What is Cushing’s Disease

What Is Cushing's Disease?

Cortisol is a hormone in the body that is directly connected to the stress response. In a healthy individual, the pituitary gland reassesses ACTH, a hormone that stimulates the production and release of cortisol. When an individual faces a stressful situation, the bodies release additional cortisol. Sometimes the body is not able to properly regulate the production of this hormone, leading to an overproduction of it. Cushing's syndrome and Cushing's disease are both conditions that occur when the body produces too much cortisol.

The Difference Between Cushing's Syndrome and Cushing's Disease

Cushing's disease and Cushing's syndrome are not the same condition, but they are often confused with one another. Cushing's syndrome occurs when the body produces too much cortisol. While this can happen for many reasons, it often occurs when the patient uses corticosteroid medication.

What is Cushing's disease, then? Cushing's disease is a medical cause of Cushing's syndrome. Cushing's disease occurs when a tumor on the pituitary gland causes the gland to produce too much ACTH, the hormone responsible for cortisol production. Too much ACTH in the system makes the adrenal glands produce cortisol in high levels.

Cushing's disease can also occur with excess growth of the pituitary gland. The excessive growth, known as hyperplasia, also causes the release of too much ACTH, which then leads to over-production of cortisol.

Both Cushing's syndrome and Cushing's disease cause the same symptoms, including red lines on the abdomen, abdominal weight gain and roundness to the face.

Understanding Cushing's Disease

Cushing's disease is a relatively rare condition, only affecting 10 to 15 people per million every year. It is more common in women and occurs most often in people between the ages of 20 and 50.

Adenoma is the most common cause of Cushing's disease. Adenoma is a pituitary tumor that is almost always benign. The tumors can be hard to diagnose, because they are quite small, so many people who have Cushing's disease have a delayed diagnosis. Having an endocrinologist help with the diagnostic process can improve the chances of a prompt, successful diagnosis for patients who have symptoms of Cushing's syndrome and Cushing's disease.

Diagnosing Cushing's Disease

Diagnosing Cushing's disease can be difficult because symptoms develop slowly. Also, the elevated cortisol levels can happen in cycles, so the levels may not be elevated at the time of testing.

Testing begins with hormone blood tests to determine if blood cortisol levels are too high. This may require more than one test to establish a state of excessive blood cortisol. If the patient is not taking cortisol medications, the doctor will schedule an MRI to pinpoint the location of any tumors.

If you are struggling with symptoms of elevated cortisol levels, schedule an appointment with your endocrinologist to rule out Cushing's disease.