Cushing’s Syndrome
Cushing’s syndrome develops when the body is exposed to abnormally high levels of cortisol over a prolonged period. The excess cortisol disrupts fat distribution, skin integrity, blood pressure, and blood sugar, producing a recognisable cluster of changes that can be easy to miss individually but striking together.
Medicine used to treat Cushing's Syndrome
What drives excess cortisol
The most common cause worldwide is long-term corticosteroid medication. When the syndrome arises from within the body itself, a pituitary tumour secreting ACTH is the usual culprit (called Cushing’s disease); less often, the adrenal glands or a tumour elsewhere produce cortisol directly.
Recognising the pattern
Central weight gain with a rounded face and fat pad at the upper back, stretch marks that are wide and purple, thinning skin that bruises easily, muscle weakness in the thighs and upper arms, and elevated blood pressure or blood sugar are the hallmark signs. Mood changes and irregular periods occur in many women. If several of these are present together, investigation for cortisol excess is warranted.
Reducing cortisol medically
When surgery on the underlying tumour is not possible or needs to be bridged, medicines that suppress cortisol synthesis are used. Ketoconazole, an antifungal agent, inhibits key enzymes in the adrenal steroid pathway and has been used for decades as a cortisol-lowering treatment in this setting.