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What are complications caused by Cushing’s syndrome?
Good to know:
Reducing cortisol to normal levels over the long term may lead to partial or complete recovery from some Cushing’s syndrome complications.1-3
Endogenous Cushing’s syndrome develops when excess cortisol circulates in the body for too long. This excess cortisol is usually produced either by an adrenal tumor or in response to excess adrenocorticotropic hormone (ACTH) produced by a pituitary or other tumor. Click here for more information. The excess circulating cortisol can cause a number of serious complications. Some of these complications can lead to heart problems, which can increase the risk of premature death (see diagram).1
Below, you can read about these and other possible complications of Cushing’s syndrome, along with treatments that doctors may recommend to help get them under control. In all cases, reducing cortisol to normal levels is key in helping to manage the complications.
Complications of Cushing’s syndrome
and ways doctors may manage them
Note: The information in this section is for educational purposes only and is not intended to be medical advice. Please always consult a doctor before starting, adjusting, or stopping any treatment.
| High blood pressure | ||
|---|---|---|
| High blood pressure means that the body’s blood flow is causing too much pressure against artery walls. Up to 80% of people with Cushing’s syndrome have high blood pressure. Though seen more often in adults, high blood pressure is also very common in children with Cushing’s syndrome.1 | Ways to manage: Treatment to normalize cortisol + standard blood pressure medicine |
|
| Diabetes | ||
| Many people with Cushing’s syndrome develop problems with the way their body processes sugars. These are called glucose metabolism disorders, and they include diabetes, a condition caused by too much sugar (glucose) in the blood. Diabetes occurs in 20% to 50% of people with Cushing’s syndrome.1 | Ways to manage: Treatment to normalize cortisol + changes in diet (as directed by a doctor); may also include medicine to reduce blood sugar |
|
| Obesity | ||
| Obesity is the term used for a high body mass index (that is, the amount of fat in the body). In people with Cushing’s syndrome, obesity can develop particularly in the middle part of the body (around the abdominal area), while arms and legs can be thin.1 Obesity occurs in more than 90% of people with Cushing’s syndrome.4 | Ways to manage: Treatment to normalize cortisol + changes in diet and/or appropriate medicines/exercise |
|
| High cholesterol and triglycerides | ||
| In people with Cushing’s syndrome, excess cortisol can cause an increase in cholesterol and triglycerides. As a result, cholesterol and triglycerides build up in arteries, making it more difficult for blood to flow to the heart.1 | Ways to manage: Treatment to normalize cortisol + dietary changes, exercise, and cholesterol-reducing medicine |
|
| Excess clotting of the blood | ||
| Blood clots are soft, thick masses of blood that form to prevent too much bleeding (for instance, at the site of a wound). However, excess cortisol can cause the blood to form unneeded clots. These extra clots can block arteries, affecting blood flow to the heart.1 | Ways to manage: Treatment to normalize cortisol + anticlotting medicine when needed (for instance, right before and after an operation) |
|
| Osteoporosis | ||
| Osteoporosis means that bones become fragile and can fracture easily. Around 50% of people with Cushing’s syndrome are reported to have osteoporosis.1 | Ways to manage: Treatment to normalize cortisol + “antiresorptive” osteoporosis medicine + daily requirements of calcium and vitamin D |
|
| Psychological and mental changes | ||
| From 50% to 80% of people with Cushing’s syndrome are reported to experience major depression. Cushing’s syndrome can also cause other mood disorders such as mania, memory problems, anxiety and, in children, obsessive-compulsive disorder.1 | Ways to manage: Treatment to normalize cortisol + therapy and medicines for specific psychological symptoms (depression or anxiety) |
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Cushing’s syndrome can also cause other complications. For example, Cushing’s syndrome may reduce thyroid function (called hypothyroidism), cause infertility in both men and women, and prevent children from growing normally in height.1
In 80% to 85% of people with endogenous Cushing’s syndrome, the cause is excess ACTH produced by a pituitary or other tumor. Treatment to reduce ACTH levels will, in turn, reduce cortisol to normal levels—which is very important in managing the complications of Cushing’s syndrome.1
Next, read about ways to diagnose Cushing’s syndrome.
References: 1. Arnaldi G, Angeli A, Atkinson AB, et al. Diagnosis and complications of Cushing’s syndrome: a consensus statement. J Clin Endocrinol Metab. 2003;88:5593-5602. 2. Nieman LK. Overview of the treatment of Cushing’s syndrome. Available at: www.uptodate.com/online/content/topic.do?topicKey=adrenal/9833. Accessed October 1, 2009. 3. Sippel RS,Elaraj DM, Kebebew E, Lindsay S,
Tyrrell JB, Duh Q-Y.Waiting for change: symptom resolution after adrenalectomy for Cushing’s syndrome. Surgery. 2008;144:1054-1061. 4. Nieman LK, Ilias I. Evaluation and treatment of Cushing’s syndrome.
Am J Med. 2005;118:1340-1346.
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