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Cushing's syndrome

Syndroma Cushingi · Cushingův syndrom

What it is

Too much cortisol — most often from steroid medication, sometimes a tumour.

Symptoms & signs

  • Round face
  • central weight gain with thin limbs
  • purple stretch marks
  • easy bruising
  • high blood pressure
  • muscle weakness
  • mood change

🚩 Get help if…

  • call 112 / 911 now Vomiting, collapse or severe weakness after suddenly stopping steroids
  • call 112 / 911 now Sudden breathlessness, chest pain or a swollen, painful calf
  • see a doctor soon Great thirst and passing lots of urine
  • see a doctor soon Sudden back pain after a minor knock

Where it strikes

Medical treatment

  • Taper steroids where possible
  • transsphenoidal pituitary surgery
  • adrenalectomy
  • metyrapone, osilodrostat
  • treat bone loss and diabetes

Natural & lifestyle

  • Bone protection
  • resistance exercise for muscle loss
  • salt and calorie control

Emerging & experimental

  • Cortisol receptor blockers (relacorilant)
  • selective SST5 agonists

Alternative, off-label & anecdotal

Approaches used outside the guidelines, with what their supporters report and what testing has found so far.

  • Ashwagandha and other adaptogens — lower cortisol a little in stressed people; no role in Cushing's anecdotal / traditional
  • Low-carbohydrate diet for the high sugar and weight — sensible; untested for Cushing's itself early / small studies

ICD codes