cushings

Cushing syndrome is a hormonal disorder. It happens when your body has too much of a hormone called cortisol over a long period of time. Hormones are chemical messengers in your bloodstream that control the actions of certain cells or organs. Cortisol is made by your adrenal glands, two small glands that sit above your kidneys.

Cortisol helps your body:

• Respond to stress (cortisol is sometimes called the "stress hormone")
• Reduce inflammation (swelling)
• Control blood glucose (also called "blood sugar")
• Control metabolism (how your body uses food for energy)
• Control blood pressure

Cushing syndrome happens when your body has too much cortisol. The most common cause is if you take high doses of glucocorticoids (a type of steroid medicine such as prednisone) for a long time. This is known as exogenous Cushing syndrome. These medicines act like cortisol and are used to treat conditions such as asthma, rheumatoid arthritis, and lupus. They're also used to keep the body from rejecting a transplanted organ.

Less often, Cushing syndrome happens when a tumor causes the body to make too much cortisol. This is known as endogenous Cushing syndrome. This type is rare. It's most common in adults ages 30 to 50, but children can also get it. It affects about three times as many women as men.

• Pituitary tumors. A tumor on the pituitary gland (at the base of the brain) makes too much of a hormone called ACTH. ACTH tells the adrenal glands to make cortisol. This type is called Cushing disease. It's the most common cause when medicine isn't to blame.
• Tumors in other parts of the body (ectopic Cushing syndrome). Some tumors outside the pituitary gland, most often in the lungs, make too much ACTH.
• Adrenal tumors. A tumor on an adrenal gland can make too much cortisol on its own.

The symptoms of Cushing syndrome can vary from person to person, and not everyone has all of them. Some of the common ones include:

• Weight gain, mostly around the belly and upper body
• A rounded face
• Thin arms and legs
• Extra fat at the base of the neck or a fatty hump between the shoulders
• Wide purple stretch marks, mostly on the abdomen (belly), breasts, hips, and under the arms
• Severe fatigue and muscle weakness
• High blood pressure
• High blood glucose
• Easy bruising

Women may grow extra hair on the face, neck, chest, abdomen (belly), or thighs, and their periods may become irregular or stop.

Men may have less interest in sex, erectile dysfunction (ED), or fertility problems.

Children often gain weight and grow more slowly than other children.

Cushing syndrome can be hard to diagnose because many of the symptoms are like other conditions. To find out if you have Cushing syndrome, your health care provider will:

• Ask about your health history. This includes asking whether you take any glucocorticoids (pills, shots, inhalers, or creams).
• Do a physical exam.
• Order tests to check the cortisol levels in your urine, saliva or blood. You will usually have at least two of these tests:
  • A 24-hour urine test, which requires you to collect your urine (pee) for 24 hours
  • A late-night saliva test, which checks when cortisol levels are usually at their lowest
  • A dexamethasone suppression test, which is a blood test that checks whether cortisol levels drop after taking a medicine that normally lowers cortisol

If the tests show you have Cushing syndrome, you may need more tests to find the cause. These tests may include an ACTH blood test and imaging tests, such as an MRI or CT scan to check for a tumor.

The treatment for Cushing syndrome depends on the cause. The goal is to return your cortisol levels to normal.

• If glucocorticoid medicine is the cause, your provider may slowly lower your dose or switch you to a different medicine. But don't stop taking any medicines or change the dose unless your provider tells you to.
• If a tumor is the cause, you will probably have surgery to remove it. Other options may include radiation, chemotherapy, or medicines that lower cortisol. In some cases, you may need surgery to remove your adrenal glands.

After surgery, you may need to take cortisol medicine for a while until your body makes enough on its own. If both adrenal glands are removed, you'll need to take hormone medicines for life.

Most people with Cushing syndrome get better with treatment, but recovery can take time.

Without treatment, Cushing syndrome can lead to serious health problems, such as heart attack, stroke, blood clots, weak bones that break easily, and type 2 diabetes.

Healthy habits can help you manage the effects of too much cortisol while you're being treated. Your provider may recommend eating enough protein and calcium to protect your muscles and bones and limit salt if you have high blood pressure. Ask your provider which changes are right for you.

