How Cushing's syndrome manifests in the body
What happens to the body?
Excess cortisol circulating the body’s bloodstream can result in the following symptomatic changes:
- Rapid weight gain (notably in the facial, chest, abdomen and buttock areas), contrasted with slender limbs (arms and legs) – weight gain can lead to upper body obesity as well (most often in children).
- Rounded face (moon-shaped) due to fatty deposits, that also appears flushed (plethora)
- Fatty deposits also occur in the upper back and between the shoulders (resulting in a ‘buffalo hump’)
- Skin changes such as purple / pink stretch marks (often on the chest, breasts, abdomen, arms and thighs) and bruising (due to thinning skin).
- Injuries, infections, and insect bites to the skin may also be slow to heal.
- Problematic skin, such as the development of acne
- Hypertension (high blood pressure)
- Oedema (swelling in the legs due to fluid build-up in the lower legs and feet)
- Osteoporosis (brittle or weakened bones and bone loss causing difficulties with lifting or bending, often resulting in fractures)
- Muscle weakness
- Cognitive dysfunction or difficulty (memory)
- Glucose intolerance
- High blood sugar levels
- Increased thirst and urination frequency
- Kidney stones
- Mood swings (irritability, anxiety or others similar to depression)
- Lack of libido (sex drive)
- Amenorrhoea (women’s menstrual periods may become irregular, infrequent or cease altogether)
- Women may experience abnormal facial and body hair (hirsutism)
- Men may experience erectile dysfunction or decreased fertility
- Children may experience a slower growth rate
- Sleeping problems
When to call the doctor
Many symptoms of Cushing’s Syndrome are non-specific, also occurring as signs of other medical conditions such as polycystic ovarian syndrome (PCOS), congenital adrenal hyperplasia, obesity, metabolic syndrome or ovarian tumours.
The collection of signs and symptoms that are most indicative of this condition include skin thinning and bruising, muscle weakness and a flushed or ruddy complexion. Obesity, although one of the main symptoms, is very rarely, on its own, a sign of Cushing’s syndrome. Most instances of obesity are as a result of poor behaviours relating to diet and exercise, and very rarely due to an underlying medical condition.
A person may also have excess cortisol in the body (autonomous cortisol secretion), but does not exhibit any clear symptoms indicative with Cushing’s syndrome. In this case a doctor may diagnose a person as having subclinical Cushing’s syndrome (SCS). This must be diagnosed by a medical doctor as symptoms can be masked by others of a similar nature, such as diabetes, hypertension and metabolic syndrome.
Any collection of signs and symptoms should be evaluated by a medical doctor as soon as possible. Left untreated, signs of Cushing’s syndrome can lead to further complications and worsening of symptoms – increased fatigue, weakening of muscles, bones and the spine, as well as a suppressed immune system, to name a few.
If symptoms develop after taking corticosteroid medications for the treatment of other conditions such as inflammatory bowel disease (IBS), asthma or arthritis, it is best to consult a doctor as soon as possible as well.