Cushing’s Syndrome
Cushing’s syndrome refers to the clinical manifestations induced by, chronic exposure to excess corticosteroid.
OVER VIEW
Basically, Pituitary corticotrope adenomas account for 70% of patients with endogenous causes of Cushing’s syndrome.
However, it should be emphasized that iatrogenic hypercortisolism is the most common cause of cushingoid features.
CAUSES
1.Firstly, ACTH excess i.e.: –
- Cushing’s disease Ectopic ACTH secretion
- Carcinoma of lung (especially small cell)
- Carcinoid tumors of either thymus or lung
- Medullary carcinoma of thyroid
- Carcinoma of colon
- Pheochromocytoma
2.Secondly, Non-ACT dependent i.e.: –
- Primary unilateral adrenocortical tumors (either adenoma or carcinoma)
- McCune-Albright syndrome: Bilateral tumor (e.g. Gsα mutation)
- Primary pigmented nodular dysplasia
3. Thirdly, ACTH – independent i.e.: –
- Macronodular adrenal hyperplasia Spontaneous Cushing’s syndrome
TYPES
There are two types of Cushing’s syndrome.
Exogenous Cushing’s syndrome
Exogenous Cushing’s syndrome is when the cause comes from something outside the body’s function.
It often results from long-term, high-dose usage of corticosteroid drugs, also known as glucocorticoids. These are similar to cortisol.
Examples include:
- prednisone
- dexamethasone
- methylprednisolone
People with rheumatoid arthritis, lupus, asthma, and recipients of an organ transplant may need high doses of these drugs.
Injectable corticosteroids, a treatment for joint pain, back pain and bursitis, can also lead to Cushing’s syndrome.
Steroid medications that do not appear to increase the risk of Cushing’s syndrome are:
- steroid creams, a treatment option for eczema
- inhaled steroids, a treatment for asthma
The National Institute of Diabetes and Digestive and Kidney Diseases Trusted Source (NIDDK) note that over 10 million people in the United States use glucocorticoid medications each year, but it remains unclear how many develop the symptoms of Cushing’s syndrome.
Endogenous Cushing’s syndrome
Endogenous Cushing’s syndrome is when the cause comes from inside the body, for example, when the adrenal glands produce too much cortisol.
Cushing’s disease is an example of this.
Similar symptoms can also result from adrenal gland tumors or from a benign or malignant tumor in the pancreas, thyroid, thymus gland, or lung.
| Body compartment/system | Signs and symptoms |
| Body fat – | Weight gain, central obesity, rounded face, fat pad on back of neck (in other words, “buffalo hump”) |
| Skin – | Facial plethora, thin also brittle skin, easy bruising, broad also purple stretch marks, acne, hirsutism |
| Bone – | Osteopenia, osteoporosis (especially, vertebral fractures), decreased linear growth in children |
| Muscle – | Weakness, proximal myopathy(prominent atrophy of gluteal also upper leg muscles) either with difficulty climbing stairs or getting up from a chair |
| Cardiovascular system – | Hypertension, hypokalemia, edema, additionally atherosclerosis |
| Metabolism – | Glucose intolerance/diabetes, dyslipidemia |
| Reproductive system – | Decreased libido, in women amenorrhea (due to cortisol-mediated inhibition of gonadotropin release) |
| Central nervous system – | Irritability, emotional lability, depression, sometimes cognitive defects; occasionally, in severe cases, paranoid psychosis |
| Blood and immune system – | Increased susceptibility to infections, increased white blood cell count, eosinopenia, hypercoagulation with increased risk of deep vein thrombosis also pulmonary embolism. |
WHAT TO EAT
For Cushing syndrome, managing diet is important to minimize symptoms. Here’s what to focus on:
- Reduce Salt: Avoid high-sodium foods to help control high blood pressure and fluid retention (e.g., processed foods, canned soups).
- Increase Potassium: Foods like bananas, oranges, spinach, and sweet potatoes can help balance sodium levels.
- Limit Sugary Foods: Reduce sugar and refined carbs (e.g., sugary drinks, white bread) to manage blood sugar levels.
- Protein-Rich Foods: Lean meats, beans, and tofu support muscle health and prevent muscle wasting.
- Calcium and Vitamin D: Dairy products, fortified foods, and leafy greens help protect bones from thinning.
- Healthy Fats: Opt for omega-3-rich foods like fish, nuts, and seeds to reduce inflammation.
Consult with a healthcare provider for tailored dietary advice.
DIET AND REGIMEN
- Reducing sodium intake
- Increasing calcium and vitamin D intake
- Reducing cholesterol
- Controlling blood sugar
- Reducing or eliminating alcohol and tobacco
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FAQ
What is Cushing’s Syndrome
Cushing’s syndrome refers to the clinical manifestations induced by, chronic exposure to excess corticosteroid.
Homeopathic Medicines used by Homeopathic Doctors in treatment of Cushing’s Syndrome
- Calcarea carbonica
- Fucous vesiculosus
- Graphites
- Mercurious
- Phosphorus
- Thyroidinum
- Silicea
- Capsicum
What are the symptoms of Cushing’s Syndrome
- Weight gain
- Central obesity
- Rounded face, fat pad on back of neck (in other words, “buffalo hump”)
- Facial plethora
- Thin also brittle skin
- Osteopenia, Osteoporosis
- Weakness
- Proximal myopathy
- Hypertension
- Hypokalemia
- Edema
- Atherosclerosis
- Irritability, Motional lability, also Depression
What are the causes of Cushing’s Syndrome
- Ectopic ACTH secretion
- Carcinoma of lung
- Carcinoid tumors of either thymus or lung
- Medullary carcinoma of thyroid
- Carcinoma of colon
- Pheochromocytoma
- adenoma
- McCune-Albright syndrome
- Primary pigmented nodular dysplasia
- Macronodular adrenal hyperplasia
REFFERENCE
[1] Medicine Golwala
[2] ABC Manual Of Materia Medica And Therapeutics (Therap Part) By Clarke G. H.
[4]What risk factors are associated with Cushing’s syndrome? (mymed.com)
[5]Cushing’s syndrome pathophysiology – wikidoc
[6]Cushing’s syndrome: Causes, symptoms, types, and diagnosis (medicalnewstoday.com)
[7]Cushing’s syndrome diagnosis – investigation (endobible.com)
[8]Prevention of cushing’s disease | Healthy Living articles | Well Being center | SteadyHealth.com
