A Simple Explanation

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From Autumn, posted with permission:

A "simple" explanation:

CUSHING'S SYNDROME is a hormonal disorder that occurs when a person's level of cortisol is too high (called hypercortisolism) for too long.


It can lead to many different symptoms. Some are textbook, some are individual to our personal experience and environments.

Cushing’s Syndrome can be exogenous (caused by something outside the body like oral steroids) or endogenous (caused by something inside the body like a tumor).


EXOGENOUS - There are a few popular instances of exogenous Cushing’s Syndrome that you may have heard about – Ashley Judd and possibly Elvis. Those cases were all about taking too much steroid for too long.


ENDOGENOUS - Then there are instances like many of us suffer from – endogenous Cushing’s Syndrome that happens because something in our bodies is producing too much cortisol. There are two things that can happen in this instance:

  1. An ACTH-independent adrenal tumor can cause the adrenal glands to secrete excessive amounts of cortisol into your body.
  2. An ACTH-dependent tumor or tumors cause excessive amounts of ACTH to be secreted. You are considered to have Ectopic Cushing’s Syndrome if you have an ACTH-dependent tumor (secreting ACTH) somewhere other than the pituitary – most commonly on the lungs, but not the adrenals…that would be an ACTH-independent tumor and is classified differently as noted above.


NOTE: You are considered to have Cushing’s Disease only if you have an ACTH-dependent tumor located on your pituitary gland. Just as an FYI – these tumors are usually referred to as “adenomas” – meaning that unlike a malignant tumor, (cancerous) they stay in their original location and do not spread through the blood or lymph glands/systems.


Cyclic Cushing’s can happen in both adrenal and pituitary tumors, but is more common in pituitary tumors. The pathology for cyclical Cushing’s is relatively unknown meaning that diagnosis is next to impossible. Frequent urinary cortisol and salivary cortisol levels tests are the best place to start testing, but it is challenging. Even stimulation or suppression tests may give spurious results because there is no pattern that can be defined as to the spontaneous highs and lows in serum cortisol. It largely depends on an individual’s ability to know when they are feeling like they are having a high…and then the can test at that time. It really is hard!


In the simplest terms, Cushing’s Syndrome is the umbrella that encompasses Cushing’s Disease.


Hope that helps!