Cushing’s disease is caused when the pituitary gland, located at the base of the brain behind the nasal passages, produces too much of adrenocorticotropic (ACTH) hormone, usually due to the growth of a pituitary tumor. Too much ACTH causes the adrenal glands, located above the kidneys, to produce excess cortisol.
A stress hormone, cortisol is responsible for maintaining fluid balance in the body. Because of its release during flight-or-fight or other stress-inducing situations, cortisol also signals the liver to increase blood sugar and controls how the body uses proteins, fats, and carbohydrates. When cortisol levels remain elevated, they cause significant changes in every organ and tissue of the body.
Benign tumors in the pituitary gland are the most common cause of Cushing’s disease. Treatment usually includes surgical removal of the tumor, though there are times when excision of the gland itself is necessary. When this happens, patients must replace sex, thyroid, and cortisol hormones through hormone replacement therapies. Fertility therapy is also usually required for patients who want to have children.
Some symptoms of Cushing’s disease include a round, or “moon,” face, and upper-body obesity while maintaining thin arms and leg. Thin skin with acne or infections and the development of wide pink or purple marks on the thighs, breasts, and abdomen that resemble stretch marks are common. An individual might also develop a hump on the back between his or her shoulders and have thin bones and weak muscles. Women may experience irregular periods and start to develop excess hair on their face, neck, chest, and thighs. Men may lose their desire for sex and experience decreased fertility and impotence.
About the Author: Dr. Ilyas Munshi is a neurosurgeon who specializes in the diagnosis and treatment of a wide range of neurological disorders affecting the brain and spine. Dr. Munshi practices out of his clinic in Lafayette, Louisiana, and has surgical privileges at Our Lady of Lourdes Regional Medical Center and Lafayette General Medical Center.