Cushing’s disease is a condition caused by a pituitary tumor (usually benign) that produces too much ACTH (adrenocorticotropic hormone).
- Excess ACTH overstimulates the adrenal glands.
- This leads to overproduction of cortisol, the body’s main stress hormone.
👉 Important note:
- Cushing’s disease = specifically pituitary-related excess ACTH.
- Cushing’s syndrome = broader term for any cause of excess cortisol (tumor, medication, adrenal problem, etc.).
🔬 How It Develops (Mechanism)
- Pituitary gland develops a tumor (adenoma).
- The tumor secretes high levels of ACTH.
- ACTH signals the adrenal glands to release excessive cortisol.
- High cortisol disrupts normal body systems (metabolism, immunity, growth, mood).
📋 Signs & Symptoms
Excess cortisol causes distinct features:
- Weight gain, especially around the trunk, face (“moon face”), and back of neck (“buffalo hump”).
- Purple stretch marks (striae) on skin.
- Thin skin, easy bruising, slow wound healing.
- Muscle weakness and fatigue.
- High blood pressure and high blood sugar (risk of diabetes).
- Mood changes: depression, anxiety, irritability.
- Bone loss (osteoporosis).
- In women: irregular periods, excess facial/body hair.
🩺 Diagnosis
- Hormone testing: Cortisol levels in blood, urine, or saliva.
- Dexamethasone suppression test: Evaluates cortisol response.
- Imaging (MRI/CT): To identify pituitary tumor.
💊 Treatment
- Surgery: Removal of the pituitary tumor (preferred treatment).
- Radiation therapy: If surgery isn’t fully successful.
- Medications: To lower cortisol (ketoconazole, metyrapone, etc.).
- Adrenal surgery: Rare cases where adrenal glands are removed if other treatments fail.
⚠️ Risks if Untreated
- Heart disease
- Stroke
- Diabetes complications
- Severe infections (since cortisol suppresses immunity)
- Osteoporosis with fractures
👉 In short: Cushing’s disease is a pituitary tumor disorder causing too much ACTH and cortisol, leading to weight gain, skin changes, high blood pressure, and metabolic problems. Treatment focuses on removing the tumor and restoring hormone balance.