Cortisol & Cushing's Syndrome
Cortisol Hormone and Weight Loss. Understanding Cushing’s Syndrome Effects in Human Health & Weight Loss Efforts
What is Cushing’s Syndrome
Cushing’s syndrome is a medical condition caused by overproduction of cortisol hormone. We discovered this hormone when discussing “Why You are Not Losing Weight” even with diet and exercise.
To understand Cushing’s Syndrome, first, we have to talk about Cortisol hormone. Hormones are important substances that regulate our body’s functioning and keep everything in working order.
One of these hormones, cortisol, is essential in keeping you alive and running properly.
Over the years, cortisol has gotten a bad reputation due to its deleterious effects when we’re exposed to large amounts.
This is undeserved because cortisol is pretty important for us to stay healthy. However, high cortisol hormone can make it difficult to lose weight.
Benefits of Cortisol:
- regulates your blood sugar
- helps maintain blood pressure
- fights off stressors and disease
- reduces inflammation and helps heal your wounds
- helps turn the food you eat in energy
Rest assured, without cortisol, you’d die pretty fast. However, like with all other hormones, both too little AND too much are bad for you.
For the body to work properly, all of its systems have to be in balance. This is called homeostasis.
If we’re under a lot of stress all the time, cortisol levels are going to go up. In the short term, that’s a good thing, because it keeps us alive.
However, when cortisol levels are chronically elevated, our body will begin to break down.
In some cases, our cortisol levels can reach unnatural supraphysiological levels. When this becomes a chronic condition, it’s called Cushing’s Syndrome.
Cortisol levels out of whack? Maybe you have Cushing’s Syndrome?
"A syndrome: a group of signs and symptoms that occur together and characterize a particular abnormality or condition."
- Definition of a syndrome from the Merriam-Webster dictionary
Cushing’s syndrome is the name for a set of symptoms that you experience when you’re to high levels of cortisol for extended periods of time.
This can happen for many different reasons. On the one hand, you can get Cushing’s Syndrome because something’s wrong with your body itself: this is called endogenous Cushing’s syndrome.
Or, it can occur because you’ve been taking certain drugs. In the latter case, we call this exogenous Cushing’s syndrome.
To be able to understand what Cushing’s syndrome is, we have to explain the different signaling mechanisms and feedback loops that regulate cortisol levels.
In medical terms, this is called the hypopituitary adrenal axis (HPA-axis). As you can see in the image above, there are three parts of our body that play a role.
At the top, there’s our hypothalamus. This little part of our brain releases a hormone called corticotropin-releasing hormone (CRH).
These hormones send a message to the anterior pituitary gland to produce adrenocorticotropic hormone (ACTH).
This, in turn, tells your adrenals to produce cortisol. What happens then, is that your hypothalamus senses that there is enough cortisol in your blood.
That tells it to stop producing CRH (this is why they call it a negative feedback loop). Normally, this system works just fine. But sometimes, things can go wrong.
Types of Cushing’s Syndrome
1.Endogenous Cushing’s Syndrome
The first way Cushing’s syndrome can occur in your body is when there’s a tumor in your pituitary gland.
This tumor causes it to produce too much ACTH, which stimulates the adrenal glands to produce excess cortisol.
This type of Cushing’s Syndrome is called Cushing’s Disease.
A second possible cause of Cushing’s syndrome is a tumor that’s not located near the pituitary gland.
This one will also cause an excess of ACTH to be produced. This is not called Cushing’s disease, but ectopic ACTH secretion.
Third, there’s a primary adrenal disease. In this scenario, there is no tumor present anywhere.
If you have this condition, your adrenal glands independently start producing too much cortisol on their own.
2. Exogenous Cushing’s Syndrome
Cushing’s Syndrome can also be directly caused by external factors.
A very common cause of Cushing’s Syndrome is the overuse of corticosteroid medications.
In this case, it’s called exogenous Cushing’s Syndrome. This is also the most common cause of Cushing’s Syndrome.
For some diseases, like asthma or arthritis or high levels of inflammation, doctors will prescribe you corticosteroids.
These are drugs that mimic cortisol. These drugs are very useful in combating disease and inflammation.
However, when you take them for too long, or you take too much of them, side-effects will occur.
These symptoms correspond to Cushing’s Syndrome and are the same symptoms you would have if your body produced too much cortisol of its own.
Endogenous Cushing’s syndrome is relatively rare, but the exogenous version is a lot more common, due to doctors prescribing too many corticosteroid drugs.
Cushing’s Syndrome Symptoms
- a puffy face
- reduced sex drive
- irregular periods
- weak skin
- low energy levels
- poor mood
- stretch marks
- lowered strength and muscle wasting
- excessive hair growth
- high blood pressure
- high blood sugar (possibly even leading to diabetes)
- osteoporosis (weakened bones)
- weight gain
Cushing’s Syndrome Diagnosis
Cushing’s Syndrome can be hard to diagnose, especially if your symptoms aren’t very severe.
Some of the symptoms, like weight gain or depression, aren’t exactly exclusive to Cushing’s Syndrome and can obscure diagnosis.
Unhealthy diet and lifestyle alone is enough to add a few pounds to your frame and cause your mood to drop.
That being said, there are dozens of other different diseases that share the same symptoms of Cushing’s Syndrome.
Two examples of diseases that share many of the same symptoms as Cushing’s are a metabolic syndrome or polycystic ovary syndrome.
