What Is Cushing’s Syndrome?

Signs and Symptoms of Cushing’s Syndrome
The signs and symptoms of Cushing’s syndrome can vary from person to person. Even with the most common symptoms of the condition, “not all patients have all of them,” says Maria Fleseriu, MD, professor of medicine and neurological surgery and director of the Pituitary Center at Oregon Health and Science University in Portland, Oregon.
- Unintended weight gain
- Round face
- Increased fat on the base of the neck
- Buffalo hump between the shoulders
- Thin arms and legs
- Muscle weakness
- Easy bruising
- Purple stretch marks on the abdomen, breasts, or hips
- Acne
According to Dr. Fleseriu, other less common symptoms are also possible:
- Sleep disruption
- Extreme fatigue
- Trouble regulating emotions
- Depression or anxiety
- Difficulty thinking
- High blood pressure
- Headaches
- Bone loss

What Causes Cushing’s Syndrome?
Generally, there are two categories of what causes Cushing’s syndrome: exogenous (outside your body) and endogenous (inside your body).
On the other hand, endogenous Cushing’s syndrome may occur when something causes your body to make too much cortisol on its own. Normally, your pituitary gland at the base of your brain releases a hormone called adrenocorticotropic hormone (ACTH). That prompts your adrenal glands, located on top of your kidneys, to produce cortisol.
How Doctors Diagnose Cushing’s Syndrome
Diagnosing Cushing’s syndrome can be a challenging process. “First, we need to exclude that the patient is taking any steroids,” says Fleseriu. If your healthcare provider rules out medications that may be raising the risk of Cushing’s syndrome, they will order additional tests. “Testing includes screening, then confirmatory testing as needed,” followed by imaging scans or other tests to locate any tumor, Flesriu added.
- 24-hour urine sample to measure your cortisol level
- Saliva sample to check your cortisol level at night
- Dexamethasone suppression test to determine your cortisol level after taking a low-dose steroid
- Abdominal or chest scan to look for ectopic or adrenal tumors
- MRI scan to find any tumors on your pituitary gland
- ACTH and dehydroepiandrosterone sulfate blood tests to analyze pituitary and adrenal gland functioning
Treatment for Cushing’s Syndrome
Generally, you won’t need any other treatments to resolve Cushing’s syndrome in this situation, but it may take you several months to recover, Fleseriu notes. But if you have endogenous Cushing’s syndrome caused by a tumor, surgery to remove the tumor may be recommended in most cases. “Complete resection [removal] of the tumor is the desired goal, but not always possible,” says Fleseriu, especially when it comes to pituitary tumors. “Treatment should be highly individualized.”
- ketoconazole (Nizoral)
- levoketoconazole (Recorlev)
- metyrapone (Metopirone)
- mifepristone (Korlym)
- osilodrostat (Isturisa)
- pasireotide (Signifor)
Lifestyle Habits to Manage Cushing’s Syndrome
Making lifestyle changes isn’t an alternative to effective medical or surgical treatment for Cushing’s syndrome. But once you receive proper treatment, “a healthy diet and exercise would be beneficial,” says Fleseriu, since these can improve your overall health and rebuild muscle that may have been lost due to the condition. Swimming, she says, may be a particularly beneficial low-impact exercise.
Fleseriu says that it’s also important to make sure you get screening and care for any mental health concerns, like depression or anxiety, as these are common with Cushing’s syndrome. She adds that you and your healthcare provider should watch for health conditions that can coexist with Cushing’s syndrome, such as high blood pressure and osteoporosis. Even after treatment is complete, it’s essential to continue advocating for your own care.
Questions to Ask Your Healthcare Provider
If you’re concerned about your symptoms, suspect you have Cushing’s syndrome, or already have a diagnosis and need more information, getting answers from your healthcare team can help you stay calm and educated. Consider the following questions to ask your provider at your next appointment:
- Could one of my medications be causing Cushing’s syndrome?
- What tests do I need to find the cause of my symptoms?
- What treatment do you recommend for me?
- Do I need to see a specialist?
- Is there anything else I can do to improve my symptoms?
- What are the chances Cushing’s disease will come back after treatment?
- How soon can I expect to feel better?
- Will the condition or the treatment cause long-term effects?
- Am I at risk of other illnesses?
- How often do I need to follow up with you?
Resources We Trust
- National Institute of Diabetes and Digestive and Kidney Diseases: Cushing’s Syndrome
- Endocrine Society: Cushing’s Syndrome and Cushing Disease
- Mayo Clinic: Cushing Syndrome
- Cleveland Clinic: Cushing Syndrome
- Cushing's Support and Research Foundation: Homepage
FAQ
- Cushing's Syndrome. National Institute of Diabetes and Digestive and Kidney Diseases. May 2018.
- Cushing Syndrome: Diagnosis & Treatment. Mayo Clinic. June 7, 2023.
- Cushing Syndrome: Symptoms & Treatment. Mayo Clinic. June 7, 2023.
- Świątkowska-Stodulska R et al. Cyclic Cushing’s Syndrome – A Diagnostic Challenge. Frontiers in Endocrinology. April 22, 2021.
- Corticosteroids (Glucocorticoids). Cleveland Clinic. October 21, 2024.
- Cushing Syndrome. Cleveland Clinic. January 28, 2026.

Elise M. Brett, MD
Medical Reviewer
Quinn Phillips
Author
A freelance health writer and editor based in Wisconsin, Quinn Phillips has a degree in government from Harvard University. He writes on a variety of topics, but is especially inte...