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Cushing's Syndrome: Know the Symptoms & Treatment

Getting the right diagnosis may take time but it’s key to being treated.
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Last updated February 9, 2022

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Care Plan


First steps to consider

  • See a healthcare provider if you have symptoms of Cushing syndrome, also called hypercortisolism. Symptoms may include weight gain of the midsection, face, and upper back, stretch marks, acne, bruising easily, and fatigue.
  • Treatment is based on what is causing the condition, like medications or a pituitary tumor.
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What is Cushing's syndrome?

Cushing's syndrome, also called hypercortisolism, is caused by unusually high levels of the hormone cortisol in the body.

Cortisol is a steroid hormone that helps with many of the body’s responses, including stress. If you have too much cortisol, it can cause excessive weight gain, stretch marks, and easy bruising. It can eventually lead to high blood pressure and diabetes.

There are three main ways your body can have too much cortisol. The most common cause is long-term use of cortisol-like glucocorticoids medications, such as for treating asthma.

Other rarer causes are having a small tumor in the pituitary gland. Or a small tumor in the adrenal gland. The tumors cause an increase in the production of cortisol.

Cushing's syndrome symptoms

Pro Tip

Cushing’s syndrome is one of the most difficult diagnoses to make. Symptoms are common and can be subtle. For example, who hasn’t experienced weight gain and fatigue at some point in their life? Don’t self-diagnose. Keep track of all the symptoms you are experiencing so that you can share them with your doctor. —Dr. Brian Walcott

Symptoms of Cushing’s are often subtle. This makes the condition hard to diagnose in the early stages.

Common symptoms include weight gain—usually around the waist, in the face, and on the back between the shoulder blades.

People may develop stretch marks, which are referred to as striae. Other symptoms include easy bruising and acne. Elevated blood pressure is also common.

Any of these symptoms alone is often common. And they can have many different causes. But all of them together could be a sign of Cushing’s syndrome.

Main symptoms

  • Weight gain in specific places: midsection, face, in back area between shoulders
  • Stretch marks
  • Elevated blood pressure
  • Acne, most commonly on the face
  • Easy bruising
  • Fatigue

Other symptoms you may have

  • Increase in facial and body hair (in women)
  • Irregular menstrual cycle (in women)
  • Lower libido
  • Osteoporosis (accelerated bone loss)
  • Mood changes (depression, anxiety, irritability)
  • Newly diagnosed type 2 diabetes

Causes of Cushing’s syndrome

Your body naturally makes the cortisol hormone. Some people need to take glucocorticoids medications (also known as steroids) over a long period of time to treat conditions like asthma or inflammatory bowel disease.

These steroids can interact with your body in a similar way that cortisol does. That causes an excess of cortisol or cortisol-like hormones, which leads to symptoms of Cushing’s.

Other causes are having a small tumor in the pituitary gland (called Cushing disease). The pituitary gland makes adrenocorticotropic hormone (ACTH), which in turn tells the adrenal glands to make cortisol. There can also be a small tumor in the adrenal gland. Both signal your adrenal gland to make too much natural cortisol.

Dr. Rx

Show your doctor your driver’s license. The photo is likely many years old and can be used to compare to how you look now. —Dr. Walcott

Cushing’s syndrome treatment

Getting a correct diagnosis may take time. Often your doctor will order blood tests and urine tests first. Then, imaging, like an MRI.

But tumors can be very small and easily missed on an MRI. In rare circumstances, the veins inside the brain might be sampled for hormone levels to figure out the cause.

Treatment depends on the cause.

If it is from medications that your doctor has prescribed, you need to work with him or her on a plan to lower your dosage. Or to use an alternative.

If the high cortisol levels are related to a tumor, you’ll need surgery to remove it.


If you have a tumor in your pituitary gland, a neurosurgeon will give you an MRI scan. Then, the surgeon will remove it using the natural opening of your nose. Since the tumor is usually very small and sometimes hard to find, sometimes you’ll need more treatment, like focused radiation or medications. These can help lower cortisol production.

If you have a tumor in the adrenal glands, located in the upper abdomen, a specialist in endocrine surgery will take an imaging scan to find it. Then, he or she will remove the tumor surgically.

Ready to treat your cushing's syndrome?

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Follow up

The side effects of having too much cortisol are the most harmful part of Cushing’s syndrome. Particularly high blood pressure and diabetes. You’ll want to monitor these conditions closely to prevent long-term health complications.

Pro Tip

One of the descriptions of patients with Cushing’s syndrome in medical textbooks is “moon face” since fat tissue builds up in the face area and it looks round like the moon. —Dr. Walcott


The tumors that cause Cushing’s cannot be prevented. However, it’s important to try to avoid using prescription steroids long term.

Talk to your doctor about all medications you are taking, particularly steroids. There are steroid alternatives that could work, depending on your condition.

Share your story
Once your story receives approval from our editors, it will exist on Buoy as a helpful resource for others who may experience something similar.
The stories shared below are not written by Buoy employees. Buoy does not endorse any of the information in these stories. Whenever you have questions or concerns about a medical condition, you should always contact your doctor or a healthcare provider.
Dr. Le obtained his MD from Harvard Medical School and his BA from Harvard College. Before Buoy, his research focused on glioblastoma, a deadly form of brain cancer. Outside of work, Dr. Le enjoys cooking and struggling to run up-and-down the floor in an adult basketball league.

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