In Cushing’s disease, as in all forms of Cushing’s syndrome, the cortisol level in the body rises to unhealthy levels (a condition called hypercortisolism). Cortisol is a glucocorticoid, or a type of steroid hormone, and is responsible for regulating various processes within the body.
Typical symptoms of Cushing’s disease
People with Cushing’s disease and Cushing’s syndrome show a variety of physical, mental, and hormonal symptoms, and not all patients will exhibit the same symptoms. Furthermore, many resemble symptoms of other illnesses, so patients and clinicians may have trouble identifying Cushing’s disease as the cause.
Diagnosis requires numerous tests, first to identify elevated cortisol levels, and then to narrow the cause to Cushing’s disease. Common signs of this disease may include:
- Excessive weight gain around the torso, with fat accumulation or minimal muscle tone in the arms and legs
- Unusual weight gain above the collarbone, known as a supraclavicular fat pad
- Development of a fat lump between the shoulders, colloquially referred to as a buffalo hump
- Bone, joint and muscle weakness, with increased risk of osteoporosis-related pain and fractures
- Red and/or full, round face, often referred to as moon face
- Development of acne, skin infections, or large, wide purple stretch marks known as striae
- Increased tendency to bruise easily
Less common symptoms
Patients with more advanced disease can exhibit other symptoms and comorbidities (other illnesses associated with the condition). Because Cushing’s progression is gradual, symptoms such as these below may go unrecognized and untreated for a long time:
- High blood pressure
- Elevated blood sugar
- High cholesterol
- Development of diabetes mellitus, marked by excessive thirst and a need to urinate
- Inadequate wound healing
- Sleep apnea and severe fatigue
- Changes in mental health, including depression and anxiety
Symptoms specific to demographic groups
Age and gender can affect the symptoms that patients experience. Because cortisol is a steroid hormone, excessive cortisol levels impact men, women, and children differently.
Women may develop:
- Irregular menstrual cycles
- Excessive hair growth, called hirsutism, on unusual parts of the body, such as the face, neck, chest, abdomen, and thighs
Men may experience:
- Reduced sex drive
- Reduced fertility
- Erectile dysfunction, or impotence
Children may show delayed growth and physical development compared to their peers, with or without disproportionate weight gain.
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