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Cushing disease
Reviewed by Medicinsk Expert•Last updated: 2026-10-22•Condition

Cushing Disease

Cushing disease is a rare hormonal disorder caused by noncancerous pituitary tumors that release excess adrenocorticotropic hormone (ACTH). This triggers the overproduction of cortisol, leading to a wide variety of physical, cognitive, and metabolic symptoms.

Overview

Cushing disease is a specific type of Cushing syndrome. Both conditions are characterized by abnormally high levels of cortisol in the body. Cortisol is a vital hormone that helps the body respond to stress, maintain blood glucose levels, and suppress inflammation. Because both conditions stem from elevated cortisol levels, they share very similar signs and symptoms.

Symptoms

The elevated cortisol levels associated with Cushing disease can affect multiple systems throughout the body, causing a range of physical and psychological symptoms:

  • Weight Gain and Fat Redistribution: Rapid and unusual weight gain, particularly around the abdomen and face. Affected individuals may also develop a fatty hump on their upper back due to changes in fat distribution.
  • Skin Changes: Easy bruising and the appearance of purple stretch marks (striae) on the thighs and abdomen.
  • Musculoskeletal Issues: Muscle weakness, fatigue, and thin, brittle bones that are highly prone to fracture.
  • Hormonal and Reproductive Changes: Irregular menstruation in women, as well as excessive hair growth (hirsutism) on the face, chest, and abdomen.
  • Metabolic and Immune Complications: An increased risk of developing high blood pressure (hypertension) and diabetes, along with a weakened immune system that elevates the risk of infections.
  • Cognitive and Mood Disturbances: Anxiety, irritability, depression, and cognitive difficulties—such as problems with learning, concentration, and memory—often referred to as "brain fog."

If left untreated, individuals with Cushing disease face an increased risk of developing life-threatening complications, including severe infections, heart disease, or stroke.

Frequency

Cushing disease is a rare condition, affecting up to 2.4 in 1,000,000 people each year. It is diagnosed more frequently in females than in males. While it typically occurs between the ages of 20 and 50, children can also be affected.

Causes & Genetic Factors

Normally, the production of cortisol by the adrenal glands (located on top of each kidney) is triggered by adrenocorticotropic hormone (ACTH), which is released by the pituitary gland at the base of the brain.

In people with Cushing disease, noncancerous (

Frequently Asked Questions

Glucocorticoid‑sparing agents (e.g., ketoconazole, metyrapone) can lower cortisol but may cause nausea or liver enzyme changes. Antihypertensives such as ACE inhibitors or ARBs are generally safe, but beta‑blockers can mask hypoglycemia symptoms. Always discuss medication changes with your endocrinologist to avoid exacerbating hypertension or diabetes.===
Rapid, central weight gain (especially around the abdomen and face) that occurs over a few months, combined with purple stretch marks, easy bruising, and a “moon face” or “buffalo hump,” strongly suggests Cushing disease. If these features appear with normal diet and exercise habits, a cortisol‑stimulating test (e.g., overnight dexamethasone suppression) should be considered.
Purple striae in Cushing disease are usually thin, well‑defined, and located on the abdomen, thighs, and upper arms. They often appear with other Cushing signs such as muscle weakness, hypertension, and glucose intolerance. A low‑dose dexamethasone suppression test or ACTH‑stimulating test can confirm excess cortisol production.
fter transsphenoidal pituitary surgery, most patients experience gradual improvement in cortisol levels over 3–6 months. Full recovery of adrenal function may take up to a year, and patients often need temporary steroid replacement during this period. Follow‑up visits every 3–6 months are standard to monitor hormone levels and adjust therapy.
Source: MedlinePlus, National Library of Medicine

MedlinePlus brings together authoritative health information from the National Library of Medicine (NLM), the National Institutes of Health (NIH), and other government agencies and health-related organizations.

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