NIH: National Institute of Diabetes and Digestive and Kidney Diseases

Your adrenal glands are two small organs that sit on top of each kidney. The adrenal glands make different types of hormones you need to stay alive and healthy. Hormones are chemicals that travel in your bloodstream and control how different parts of your body work.

The adrenal glands make the hormones cortisol, aldosterone, adrenaline, and noradrenaline. They also make hormones that your body uses to make sex hormones (estrogen and testosterone). All of these hormones do many important jobs, including:

• Turning food into energy and managing blood sugar levels
• Balancing salt and water
• Keeping blood pressure normal
• Responding to illness and stress (your "fight or flight" response)
• Timing when and how fast a child develops sexually
• Supporting pregnancy

When you have an adrenal gland disorder, your body makes too much or too little of one or more hormones. The symptoms depend on the type of problem you have and how much it affects the hormone levels in your body.

There are many types of adrenal gland disorders, including:

• Addison Disease - a condition in which the adrenal glands don't make enough cortisol
• Cushing Syndrome - a condition caused by too much cortisol in the body, often from taking steroid medicines for a long time
• Aldosterone-producing adenoma - a benign tumor (not cancer) that makes too much aldosterone and may cause serious high blood pressure
• Hereditary paraganglioma-pheochromocytoma - an inherited condition causing different types of tumors that make adrenaline and other hormones. Some tumors may become cancerous.
• Adrenal gland cancer - cancerous tumors, including adrenocortical carcinoma and neuroblastoma
• Congenital Adrenal Hyperplasia (CAH) - a group of inherited disorders in which the adrenal glands don't make enough cortisol. The most common type is 21-hydroxylase deficiency (also called CAH1). In the United States, newborn babies get a blood test to see if they have CAH. People born with CAH may not have symptoms until childhood or later in life.

The cause of adrenal gland disorders depends on the type of disorder you have. Causes can include:

• Medicines such as steroids.
• A problem in another gland, such as the pituitary gland. The pituitary gland releases hormones that affect how the adrenal glands work.
• Changes in genes (mutations). These changes can cause the adrenal glands to make too much or too little of one or more hormones.
• Infections.

In many cases the cause of the problem isn't clear.

Health care providers use different tests to check for adrenal disorders depending on your symptoms and health history. For example, you may have tests of your blood, urine (pee), or saliva (spit). These tests check your hormone levels. Your provider may order x-rays, CT scans, or MRI scans to look for tumors.

Different types of adrenal gland disorders have different treatments. They include medicines and surgery. Radiation therapy is sometimes a treatment for tumors. There are treatments to cure certain adrenal gland disorders. For other disorders, treatments can manage your symptoms.

NIH: National Institute of Child Health and Human Development

Pets can add fun, companionship and a feeling of safety to your life. Before getting a pet, think carefully about which animal is best for your family. What is each family member looking for in a pet? Who will take care of it? Does anyone have pet allergies? What type of animal suits your lifestyle and budget?

Once you own a pet, keep it healthy. Know the signs of medical problems. Take your pet to the veterinarian if you notice:

• Loss of appetite
• Drinking a lot of water
• Gaining or losing a lot of weight quickly
• Strange behavior
• Being sluggish and tired
• Trouble getting up or down
• Strange lumps

Your pituitary gland is a pea-sized gland at the base of your brain. The pituitary is the "master control gland" - it makes hormones that affect growth and the functions of other glands in the body.

Pituitary tumors are common, but often they don't cause health problems. Most people with pituitary tumors never even know they have them. The most common type of pituitary tumor produces hormones and disrupts the balance of hormones in your body. This can cause endocrine diseases such as Cushing syndrome and hyperthyroidism.

Symptoms of pituitary tumors include:

• Headaches
• Vision problems
• Nausea and vomiting
• Problems caused by the production of too many hormones

Pituitary tumors are usually curable. Treatment is often surgery to remove the tumor. Other options include medicines, radiation therapy, and chemotherapy.

