When your body produces too much cortisol, it may lead to Cushing’s syndrome. Cortisol is a hormone that the body can produce naturally or cortisol can be taken into the body through medicines. These medicines are called corticosteroids and are used to control asthma, arthritis, inflammatory bowel disease or lupus.
It is very important that medical help is obtained as soon as possible due to the type of complications that can develop. They are as follows:
high blood pressure
loss of muscle mass and strength
In extreme cases, if treatment is not obtained as needed, death can result. So what are some symptoms? The patient may look for symptoms like:
fatty lump between the shoulder blades
roundness of face (moon face)
pink or purple stretch marks on the skin of abdomen, thighs, breasts, and arms
thin and fragile skin that bruises easily
slow healing of cuts, insect bites and infections
depression, anxiety and irritability
loss of emotional control
thicker or more visible body/facial hair
irregular or absent menstrual periods
new or worsened high blood pressure
bone loss, leading to fracture over time
Plan and Treatment
When you start experiencing the above symptoms, it is best for you to schedule an appointment with your doctor as soon as possible. You no doubt will be referred to an endocrinologist. Sometimes, Cushing’s syndrome is hard to diagnose because some of the symptoms mimic other conditions. Don’t be discouraged. Remember to be proactive and alert. Ask questions until you are satisfied with the answers provided. If you feel you can’t remember all the questions you want to ask, then write them down. If you feel too fatigued and overwhelmed to go by yourself to the doctor, enlist the help of a friend or family member.
No doubt, the endocrinologist will start with urine and blood tests. These will show whether or not you have an extreme amount of cortisol. A saliva test can indicate whether or not cortisol is high as well. This test is done at night when cortisol normally drops, but with patients who have Cushing’s syndrome; their cortisol level is still high at this time. And finally, there are the imaging tests, such as CT scans or MRI scans. They show if the pituitary or adrenal gland have any abnormalities like tumors.
If your prognosis is Cushing’s syndrome, there are several options based on the cause of the syndrome. If the syndrome is caused by long-term use of corticosteroid medicines, your doctor will “wean” the dosage down to a safer level until symptoms disappear. In some cases, the physician may switch meds altogether and prescribe a noncorticosteroid med. There is the possibility of surgery for those who have tumors. After this procedure, the patient will still need to take cortisol meds for a while. The doctor will taper them down until they are no longer needed. There are always exceptions to the rule and the exception in this case is that there are some, who after having surgery, will never recover normal adrenal function. They will have to take replacement therapy on an ongoing basis. Lastly, there is radiation therapy and medications. These two are sometimes used in conjunction with surgery to control cortisol overproduction.
The point is to talk openly and honestly with your physician and find out what will work best for you. As stated before, don’t be afraid to ask questions. Information makes you a better patient and a better advocate.
Resources: Mayo Clinic
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