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What is the impact of Cushing’s syndrome on obesity? – Part 2

What is Cushing Syndrome?

• Cushing’s syndrome describes the signs and symptoms associated with prolonged exposure to inappropriately high levels of the hormone cortisol.
• This can be caused by taking glucocorticoid drugs, or diseases that result in excess cortisol, adrenocorticotropic hormone (ACTH), or CRH levels.
• Cushing’s disease refers to a pituitary-dependent cause of Cushing’s syndrome: a tumor (adenoma) in the pituitary gland produces large amounts of ACTH, causing the adrenal glands to produce elevated levels of cortisol.
• It is the most common non-iatrogenic cause of Cushing’s syndrome, responsible for 70% of cases excluding glucocorticoid related cases.
• This pathology was described by Harvey Cushing in 1932.
• The syndrome is also called Itsenko-Cushing syndrome, hyperadrenocorticism or hypercorticism.
• Cushing’s syndrome is not confined to humans and is also a relatively common condition in domestic dogs and horses.
• It also occurs in cats, but rarely.
• It should not be confused with Cushing’s triad, a disease state resulting from increased intracranial pressure.
• Cushing’s syndrome is an endocrine, or hormone condition.
• It occurs when the body is exposed to high levels of the hormone cortisol for long periods of time.

How Cushing Syndrome Works?

• In patients with Cushing’s syndrome, the adrenal cortex, which secretes corticosterone and sex hormones, produces too much cortisol.
• Cortisol is crucial to protein and carbohydrate metabolism.
• When the adrenal cortex produces too much cortisol, this overproduction may result in adrenal tumors.
• This is also an excess production of Adrenocorticotropic hormone (ACTH).
• ACTH is the major pituitary hormone regulating adrenal function.

Cushing Syndrome and Weight Gain
• Symptoms of Cushing’s syndrome, such as sudden weight gain, are caused by excess cortisol.
• The excess cortisol in the body does not increase protein and carbohydrate metabolism.
• It slows or nearly disables metabolism function.
• This can cause weight gain (fat accumulation) in the buttocks, abdomen, cheeks, neck, or upper back.
• This rare disease also causes loss of muscle mass.
• This means some areas of the body, such as the arms and legs, will remain thin.

Controlling Weight Gain Resulting from Cushing’s Syndrome

• Weight gain resulting from Cushing’s syndrome cannot be controlled with diet and exercise.
• The only way to manage excess weight associated with the disease is to see your doctor for an official diagnosis.
• Your doctor will collect a saliva or urine sample.
• Based on the levels of cortisol found in the sample, the physician can determine whether you have the condition and the exact cause of it.
• After diagnosis, your doctor will create a treatment program.
• This program is based on the cause of excess cortisol production (i.e., pituitary tumors, ACTH, etc.).

Depending on the cause, treatment may include oral medications such as :
– Decadron (dexamethasone), a synthetic andrenocortical steroid
– Radiation therapy
– Chemotherapy
– Surgical removal of pituitary tumors
• Although uncommon, some conditions may be so severe that the adrenal glands must be either partially or completely removed.
• Once the adrenal glands have been removed, the patient must be treated with cortisol, daily.
• Even after the disease has been cured, a host of other problems may occur.
• This is as a direct result of the changes that occurred in the body during the development of the disease.

What can Cushing Syndrome cause?

• Osteoporosis
• Diabetes
• Kidney, heart, and blood vessel conditions

When to See Your Doctor?

• Unevenly distributed, sudden weight gain is not the only symptom of Cushing’s syndrome.
• If sudden weight gain is accompanied by any of the symptoms listed below, or if it is your only symptom, please see your doctor immediately.
– Acne
– Easy bruising
– Facial plethora (flushed face)
– Glucose intolerance or diabetes mellitus
– Hirsutism (excess hair in odd places such as the face for women)
– Hyperlipidemia (elevated lipids (cholesterol) in the blood stream)
– Hypertension
– Menstrual disorders
– Osteoporosis
– Proximal muscle weakness
– Recurrent opportunistic or bacterial infections

Cushing’s Syndrome Cushing’s Syndrome: Pathophysiology, Diagnosis and Treatment The Cushing’s Syndrome Diet

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