Cushing’s Syndrome: When Excess Cortisol Disrupts the Body’s Balance
Verified By
KIMS-SUNSHINE
Specialist,
16 November, 2025
Endocrinal diseases are often the hardest conditions to deal with as any disruption of hormones in our body can lead to multiple diseases and difficulties. Cushing syndrome is an endocrine disorder caused by prolonged exposure to high levels of cortisol hormone. The ages between 20 to 50 yrs are commonly affected with this syndrome and more women get affected, when compared to men. Around 0.8% cases of Cushing’s syndrome are prevalent in the southern part of India. This prevalence is associated with other comorbidities. A recent study in India reported that about 79 people per million suffer from this condition.
Cushing’s Syndrome, Its Causes And Symptoms
Cushing’s syndrome/ hypercortisolism is an endocrinal abnormality that is caused by excess cortisol hormone in the body. These excesses can be genetic or may be due to certain medications and tumours in the glands like pituitary, adrenal and hypothalamus, respectively.
The adrenal glands and pituitary glands control cortisol levels by working in sync. A tumour in these glands can be a leading cause for Cushing’s syndrome. This can be termed an endogenous cause. Exogenous causes like over use of steroidal medications can cause excessive cortisol in the body too.
Symptoms
- A red, round face
- Easy bruising and poor wound healing
- High blood pressure
- Excessive, thick, unwanted hair growth especially on face, neck, chest, abdomen, breasts and thighs
- Balding over the scalp
- Purple stretch marks over abdomen
- Fat pad between shoulders
- General weakness and tiredness or fatigue
- Blurry vision and dizziness
- Weak muscles and thinner arms and legs
- Libido changes and erectile dysfunction
- Stunted growth in children
- Osteoporosis
- Irregular menses or absent menstrual cycles.
- Mental and emotional symptoms like anxiety, depression, irritability, mood swings, difficult concentration and sleep problems.
- Diabetes
- Heart attacks
Cortisol And Hormone Imbalance
Normally, cortisol levels vary by time and day. A morning blood test can reveal values from 6 to 23mcg/dl, when it is the highest. The values then proceed to decrease through the day. Cortisol is a steroidal hormone that helps your body to cope up during stress by increasing heart rate, increasing blood pressure, respiration and increasing muscle tension. It also helps in shutting down systems that the body doesn’t require during the time of stress, temporarily.
This hormone is essential to manage blood pressure levels, regulates sugar levels, reduces inflammation, forms memories, manages respiration, balances salt in the body and converts food to energy on a normal day. Cortisol hormone imbalance can involve either high or low cortisol levels, causing a range of physical and mental symptoms.
High cortisol in blood is mainly found due to tumours in the adrenal and pituitary glands, long term use of steroids and even chronic stress, while low levels of cortisol results from adrenal gland malfunctioning – where not enough of the hormone is produced. This happens in auto-immune diseases like Addison’s disease, infections and with problems of the pituitary or hypothalamus
Pituitary Vs. Adrenal Cushing’s Syndrome
Pituitary Cushing syndrome, also known as Cushing’s disease is seen when a benign pituitary tumour is present, causing the gland to produce higher than necessary amounts of adrenocortico-tropic hormone, urging the adrenal glands to produce excessive cortisol.
In adrenal Cushing’s syndrome, the excessive production of cortisol is due to tumour or hyperplasia in the adrenal glands themselves. This high release of cortisol due to adrenal tumours doesn’t require pituitary ACTH stimulation.
Diagnosing Cushing’s Syndrome
A 24-hour urinary cortisol test is done to check how much of the hormone is secreted in a day.
Midnight salivary cortisol test, where the saliva of the suspected individual is taken in between 11pm and 12 am is also done. During this time, the cortisol levels are lowest. But if it is high, then it’s an indication of hypercortisolism. Other tests like low dose and high dose dexa-methasone suppression tests, blood tests for ACTH level, CT scan and MRI to rule out tumours are conducted.
Conclusion
Cushing’s syndrome is a rare kind of endocrine disorder which affects almost every system of the body. This syndrome affects children too, due to the use of specific drugs or genetic reasons. Managing cortisol levels naturally can happen through corrections in lifestyle like getting quality sleep, regular exercise and to calm one’s mind by inculcating mind-ful breathing exercises in a day. Along with these, a well balanced diet is also necessary. Processed foods, sugars and caffeine are dangerous. Cortisol is released during stress situations; spending quality time and doing things you like, with your favourite kind of people can help reduce the release of cortisol.
Frequently Asked Questions
What causes excessive cortisol production?
What’s the difference between pituitary and adrenal Cushing’s?
Can lifestyle changes help control cortisol levels?
What are the complications of untreated Cushing’s?
Is Cushing’s syndrome curable?
