrome
By: Carolyn V. Pilgrom
What is Cushing’s Syndrome?
Cushing’s Syndrome is a condition characterized by high cortisol levels in the body (Hypercortisolism). This rare condition can occur from a small tumor on the pituitary gland, a tumor on one or both of the adrenal glands, or hormone producing tissue found in other areas of the body. This condition can result in many symptoms including but not limited to weight gain, high blood pressure, stretch marks (large and purple or pink), fatigue, and rounded or moon shaped face. The specific term for the type of Cushing’s Syndrome that is related to a tumor on the pituitary gland is Cushing’s Disease. Cushing’s requires a medical diagnosis and extensive testing. If you suspect that you have it, speak to your primary care physician first and they should refer you to an endocrinologist.
What is Cyclical Cushing’s?
Cyclical Cushing’s is a situation in which the pattern of hypercortisolism is not consistent and can have periods of very high cortisol and low in an erratic pattern. People with this type of Cushing’s sometimes feel like they can take on the world in a high cortisol time and during low periods have severe fatigue, inability to properly function, muscle aches, and nausea/vomiting. Cyclical Cushing’s is a roller coaster of hormones that can have severe effects on your mental and physical health.
How is Cushing’s treated?
To properly treat Cushing’s, the source of the hypercortisolism must first be determined, then you and your medical team can determine the best method of correction. In the case of a pituitary tumor the result of often a surgery to remove the tumor, sometimes this is followed by gamma knife radiation if Cushing’s is not resolved. If the tumors reside elsewhere in the body or on the adrenals these are also removed with surgery. In some cases, the high levels of cortisol in the body for long periods of time can cause changes in the adrenal glands in which they will become dense and over-function on their own. If this occurs, then your endocrinologist may recommend bilateral adrenalectomy or removal of both adrenal glands.
Oh no! They want to take my adrenal glands? Won’t I die?
No, you will not die without your adrenal glands. More people than you think, myself included, have had their adrenal glands removed due to Cushing’s or other conditions. The complete lack of cortisol is called Addison’s disease and is managed with hormone replacements. When the body has stress due to fatigue, trauma, or illness these hormone replacements will need to be supplemented, but with time one learns what these situations are and what to expect.