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Cushing's Disease caused by too much cortisol

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Cushing's disease results from too much cortisol


Paul G. Donohue, M.D. To Your Good Health

DEAR DR. DONOHUE: What can you tell me about Cushing's disease? Is it hereditary? What are the symptoms? What tests are done to diagnose it? Is it treatable?

-- J.C.

Cushing's disease is an illness in which the adrenal glands put out too much of their hormones ? principally cortisol, one of the cortisone hormones. The result is deposition of fat in the stomach and chest. The face looks like a full moon because of fat deposits there. Stretch marks appear on the skin. Muscles weaken. Bones might develop osteoporosis. Women sprout facial and chest hair, and their periods diminish or stop. Men often develop erectile dysfunction. Blood pressure often rises.

Trouble can be in two places, either the pituitary gland or the adrenal glands.

The pituitary gland ? located at the base of the brain ? is the body's master gland. It releases hormones that stimulate other endocrine glands ? the thyroid, ovaries, testes, adrenals ? to produce their unique hormones. The pituitary gland makes ACTH, adrenocorticotropic hormone ? the hormone that spurs adrenal gland production of cortisol. If the pituitary gland has a tumor that's secreting too much ACTH, the adrenal glands make too much cortisol, and Cushing's disease results.

The adrenal glands can also be the site where the problem lies. One of the adrenal glands can house a tumor that's making too much cortisol, independent of ACTH.

The diagnosis is made by checking hormone blood levels and scanning the pituitary and adrenal glands for tumor.

In either case, whether it's the adrenal gland or the pituitary gland, surgery can cure Cushing's disease. It is not an inherited illness.

There's another cause of Cushing's. A person who has to take one of the cortisone medicines, like prednisone, in large doses for long periods can come down with the signs and symptoms of Cushing's disease.

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  • Chief Cushie

There can also be the steroid induced and the food-dependent (GIP) types. Maybe even types yet known.

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