OHSU

Cushing's Disease

Cushing's disease is caused by a pituitary adenoma (non-cancerous tumor) that makes too much adrenocorticotropic hormone (ACTH). About 10 percent of pituitary adenomas are this type.

When your pituitary gland makes too much ACTH, this tells your body's adrenal glands (small glands located above your kidneys) to make too much of another hormone called cortisol. This creates serious problems with your body's hormone balance, causing many symptoms. The condition is called Cushing's disease after the famous neurosurgeon Harvey Cushing, who discovered it.  

Symptoms of Cushing's disease

Cushing's disease can cause:  

  • Vision problems
  • Headaches
  • Extreme fatigue (being very tired)
  • Trouble sleeping
  • Muscle weakness
  • Infections, high blood pressure and diabetes 
  • Osteoporosis (weak, brittle bones and bone loss) 

Cushing's disease can also cause changes in your appearance. These include:  

  • Round or red face
  • Hump on back of neck
  • Weight gain around the belly with thinner arms and legs
  • Purple stretch marks
  • Acne or hair growth on the face

Diagnosis

Cushing's disease can be difficult to diagnose. At the OHSU Northwest Pituitary Center, your doctor takes a complete medical history and does a physical examination and testing.  

Tests for Cushing's disease include:

  • Urine test of your cortisol levels
  • Saliva test of your cortisol levels
  • Other hormone tests

Treatment for Cushing's disease

If you have Cushing's disease, you might have surgery to remove the tumor or your adrenal glands. Other treatments include: 

  • Radiation therapy (stereotactic radiosurgery)
  • Medication

If you have surgery, your doctor gives you medication after surgery to replace the cortisol your body does not make any longer. You may need medication for several months, a year or more. 

You need regular examinations and tests by a pituitary expert to measure your hormone levels and treat any medical conditions. This is necessary because the symptoms of Cushing's disease can take time to go away. The doctors at the OHSU Northwest Pituitary Center will work with you to determine the best treatment for you.