Cushing's syndromeSymptoms, Doctors, Treatments, Advances & More
Learn About Cushing's syndrome
Cushing syndrome is a disorder that occurs when your body has a high level of the hormone cortisol.
Hypercortisolism; Cortisol excess; Glucocorticoid excess - Cushing syndrome; Cushing's syndrome
The most common cause of Cushing syndrome is taking too much glucocorticoid or corticosteroid medicine. This form of Cushing syndrome is called exogenous Cushing syndrome. Prednisone, dexamethasone, and prednisolone are examples of this type of medicine. Glucocorticoids mimic the action of the body's natural hormone cortisol. These medicines are used to treat many conditions such as asthma, skin inflammation, cancer, bowel disease, joint pain, and rheumatoid arthritis.
Other people develop Cushing syndrome because their body produces too much cortisol. This hormone is made in the adrenal glands. Causes of too much cortisol are:
- Cushing disease, which occurs when the pituitary gland makes too much of the hormone adrenocorticotrophic hormone (ACTH). ACTH then signals the adrenal glands to produce too much cortisol. A pituitary gland tumor can cause this condition.
- Tumor of the adrenal gland
- Tumor elsewhere in the body that produces corticotropin-releasing hormone (CRH)
- Tumor elsewhere in the body that produces ACTH (ectopic Cushing syndrome)
Not everyone with Cushing syndrome has the same symptoms. Some people have many symptoms while others have hardly any symptoms. Symptoms usually get worse over time.
Most people with Cushing syndrome have:
- Round, red, full face (moon face)
- Slow growth rate (in children)
- Weight gain with fat accumulation on the trunk, but fat loss from the arms, legs, and buttocks (central obesity)
Skin changes can include:
- Skin infections
- Purple stretch marks [1/2 inch (in) or 1 centimeter (cm) or more wide] called striae on the skin of the abdomen, upper arms, thighs, and breasts
- Thin skin with easy bruising (especially on the arms and hands)
Muscle and bone changes include:
- Backache, which occurs with routine activities
- Bone pain or tenderness
- Collection of fat between the shoulders and above collar bones
- Rib and spine fractures caused by thinning of the bones
- Weak muscles, especially of the hips and shoulders
Body-wide (systemic) changes include:
- Type 2 diabetes mellitus
- High blood pressure (hypertension)
- Increased blood cholesterol and triglycerides (hyperlipidemia)
Women with Cushing syndrome may have:
- Excess hair growth on the face, neck, chest, abdomen, and thighs
- Periods that become irregular or stop
Men may have:
- Decreased or no desire for sex (low libido)
- Erection problems
Other symptoms that may occur with this disease:
- Mental changes, such as depression, anxiety, or changes in behavior
- Fatigue
- Frequent infections
- Headache
- Increased thirst and urination
Treatment depends on the cause.
Cushing syndrome caused by corticosteroid use:
- Your provider will instruct you to slowly decrease the medicine dosage. Stopping the medicine suddenly can be dangerous.
- If you cannot stop taking the medicine because of the disease it is treating, your high blood sugar, high cholesterol levels, and bone thinning or osteoporosis should be closely monitored and treated.
With Cushing syndrome caused by a pituitary tumor that releases too much ACTH (Cushing disease), you may need:
- Surgery to remove the tumor
- Radiation after removal of the pituitary tumor (in some cases)
- Cortisol replacement therapy after surgery
- Medicines to replace pituitary hormones that become deficient
- Medicines to prevent the body from making too much cortisol
With Cushing syndrome due to a pituitary tumor, adrenal tumor, or other tumors:
- You may need surgery to remove the tumor.
- If the tumor cannot be removed, you may need medicines to help block the release of cortisol or the ability of cortisol to signal.
Brain Tumor Clinic
Maya Lodish is a Pediatric Endocrinologist practicing medicine in San Francisco, California. Dr. Lodish is rated as an Elite provider by MediFind in the treatment of Cushing's syndrome. She is also highly rated in 15 other conditions, according to our data. Her clinical expertise encompasses Cushing's syndrome, Cushing's disease, Gigantism, Pituitary Tumor, and Thyroidectomy. Dr. Lodish is board certified in Pediatrics and Pediatric Endocrinology.
