The hypothalamus in the brain, the pituitary gland, and the adrenal glands all work together to control the production of the hormone cortisol by the adrenal. Cortisol is known as a stress hormone, as it is produced by the body in response to a variety of stressors, both external and internal. Cortisol helps the body to regulate numerous functions including maintenance of blood sugar, control of heart function and blood pressure, breakdown of fats and proteins, and modulating the immune system.
How is Cortisol Production Controlled?
When required by the body, the hypothalamus releases a hormone called corticotrophin releasing hormone which acts on the pituitary gland to stimulate the release of adrenocorticotrophic hormone (or ACTH). Once released into the circulation by the pituitary, ACTH stimulates the adrenal glands (located above the kidneys) to produce and release cortisol into the bloodstream.
What Causes Cushing’s Syndrome?
Cushing’s syndrome occurs when the body is exposed to higher than normal amounts of cortisol (or drugs that are similar to it such as synthetic glucocorticoids) for an extended period of time. This can happen when people take steroids such as prednisone for an extended period of time to treat conditions such as asthma or Lupus. Cushing’s syndrome can also occur when the body has problems keeping cortisol production under control as might happen with some tumors, both malignant and benign.
What are the Symptoms Associated with Cushing’s Syndrome?
One of the more common signs of Cushing’s syndrome is the “rounding” of the face and its features and the deposition of fat in the upper body. Deposition of fat at the top of the back between the shoulder blades can lead to a noticeable fat pad or hump. The skin can become frail and thin, bruising easily. The bones may become more prone to fracture and patients often show excessive fatigue. Higher than normal facial hair growth, especially in women, is also seen. Some may also experience difficulty regulating their blood sugar and/or their blood pressure.
How is Cushing’s Syndrome Treated?
First and foremost is determining the cause for elevated cortisol levels. If it is because of needing to use drugs that mimic the effects of cortisol, if possible, the treating physician may try to taper the dose of the drug to minimize the side effects. If the cause is either a benign or malignant tumor, surgical removal of the tumor may be undertaken. If access to the tumor is problematic, radiation treatment can be used. There are also drugs that interfere with the action of cortisol such as metyrapone.
As for any medical condition, speak with your physician to get appropriate treatment information. To learn more about Cushing’s syndrome visit the website of the U.S. National Endocrine and Metabolic Diseases Information Service.
 |
 |
