Cushing's syndrome
Cushing's syndrome is the condition caused by a prolonged excess of cortisol in the body. Most often that excess comes from outside, in the form of…
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Medicines commonly prescribed for Cushing's syndrome
For informational purposes only. Always consult a doctor before using any medicine.
Dosage form: INJECTABLE, Injectable solution in ampoule of 1 mlActive substance: dexamethasoneManufacturer: Kern Pharma S.L.Prescription requiredDosage form: INJECTABLE, 4 mg/mlActive substance: dexamethasoneManufacturer: Medochemie LimitedPrescription requiredDosage form: TABLET, 4 mgActive substance: dexamethasoneManufacturer: Tad Pharma GmbhPrescription required
Cushing's syndrome is the condition caused by a prolonged excess of cortisol in the body. Most often that excess comes from outside, in the form of corticosteroids taken for another illness. Less commonly the cause is internal: a hormone-producing tumour. The features are characteristic and recognisable, and the condition is treatable, although recovery takes time.
Causes
- taking corticosteroids — the most common cause. Tablets, injections and, with prolonged high-dose use, inhaled and topical forms as well;
- a pituitary adenoma producing ACTH — this form is called Cushing's disease;
- an adrenal tumour producing cortisol;
- tumours in other organs, most often in the lungs, producing ACTH;
- very rarely, inherited forms.
Symptoms
What is most telling is not the presence of individual signs but their combination and the fact that they have appeared relatively recently.
- weight gain with a characteristic distribution: fat accumulates on the trunk and abdomen while the arms and legs stay relatively thin;
- a rounded, flushed face;
- a fat pad between the shoulder blades and at the back of the neck;
- wide purple stretch marks on the abdomen, thighs, chest and shoulders;
- thin skin, easy bruising, slow wound healing;
- marked muscle weakness, particularly in the thighs and shoulders: it becomes hard to get up from a chair or raise the arms;
- raised blood pressure;
- raised glucose or newly diagnosed diabetes;
- low mood, anxiety, irritability, insomnia;
- in women: irregular periods, excess facial and body hair, acne;
- in men: reduced sex drive and erectile problems;
- reduced bone density and fractures from minor injury;
- frequent infections;
- in children: slowed growth alongside weight gain.
When to see a doctor
- a combination of weight gain on the trunk, purple stretch marks and muscle weakness;
- a rounded face and a pad at the back of the neck have developed;
- your skin has become thin and bruises easily;
- blood pressure or glucose has risen with no obvious explanation;
- you have been taking corticosteroids long-term and have noticed these changes;
- a child is gaining weight and has stopped growing;
- comparing photographs from one or two years ago shows a clear change in appearance.
Important: corticosteroids must never be stopped on your own. Abrupt withdrawal after prolonged treatment is dangerous — the body has no time to restore its own hormone production and acute adrenal insufficiency can develop. The dose is reduced gradually and only according to a doctor's schedule.
How it is investigated
The first thing the doctor establishes is whether you take corticosteroids in any form — including ointments, inhalers, joint injections and supplements of unclear composition. If so, further investigation is usually unnecessary and the work centres on the dose.
If there is no medication cause, cortisol is measured — and the method matters here, because a single blood test tells you little:
- cortisol in a 24-hour urine collection;
- late-night salivary cortisol;
- a dexamethasone suppression test.
If excess is confirmed, the source is sought: blood ACTH, pituitary MRI, adrenal CT, specific tests where needed and a chest CT. In parallel the consequences are assessed: blood pressure, glucose, lipids and bone density.
Treatment
- medication-induced form — gradual reduction of the corticosteroid to the lowest effective dose, switching to another drug where possible, and moving to topical forms;
- pituitary adenoma — surgery through the nose, with radiotherapy if needed;
- adrenal tumour — surgical removal;
- drugs that reduce cortisol production — in preparation for surgery or when surgery is not possible;
- treating the consequences — blood pressure, diabetes, osteoporosis, depression.
After surgery, hormone replacement is often needed until the adrenal glands recover their own function, which can take months. Recovery of appearance and muscle strength is gradual, over a year or more, and that is a normal timescale.
Risks if untreated
Prolonged cortisol excess leads to type 2 diabetes, persistent hypertension, osteoporosis with fractures, increased risk of blood clots, infections and cardiovascular disease, as well as significant mood disturbance.
Common questions
Is this the same as ordinary weight gain? No. What is characteristic is the distribution of fat on the trunk with slim limbs, the purple stretch marks and the muscle weakness.
Are steroid creams dangerous? In short courses on limited areas, no. The risk arises with prolonged use over large areas, particularly in children.
Will the weight go after treatment? Generally yes, but gradually. Stretch marks fade but remain.
Online consultation
In an online consultation the doctor goes through your symptoms, reviews every preparation you use — including topical and inhaled ones — explains exactly which cortisol tests are needed and how to do them correctly, and advises which specialist to see.
This material is for information only and does not replace a medical consultation.
Consult with a doctor about Cushing's syndrome
Discuss your symptoms and possible next steps with a doctor online.
Medically reviewed by
Reviewed on Jul 6, 2026
Online doctors for Cushing's syndrome
Discuss your symptoms and possible next steps for Cushing's syndrome with a doctor online.