Domino's Farms
Dr. Richard Auchus is a professor of Internal Medicine, Division of Metabolism, Endocrinology & Diabetes (MEND) and Chief of the Endocrinology & Metabolism Section at the Ann Arbor VA Medical Center. He received his medical degree and Ph.D. in pharmacology from Washington University in St. Louis. Then Dr. Auchus completed a residency at the University of Iowa and an endocrinology fellowship at UTHSC-San Antonio/Wilford Hall Medical Center. Dr. Auchus came to UMHS from the Graduate School of Biomedical Sciences in Southwestern Medical School, University of Texas, where he was a Professor of Internal Medicine - Endocrinology.Dr. Auchus is a steroid biologist with expertise both in basic science and clinical/translational science. His work has included translational research into: molecular and genetic mechanisms of human hypertension, improved diagnostic studies and management in primary aldosteronism and Cushing syndromes, modifier genes in 21-hydroxylase deficiency, cardiovascular disease in polycystic ovary syndrome, and the endocrinology of traumatic brain injury. Dr. Auchus is rated as an Elite provider by MediFind in the treatment of Cushing's syndrome. He is also highly rated in 20 other conditions, according to our data. His clinical expertise encompasses Congenital Adrenal Hyperplasia (CAH), Intersex, Cushing's syndrome, Hormone Replacement Therapy (HRT), and Orchiectomy. Dr. Auchus is board certified in Endocrinology, Diabetes & Metabolism.
Johns Hopkins Health Care & Surgery Center - Green Spring Station, Lutherville
Amir Hamrahian, M.D. is an endocrinologist with specialized experience in the treatment of adrenal and pituitary disorders. Dr. Hamrahian is located in Baltimore, Maryland. He received his medical degree from Hacettepe University in Ankara, Turkey, did his internal medicine residency at the University of North Dakota and completed his endocrinology fellowship at the Case Western Reserve University. Dr. Hamrahian is an Associate Professor of Medicine and has published more than 80 peer-reviewed articles, and has served as a co-author in developing guidelines for adrenal and pituitary disorders. He has presented at national and international conferences and has served as the principal investigator for a number of clinical research studies. Accolades received include Teacher of The Year award and Human Subject Research Annual Professional Excellence award in 2003 and 2011, respectively. Dr. Hamrahian has held roles including the chief of endocrinology in Abu Dhabi. Dr. Hamrahian is a co-director of the Adrenal Center. Dr. Hamrahian is rated as an Elite provider by MediFind in the treatment of Cushing's syndrome. He is also highly rated in 33 other conditions, according to our data. His clinical expertise encompasses Cushing's disease, Pituitary Tumor, Cushing's syndrome, Prolactinoma, and Gamma Knife Radiosurgery. Dr. Hamrahian is board certified in American Board Of Internal Medicine.
Removing the tumor may lead to full recovery, but there is a chance that the condition will return.
Survival for people with Cushing syndrome caused by tumors depends on the tumor type.
Untreated, Cushing syndrome can be life threatening.
Health problems that may result from Cushing syndrome include any of the following:
- Diabetes
- Enlargement of pituitary tumor
- Bone fractures due to osteoporosis
- High blood pressure
- Kidney stones
- Serious infections
Contact your provider if you have symptoms of Cushing syndrome.
If you take a corticosteroid, know the signs and symptoms of Cushing syndrome. Getting treated early can help prevent any long-term effects of Cushing syndrome. If you use inhaled steroids, you can decrease your exposure to the steroids by using a spacer and by rinsing your mouth after breathing in the steroids.
Summary: Between 10% and 15% of patients with endogenous hypercortisolism (Cushing syndrome) have ectopic (non-pituitary) production of adrenocorticotropin hormone (ACTH) that causes cortisol excess. In approximately 50% of these patients, the tumoral source of ACTH cannot be found initially despite very detailed and extensive imaging, including studies such as computed tomography, magnetic resonance imagi...
Summary: A Phase 1b/2a, first-in-disease, open-label, multiple-ascending dose exploratory study to evaluate safety, tolerability, pharmacokinetics (PK), and pharmacodynamic biomarker responses associated with CRN04894 (an adrenocorticotropic hormone \[ACTH\] receptor antagonist) in participants with ACTH-dependent Cushing's syndrome (Cushing's disease or Ectopic ACTH Syndrome \[EAS\])
Published Date: April 24, 2025
Published By: Sandeep K. Dhaliwal, MD, board-certified in Diabetes, Endocrinology, and Metabolism, Springfield, VA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
Auchus RJ, Pandey CEF. The adrenal cortex. In: Melmed S, Auchus RJ, Goldfine AB, Rosen CJ, Kopp PA, eds. Williams Textbook of Endocrinology. 15th ed. Philadelphia, PA: Elsevier; 2025:chap 13.
Fragoso MCBV, Berthon A, Bertherat J. Adrenocorticotropic hormone-independent Cushing syndrome. In: Robertson RP, ed. DeGroot's Endocrinology. 8th ed. Philadelphia, PA: Elsevier; 2023:chap 97.
Nieman LK. Adrenal cortex. In: Goldman L, Cooney KA, eds. Goldman-Cecil Medicine. 27th ed. Philadelphia, PA: Elsevier; 2024:chap 208.