Cushing's diseaseSymptoms, Doctors, Treatments, Advances & More
Learn About Cushing's disease
Cushing disease is a condition in which the pituitary gland releases too much adrenocorticotropic hormone (ACTH). The pituitary gland is an organ of the endocrine system.
Cushing disease is a cause of Cushing syndrome. Other causes of Cushing syndrome include exogenous Cushing syndrome, Cushing syndrome caused by an adrenal tumor, and ectopic Cushing syndrome.
Pituitary Cushing disease; ACTH-secreting adenoma
Cushing disease is caused by a tumor or excess growth (hyperplasia) of the pituitary gland. The pituitary gland is located just below the base of the brain. A type of pituitary tumor called an adenoma is the most common cause. An adenoma is a benign tumor (not a cancer).
With Cushing disease, the pituitary gland releases too much ACTH. ACTH stimulates production and release of cortisol, a stress hormone. Too much ACTH causes the adrenal glands to make too much cortisol.
Cortisol is normally released during stressful situations. It also has many other functions, including:
- Regulating the body's use of carbohydrates, fats, and proteins
- Reducing the immune system's response to swelling (inflammation)
- Regulating blood pressure and the body's water balance
Symptoms of Cushing disease include:
- Upper body obesity (above the waist) and thin arms and legs
- Round, red, full face (moon face)
- Slow growth rate in children
Skin changes that are often seen include:
- Acne or skin infections
- Purple stretch marks [1/2 inch (in) or 1 centimeter (cm) or more wide], called striae, on the skin of the abdomen, thighs, upper arms, and breasts
- Thin skin with easy bruising, most commonly 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 (buffalo hump)
- Weakening of the bones, which leads to rib and spine fractures
- Weak muscles causing exercise intolerance
Body-wide (systemic) changes include:
- Type 2 diabetes mellitus
- High blood pressure (hypertension)
- Increased blood cholesterol and triglycerides (hyperlipidemia)
Women may have:
- Excess hair growth on the face, neck, chest, abdomen, and thighs
- Menstrual cycle that becomes irregular or stops
Men may have:
- Decreased or no desire for sex (low libido)
- Erection problems
Other symptoms or problems may include:
- Mental changes, such as depression, anxiety, or changes in behavior
- Fatigue
- Frequent infections
- Headache
- Increased thirst and urination
Treatment involves surgery to remove the pituitary tumor, if possible. After surgery, the pituitary gland may slowly start to work again and return to normal.
During the recovery process from surgery, you may need cortisol replacement treatments because the pituitary needs time to start making ACTH again.
Radiation treatment of the pituitary gland may also be used if the tumor is not completely removed.
If the tumor does not respond to surgery or radiation, you may need medicines to stop your body from making cortisol.
If these treatments are not successful, the adrenal glands may need to be removed to stop the high levels of cortisol from being produced. Removal of the adrenal glands can cause the pituitary tumor to get much bigger (Nelson syndrome).
Barrow Neuro-Endocrine Clinic
Kevin C. J. Yuen, MD, is a neuroendocrinologist and Medical Director of the Pituitary Program at Barrow Neurological Institute, specializing in the management of hypothalamic-pituitary disorders. He is double board-certified in Endocrinology and Internal Medicine by the American Board of Internal Medicine, and General Medical Council in the UK.Dr. Yuen's expertise includes clinical and research interest in the management of pituitary and adrenal disorders, particularly adults with growth hormone deficiency, acromegaly, hypogonadism, Cushing's disease and adrenal insufficiency. He also has a particular interest in neuroendocrine disorders in young adult cancer survivors and adults with traumatic brain injury. His research is devoted to new diagnostics and treatments of pituitary disorders.Dr. Yuen completed his medical degree from the University of Sheffield. He completed his residency in internal medicine at the University of Southampton, UK, clinical and research fellowship in Endocrinology at the University of Cambridge, UK, and clinical and research instructor at Oregon Health and Science University, Portland OR. Dr. Yuen is active in international collaborative studies and has published numerous peer-reviewed medical articles.My mission, along with the Dignity Health Medical Group, is to focus on innovative clinical care and the pursuit of excellence through scholarly activities. This allows me to provide patients with state-of-the-art patient services and exceptional patient experiences. Dr. Yuen is rated as an Elite provider by MediFind in the treatment of Cushing's disease. He is also highly rated in 42 other conditions, according to our data. His clinical expertise encompasses Growth Hormone Deficiency (GHD), Hypopituitarism, Sheehan Syndrome, Hormone Replacement Therapy (HRT), and Endoscopic Transnasal Transsphenoidal Surgery. Dr. Yuen is board certified in Internal Medicine (Sub: Endocrinology, Diabetes & Met and Internal Medicine. Dr. Yuen is currently accepting new patients.
Cleveland Clinic Main Campus
Pablo Recinos is a Neurosurgery provider practicing medicine in Cleveland, Ohio. He has been practicing medicine for over 25 years. Dr. Recinos is rated as an Elite provider by MediFind in the treatment of Cushing's disease. He is also highly rated in 50 other conditions, according to our data. His clinical expertise encompasses Meningioma, Pituitary Tumor, Cushing's disease, Endoscopic Transnasal Transsphenoidal Surgery, and Balloon Sinuplasty. Dr. Recinos is board certified in American Board Of Neurological Surgery, 2018.
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 disease. 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.
Untreated, Cushing disease can cause severe illness, even death. Removal of the tumor may lead to full recovery, but the tumor can grow back.
Health problems that may result from Cushing disease include:
- Blood clots in veins (deep vein thrombosis)
- Compression fractures in the spine
- Diabetes
- High blood cholesterol (hyperlipidemia)
- High blood pressure
- Infections
- Kidney stones
- Mood or other psychiatric problems
- Weight gain
Contact your provider if you develop symptoms of Cushing disease.
If you have had a pituitary tumor removed, call your provider if you have signs of complications, including signs that the tumor has returned.
Background: The pituitary gland produces hormones. A tumor in this gland can cause it to produce too much of the hormone cortisol. Too much cortisol in the body causes Cushing disease. This disease causes many problems. Some of these problems might persist after the disease is cured.
Summary: This study is designed as a single institution trial. The study utilizes safe and clinically-validated tools for preoperative workup of patients with small pituitary tumors. DDAVP stimulation and 18F-labeled fluoro-deoxyglucose (FDG) uptake for PET-imaging will be used to detect MRI-negative pituitary adenomas in patients with Cushing s disease. Patients who have MRI-negative pituitary microadenom...
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.
Tabarin A, Corcuff J-B. Cushing disease. In: Robertson RP, ed. DeGroot's Endocrinology. 8th ed. Philadelphia, PA: Elsevier; 2023:chap 7.
Weiss RE. Anterior pituitary. In: Goldman L, Cooney KA, eds. Goldman-Cecil Medicine. 27th ed. Philadelphia, PA: Elsevier; 2024:chap 205.