Do you have acne and irregular periods and excess facial hair?

All these signs point to excessive androgen hormones in your blood. A common cause is Cushing's syndrome.

What is Cushing's syndrome?

Cushing's syndrome is a condition in which there is excess amounts of steroid(cortisol) and associated androgenic hormones in your blood. It has many different causes, and can be diagnosed by means of blood testing.

Common Causes

The cause may be in the pitutitary gland of the brain, or in the adrenal glands(above your kidneys). It may also be due to medications.

Rare Causes

Rarely a cancer in your lungs, or pancreas may be the actual cause.

What other symptoms will be seen?

In women, Cushing's syndrome will show osteoporosis, or a weakning of the bones. It may also show eleveated blood sugar levels

Obesity

Obesity is one of the most common signs of Cushing's syndrome. There will be excess fat deposition in the back (called buffalo hump) as well as around the center of gravity of the body.

Skin Changes

You may notice thay your skin shows stripes (striae) which are due to changes in the composition of your subcutaneous tissue.

Can medicines cause this?

Ironically steroid medicines (which are some of the most commonly prescribed medicines), may cause Cushing's syndrome.

Examples

Prednisolone is an example of a steroid medicine, that if given in excess or taken over long periods of time can cause Cushing's syndrome.

How to diagnose it?

The diagnosis is done by testing the steroid hormone levels (cortisol) usually at 8 am and midnight or (8pm).

Circadian Rhythm

Cortisol levels are normally lowest at midnight. If the level shows no change between morning and night, and is persistently elevated. It probably indicates the diagnosis of Cushing's syndrome

Suppresion Test

Once the diagnosis of elevated cortisol is confirmed, the originating cause of Cushing's syndrome can be further estimated by means of the Dexamethason suppression test. In this test , the patient is given a dose of Dexamethasone, and we measure whether the ACTH Level falls in response to it. If the cause of Cushing's syndrome is in the pituitary gland, the level will fall. The level stays unchanged if the cause is anything else.

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