If you are struggling with your weight, you are not alone. In the United States, more than 70 percent of adults are overweight or have obesity. Having this extra weight raises your risk for many health conditions, such as type 2 diabetes, heart disease, kidney disease, and certain cancers.

Reaching and staying at a healthy weight can be challenging. But having a healthy lifestyle, including healthy eating patterns and regular physical activity, can help you lose weight. It can also lower your chance of developing weight-related health conditions.

You gain weight when you take in more calories (through food and drinks) than you use up from physical activity and daily living. But there are many different factors that can affect weight gain, such as:

• The world around you. Your home, community, and workplace all may affect how you make daily lifestyle choices. For example:
  • It is often easier to find food and beverages high in calories, sugar, and fat. For instance, vending machines, cafeterias, and special events may not offer healthy, lower calorie options.
  • Less healthy foods may be cheaper than healthier foods.
  • Many people are getting less physical activity because they are spending more time using smartphones and other devices.
• Families. Overweight and obesity tend to run in families. This suggests that genes may play a role in weight gain. Families may also share eating and lifestyle habits. For example, some families may often have foods and drinks that are high in calories, sugar, and fat. And some families may tend to be less active and spend more time doing things like sitting and watching TV or using computers.
• Not enough sleep. People who don't get enough sleep may eat more calories and snack more.
• Emotions. Some people eat when they feel bored, sad, or stressed, even if they are not hungry.
• Medicines and health conditions. Taking certain medicines, such as steroids and certain antidepressants, can lead to weight gain. Some chronic health problems can also cause you to gain weight. A few examples are Cushing syndrome and polycystic ovary syndrome (PCOS).

Getting to and staying at a healthy weight involves finding a balance of food and activity. To lose weight, you need to take in fewer calories than you use up. Some ways to do this are:

• Eating more nutrient-rich foods, such as foods with lots of vitamins, minerals, and fiber.
• Eating and drinking less of the foods and beverages that have lots of calories, salt, sugar, and fat.
• Limiting alcohol.
• Finding healthier ways to cook, such as using healthier oils to cook with and baking or grilling instead of frying foods.
• Getting more physical activity. The general recommendation is for adults to get 150 minutes of physical activity each week. This time can be broken down into short bursts of activity throughout your day. Types of physical activity include:
  • Aerobic activity, which is also called cardio. It uses your large muscle groups (chest, legs, and back) to speed up your heart rate and breathing.
  • Muscle-strengthening activity, which is also called strength training. It works your muscles by making you push or pull against something.

You may decide to do these lifestyle changes on your own, or you may decide to try a weight-loss diet or program. Before you start, it's important to check with your health care provider first. Your provider can tell you what a healthy weight is for you, help you set goals, and give you tips on how to lose weight.

If making lifestyle changes or doing a weight-loss program are not enough to help you lose weight, your provider may prescribe medicines. These medicines are meant to help people who have weight-related health conditions and should be used along with healthy eating and physical activity. The prescription medicines to treat overweight and obesity work in different ways. Some may help you feel less hungry or full sooner. Others may make it harder for your body to absorb fat from the foods you eat.

Another treatment is weight loss surgery. Your provider may recommend the surgery if you have severe obesity or serious obesity-related health problems and you have not been able to lose enough weight.

Maintaining weight loss can be challenging, and it's normal to slip back into old habits sometimes. The key is to keep a healthy balance of food and activity that works for you. Checking your weight regularly can help you notice small changes early and stay on track. And if you have a setback, don't be discouraged, simply refocus on your healthy habits and keep going.

NIH: National Institute of Diabetes and Digestive and Kidney Diseases

You may have heard of anabolic steroids, which can have harmful effects. But there's another type of steroid - sometimes called a corticosteroid - that treats a variety of problems. These steroids are similar to hormones that your adrenal glands make to fight stress associated with illnesses and injuries. They reduce inflammation and affect the immune system.

You may need to take corticosteroids to treat:

• Arthritis
• Asthma
• Autoimmune diseases such as lupus and multiple sclerosis
• Skin conditions such as eczema and rashes
• Some kinds of cancer

Steroids are strong medicines, and they can have side effects, including weakened bones and cataracts. Because of this, you usually take them for as short a time as possible.