Cushing’s Syndrome
Cushing’s syndrome is a rare but serious health condition that occurs when the body is exposed to high levels of the stress hormone cortisol for an extended period. This can happen either because of taking medications containing steroids or because the body starts producing too much cortisol on its own. The most frequent cause of this internal cortisol spike is Cushing's disease, where a small tumor in the pituitary gland sends signals to the adrenal glands to produce more cortisol.
Recognizing the Symptoms
Cushing’s syndrome develops gradually, with symptoms often mistaken for other conditions. It can go undiagnosed for months or even years. Subtle changes like weight gain around the midsection, a rounder face (“moon face”), or a fat hump at the back of the neck may emerge. Skin changes such as deep purple stretch marks, easy bruising, and slow-healing cuts are common. Patients may also experience muscle weakness, high blood pressure, or mood changes like depression or irritability. Because symptoms progress slowly, the condition can be challenging to identify early.
How Diagnosis Unfolds
Because its symptoms overlap with many other conditions, Cushing’s syndrome can be tricky to diagnose. After ruling out steroid medications as a possible cause, endocrinologists usually begin with one of three tests: a 24-hour urine test to measure cortisol levels, a late-night saliva test, or a pill that checks whether cortisol levels drop as expected overnight. If the results suggest an abnormal increase in cortisol, further testing is needed. Blood work can help determine whether the pituitary gland or another part of the body is responsible, and scans of the pituitary or adrenal glands may be required to locate the source.
Finding the Right Treatment
Once diagnosed, surgery is often the go-to treatment to remove the tumor causing the problem. For pituitary tumors, doctors usually perform surgery through the nose, a less invasive option. If surgery doesn’t fully solve the problem, medication to control cortisol levels may be necessary. In stubborn cases, radiation or removal of the adrenal glands may be needed.
Adjusting to Life After Treatment
Living with Cushing’s syndrome doesn’t end after surgery or medication. Patients need regular check-ups to watch for signs of recurrence or other health issues that may linger. Keeping a close eye on heart health, blood sugar levels, and bone strength becomes part of the routine. For many, changing lifestyle habits like eating better and staying active helps manage weight and improve overall well-being. Patients also learn to recognize the warning signs of low cortisol levels, a potential side effect of treatment, and how to respond during stressful situations when extra medication might be needed.
Dr. Farhad Hasan’s Approach to Cushing’s Syndrome
Dr. Hasan offers personalized care for those affected by Cushing’s syndrome. He emphasizes a thorough evaluation, working closely with patients to ensure an accurate diagnosis. For treatment, Dr. Hasan collaborates with surgeons and other specialists to achieve the best results. He provides guidance on lifestyle adjustments and ongoing monitoring, focusing not only on controlling the condition but also on improving overall quality of life.