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Cushing’s disease occurs due to excess cortisol production resulting from a malfunctioning pituitary gland. The pituitary gland is present at the base of the brain. In this condition, a non-cancerous tumour on the gland induces it to release excessive adrenocorticotropic hormone (ACTH). ACTH further fuels the adrenal glands to produce more cortisol. Cortisol affects entire organs and tissues in the body, leading to their abnormal growth syndrome called Cushing disease.
Pituitary gland: An organ of the endocrine system
The following factors can cause Cushing’s disease:
Common signs and symptoms of cushings disease include:
Signs and symptoms among women:
Signs and symptoms among men:
The treatment options for Cushing’s disease focus on lowering the cortisol level in the body. Some of the best treatments are:
Suppose you suffer from Cushing’s disease due to the long-term usage of corticosteroid medications. In that case, your doctor can reduce the dosage while maintaining your condition. Please Note: Do not start or stop taking these medications without your doctor’s supervision.
Your doctor may recommend the removal of tumours through a surgical process. Medical professionals can remove pituitary tumours through a nasal procedure. However, the adrenal glands, pancreas, or lungs require minimally invasive surgical techniques.
If the pituitary tumour is not removed even after surgery, the doctor will also prescribe you radiation therapy. Radiation is typically for patients who can’t undergo surgery.
If both surgery and radiation don’t work, you can be prescribed medications to control cortisol production. Such medicines include:
If all the treatments mentioned above fail, your doctor might recommend bilateral adrenalectomy. It is a surgical process that includes the removal of adrenal glands. While the process cures excessive cortisol production, it requires lifelong replacement medications.
Factors that can increase the risk of Cushing disease are:
As the changes in appearance and body develop gradually, decoding the early stages of Cushing’s disease is difficult. The hormone elevations appear and disappear. Therefore, one can term them ‘periodic’ or ‘cyclical’ Cushing’s disease, making the diagnosis more difficult.
If you are not using any corticosteroid medication, the following diagnostic tests may help in identifying Cushing’s disease: Urine and blood tests: You must undergo these tests to determine hormone levels to check if your body produces too much cortisol. The healthcare professional may ask you to take 24-hour urine free cortisol (UFC) measurement. This test collects and examines urine for over 24 hours. Medical professionals also analyse your blood samples to gauge cortisol levels. Saliva test: Cortisol levels keep rising and falling during the day and fall drastically during the evening. Therefore, analysing several saliva samples collected late at night help in decoding the high cortisol levels. Imaging tests: Magnetic resonance imaging (MRI) or computerised tomography (CT) scans help examine tumours and other abnormalities in your adrenal and pituitary glands. Petrosal sinus sampling: Pathologists carry out this sampling test to confirm if the root cause of the disease is in the pituitary gland or somewhere else.
Cortisol is integral for carrying out several functions like managing respiration, regulating blood sugar levels, turning food into energy, helping in coping with stress, and more. However, too much cortisol is your body’s enemy. For primary prevention, get your cortisol levels monitored from time to time, especially if you are taking steroids or glucocorticoids. However, there is no way to avoid or prevent tumours causing Cushing’s disease.
ACTH-Secreting Adenoma, Pituitary Cushing’s Disease
Cushing’s disease can lead to severe illness and even death if left untreated. However, removing the tumour might help you recover fully, but there are chances of the tumour growing back.
Cushing’s disease can lead to severe illness and even death if left untreated.
The adrenal gland secretes steroid hormones and cortisol stimulated by excessive ACTH. The pituitary gland secretes ACTH, while the hypothalamus secretes the corticotropin-releasing hormone. The latter causes the ACTH to transfer to the petrosal venous sinuses.
Cushing’s disease can lead to several health problems like:
If you are facing any similar signs or symptoms please contact the BLK-Max team to schedule an appointment at : +91-11-30403040
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