Cushing Syndrome: Causes, Symptoms, and Treatment
Medically reviewed by Achuta Uppu, MD, Internal Medicine. Last reviewed: October 23, 2026.
What kind of doctor treats Cushing Syndrome?
An endocrinologist, a doctor who treats hormone problems, usually helps diagnose Cushing syndrome. If a growth is the cause, a surgeon who removes pituitary or adrenal growths may take part in care. A direct primary care or concierge doctor can be a first stop for an evaluation and can refer you to a specialist when needed.
What is Cushing syndrome?
Cushing syndrome happens when the body has too much cortisol for a long time. Cortisol is a hormone made by the adrenal glands, two small glands on top of the kidneys. Too much cortisol can affect the skin, bones, heart, and mood.
Cushing disease is one type of Cushing syndrome. It is caused by a small growth on the pituitary gland, a pea-sized gland at the base of the brain. The growth makes too much ACTH, a hormone that tells the adrenal glands to make cortisol.
Symptoms
Common signs include:
- A round, red, full face, often called moon face.
- Weight gain around the middle, with thin arms and legs.
- A fatty hump between the shoulders.
- Wide purple stretch marks on the belly, thighs, or breasts.
- Thin skin that bruises easily.
- Weak muscles, especially in the hips and shoulders.
Other changes include high blood pressure, high blood sugar (type 2 diabetes), and thin bones (osteoporosis) that break easily. Mood changes like depression or anxiety can happen, along with trouble thinking clearly. Women may have irregular periods and extra facial hair.
Causes and who gets it
The most common cause is taking too much of a steroid medicine, such as prednisone, for a long time. These medicines treat conditions like asthma, rheumatoid arthritis, and lupus. This type is called exogenous Cushing syndrome.
Sometimes the body makes too much cortisol on its own. Doctors call this endogenous Cushing syndrome, and it is rare. About 8 out of 10 of these cases come from a small growth on the pituitary gland. A growth on an adrenal gland can also make cortisol directly. Sometimes a growth elsewhere in the body, usually in the lungs, makes ACTH.
How doctors diagnose it
Diagnosis can be hard. Symptoms can have many causes, and doctors first rule out look-alike conditions like polycystic ovary syndrome and metabolic syndrome. No single test is perfect, so doctors usually do two of these tests to measure cortisol:
- A 24-hour urine test measures cortisol in a full day of urine.
- A late-night saliva test checks cortisol in the evening. Normally it drops after sleep. In Cushing syndrome it stays high.
- A dexamethasone suppression test. You take a lab-made steroid the night before, then blood cortisol is checked. Normally cortisol drops. If it does not drop, Cushing syndrome is likely.
After that, an ACTH blood test helps find the cause. Low ACTH points to an adrenal growth. Normal or high ACTH points to a pituitary growth or a growth elsewhere. MRI and CT scans then look for the growth.
Treatment
Treatment depends on the cause. If a steroid medicine is the cause, the doctor lowers the dose slowly. Stopping the medicine suddenly can be dangerous, so never stop it on your own.
For growths, surgery to remove them is usually the first choice. After surgery, the body may not make enough cortisol for a while, so the doctor prescribes cortisol medicine until it recovers. Never skip or stop that medicine on your own. If tumor cells remain after surgery, radiation may be used. Medicines that block cortisol production can help when surgery is not an option or did not fully work. Rarely, both adrenal glands are removed to control the condition.
When to see a doctor
Call 911 or go to the emergency room if you have chest pain or discomfort lasting two minutes or more, trouble breathing, fainting, confusion, or sudden weakness or trouble speaking. If you are thinking about hurting yourself, call or text 988 or call 911. See a doctor if you notice a round face, wide purple stretch marks, easy bruising, or weak muscles. Also check in if high blood pressure and high blood sugar show up together. Cushing syndrome can usually be cured, but it can be fatal if it is not treated.
How a direct primary care or concierge doctor fits in
A direct primary care doctor charges a flat monthly fee instead of billing insurance, while a concierge doctor usually charges more and often works alongside insurance. Such a doctor can review your medicines, order screening tests, track blood pressure and blood sugar, and coordinate care with an endocrinologist.
Common questions
Is Cushing syndrome the same as Cushing disease?
No. Cushing syndrome means the body has too much cortisol from any cause. Cushing disease is one type of it. It is caused by a small growth on the pituitary gland that drives the adrenal glands to make too much cortisol.
Can Cushing syndrome come from medicine?
Yes. Taking steroid medicine at high doses for a long time is the most common cause. This type goes away after the medicine is slowly lowered and stopped under a doctor's care.
How do doctors test for Cushing syndrome?
Doctors measure cortisol in urine, saliva, or blood. Because cortisol levels can rise and fall over time, they usually confirm it with two tests. They may also check ACTH and use scans to find the cause.
Is Cushing syndrome curable?
It can usually be cured, but it can be fatal if it is not treated. Removing the tumor may lead to full recovery, but there is a chance that the condition will return.
Sources
- MedlinePlus - Cushing syndrome
- National Institute of Diabetes and Digestive and Kidney Diseases - Cushing's Syndrome
- Endocrine Society - Cushing's Syndrome and Cushing Disease
Medical Disclaimer
This content is for general educational and informational purposes only and is not medical advice. It is not a substitute for professional medical advice, diagnosis, or treatment, and reading it does not create a doctor-patient relationship. Always seek the advice of your physician or another qualified health provider with any questions about a medical condition, and never disregard or delay seeking professional advice because of something you read here. If you think you may have a medical emergency, call 911 (or your local emergency number) immediately.
