All you need to know about: Cushing’s syndrome

In 2024, American comedian and actor Amy Schumer shared that she had been diagnosed with Cushing’s syndrome, bringing public attention to a condition that is often overlooked. She had also spoken about experiencing facial swelling and other physical changes linked to excess cortisol, helping raise awareness about how the disorder can present.

Recent studies have reported expanding treatment options for Cushing’s syndrome, particularly for patients who are not candidates for surgery or whose disease persists after surgery. Newer medications that reduce cortisol production have shown sustained hormone control in clinical studies, for more individualised and long-term management.

What is Cushing’s syndrome?

Cushing’s syndrome happens when there is too much cortisol in the body over a long period. Cortisol is produced by the adrenal glands and helps control blood pressure, metabolism, immunity, and the body’s response to stress. When cortisol remains high, it affects many organs. The most common cause is long-term use of steroid medicines prescribed for asthma, autoimmune diseases, arthritis, or after organ transplants. This is called exogenous Cushing syndrome.

In endogenous Cushing’s syndrome on the other hand, the body produces excess cortisol on its own. This is usually due to a non-cancerous tumour in the pituitary gland (called Cushing’s disease). The pituitary gland is a small gland located at the base of the brain. Less commonly, it may be caused by tumours in the adrenal glands or by tumours elsewhere in the body that produce ACTH (adrenocorticotropic hormone), a hormone normally released by the pituitary gland.

Though rare affecting about 1 to 3 people per million each year, diagnosis is often delayed because symptoms resemble those of obesity or type 2 diabetes.

Whar are the signs and symptoms?

One of the earliest signs is weight gain, especially around the abdomen and face. The face may become round and red, often called a “moon face.” Some people develop fat buildup between the shoulders.

The skin becomes thin and bruises easily. Wounds may heal slowly. Wide purple stretch marks can appear on the abdomen, thighs, breasts, or arms. Acne and increased facial or body hair (especially in women) can also occur. Women may notice irregular or absent periods, while men may experience reduced libido or fertility issues.

Muscle weakness is common, especially in the upper arms and thighs, making it hard to climb stairs, lift objects, or get up from a chair. Fatigue is frequent.

High cortisol also affects metabolism and the heart. Many people develop high blood pressure and high blood sugar, and some develop diabetes. Cholesterol levels may increase. Bone loss can lead to osteoporosis and fractures. Mood and brain function can also be affected. Anxiety, irritability, depression, mood swings, and sleep problems are common. Some people experience difficulty concentrating, memory problems, or brain fog. In severe cases, confusion or more serious mental health changes can occur.

Frequent infections may happen because high cortisol weakens the immune system. In children, weight gain with slowed height growth is a typical sign. If left untreated, the condition increases the risk of heart disease, blood clots, infections, and other serious complications, making early diagnosis and treatment important.

Who is at risk?

People who take steroid medicines for a long time are at highest risk. Even moderate doses over time can increase cortisol levels.

Women are more commonly affected than men in naturally occurring (endogenous) cases, especially between ages 30 and 50.

Doctors may test for Cushing’s syndrome in people with difficult-to-control high blood pressure, early osteoporosis, unexplained diabetes, or several typical symptoms appearing together.

What are the treatment options?

Research published recently in medical journals highlights significant advancements in the diagnosis and management. Treatment depends on the cause and aims to bring cortisol levels back to normal. If steroid medicines are the cause, doctors slowly reduce the dose under supervision. Stopping them suddenly can be harmful. If a tumour is causing excess cortisol, surgery is usually the first treatment. Pituitary tumours are removed through specialised surgery, and adrenal tumours may require removal of the affected gland. If surgery is not possible or incomplete, radiation therapy may be used.

Newer medicines that block cortisol production or its effects are also available, especially for patients who cannot undergo surgery.

After treatment, some patients may need temporary cortisol replacement until their body recovers. Long-term follow-up is important because the condition can return.

Published – March 03, 2026 03:06 pm IST