What is Hypercortisolism?

Hypercortisolism, also known as Cushing’s syndrome, is a medical condition characterized by prolonged and excessive exposure to high levels of the hormone cortisol in the body. Cortisol is produced by the adrenal glands and plays a crucial role in regulating various bodily functions, including metabolism, immune response, and stress management.

What Causes Hypercortisolism?

  • Endogenous Cushing’s Syndrome: This type of hypercortisolism is caused by factors within the body that lead to overproduction of cortisol. It can result from various conditions:
    • Pituitary Tumors: A tumor in the pituitary gland (Cushing’s disease) can cause excessive adrenocorticotropic hormone (ACTH) production, which stimulates the adrenal glands to produce more cortisol.
    • Adrenal Tumors: Tumors in the adrenal glands can produce excess cortisol.
    • Ectopic ACTH Production: Some non-pituitary tumors, such as those in the lungs or pancreas, can produce ACTH, leading to increased cortisol production.
  • Exogenous Cushing’s Syndrome: This form is caused by the prolonged use of corticosteroid medications, either for medical reasons or due to excessive self-administration. These medications mimic the effects of cortisol.

What are the Symptoms of Hypercortisolism?

  • Weight Gain: Particularly around the abdomen and face, giving a “moon face” appearance.
  • Muscle Weakness: Due to the catabolic effects of excess cortisol on muscle tissue.
  • Skin Changes: Thin and fragile skin that bruises easily and purple stretch marks (striae).
  • Elevated Blood Pressure: High blood pressure is common.
  • Glucose Intolerance: Increased blood sugar levels can lead to diabetes or worsen existing diabetes.
  • Mood Changes: Depression, anxiety, irritability, and cognitive disturbances.
  • Osteoporosis: Bone loss and an increased risk of fractures.
  • Menstrual Irregularities: In women, changes in menstrual cycles or even cessation of menstruation.
  • Virilization: In women, excessive hair growth, acne, and other masculine characteristics.

    What are the Treatment Options for Hypercortisolism?

    • Treatment varies based on the underlying cause:
      • Surgery: Surgical removal of tumors causing excess cortisol production.
      • Medications: In some cases, medications can be used to regulate cortisol production.
      • Gradual Reduction of Corticosteroids: If exogenous corticosteroids are the cause, reducing the dose under medical supervision is key.

    If you suspect you or someone you know has hypercortisolism, it’s important to consult a healthcare provider for proper evaluation and treatment. Early diagnosis and treatment can help manage symptoms and improve quality of life.