Because of this, having the symptoms mentioned above is definitely not enough to conclude that you suffer from Cushing’s Syndrome.
If you have some of these symptoms, don’t start automatically assuming you have Cushing’s.
It’s always best to get a doctor to diagnose you. A doctor will not diagnose you only based on your symptoms.
He’ll also check your medical history and run some lab tests. In Cushing’s syndrome or disease, the most important thing to check is obviously your cortisol levels.
But these change throughout the day. In healthy people, they peak in the morning and slowly drop down over the course of the day.
To get a clear image of your cortisol levels, it’s important to test your hormone levels at different times of the day.
Once it’s established that you suffer from Cushing’s Syndrome, all that rests is to determine the cause.
Is your Cushing’s Syndrome caused by a tumor, drugs, or your adrenal glands?
Unless your doctor can figure out what’s the cause of your Cushing’s Syndrome, he won’t be able to choose the right treatment.
And you probably don’t want your adrenal glands to be removed when there’s nothing wrong with them, right?
Determining the cause of your Cushing’s Syndrome can be done in many different ways.
Blood tests Testing blood is the most common way to diagnose Cushing’s Syndrome.
Your doctor will usually administer a certain drug and measure the effects it has on your ACTH levels.
When you have Cushing’s Syndrome and normal to high ACTH levels, chances are you’ve got a tumor that’s causing it.
When ACTH levels are low, that’s usually because your adrenals themselves are malfunctioning.
Imaging tests What better way to look for a tumor than to go and have a look, right? With an MRI or a CT scan, it’s usually pretty simple to determine whether there is a tumor present in your pituitary, or somewhere else.
Once that’s established, getting to the next step is simple. However, it is possible in some cases that the tumor is impossible to see.
Pituitary tumors can evade detection through normal means.
In that case, there’s a last resort, which is… Petrosal sinus sampling Your petrosal sinus is a vein that’s linked to the pituitary.
Thanks to this vein, it’s possible to determine whether there’s a tumor present over there.
When performing a petrosal sinus sampling, your doctor will first administer CRH, which is the hormone that signals your pituitary to release ACTH.
The doctor will then draw blood from both the petrosal sinus, as well as another vein that is located far away from it.
If ACTH levels are higher in the blood drawn from the petrosal sinus than in the other blood sample, you probably have a pituitary tumor.
If ACTH levels are equally high in both blood samples, that’s an indication that the tumor is located somewhere else in your body.
Cushing’s syndrome versus Cushing’s disease
Cushing’s syndrome is not the same as Cushing’s disease. In Cushing’s syndrome, there is too much cortisol in the blood, regardless of what causes it.
Whether it’s a tumor, drugs or your adrenals themselves that are going wild, it’s called Cushing’s Syndrome.
In Cushing’s disease specifically, these high levels are caused by a tumor in the pituitary gland.
So Cushing’s disease is more of a specific variety of Cushing’s syndrome.
Cushing’s disease is also much less common than ‘regular’ Cushing’s syndrome, the latter usually being caused by anti-inflammatory steroid medications.
This pituitary tumor is usually not cancerous, so it won’t spread throughout the body and kill you.
Nevertheless, even if a tumor is benign, it can still have effects on near tissue. In this case, that’s the pituitary gland.
In Cushing’s disease, the tumor causes your pituitary gland to start producing high levels of ACTH, which signals your adrenals to increase cortisol production.
As a result, you will have chronically elevated levels of this ‘stress hormone’ in your blood.
A tumor can also progress and become malignant in the future, effectively making it cancerous. So it’s best to do something about it…fast.
Cushing’s Syndrome Treatment
For people with Cushing’s disease, doctor’s have a variety of treatments at their disposal to stop the disease and cure you.
Number one is the most straightforward one – just remove the tumor through surgery.
Even though the pituitary gland is located in your brain, don’t worry, they don’t cut open your head.
The surgery is usually done through the nose. In general, this method of curing the disease works pretty well. In 80 to 90 percent of all cases, surgery is enough to cure the patient.
The second option your doctor has at his disposal is removing your adrenal glands.
This route is taken if removing the tumor itself is impossible or has proven unsuccessful.
Surgery is usually the number one solution for Cushing’s Disease It’s also possible for doctors to give you medications to reduce the amount of cortisol in the blood.
However, they do not really cure the disease. They just disguise the symptoms.
Usually, these medications are only used in the preparation of surgery.
Finally, Cushing’s disease can also be treated through radiotherapy. This is also used when surgery isn’t possible, or has proven unsuccessful.
In this option, the tumor is treated with radioactivity in an attempt to ‘kill’ it. Even with your tumor gone, the disease can have lasting effects.
The surgery itself can cause a myriad of various symptoms, like pain, infections or excessive bleeding.
After surgery, you’ll also probably be given replacement hormones to keep your cortisol levels stable.
In most cases, you’ll only have to take these for a few months, while your body regains its natural balance.
In the worst case scenario, you’ll have to be taking these for the rest of your life.
For example, if the treatment required that your adrenals were removed, your body will become unable to produce cortisol.
This means that you will have to keep taking hydrocortisone tablets for the rest of your life.
Without these, even the smallest injury would have the potential to kill you. Usually, after treatment, your body will be restored to its former state over time.
Even if you are severely weakened, given some weight training and exercise, your muscles and your bones will regain their former strength.
With a healthy lifestyle, you’ll also lose those excessive fat deposits you’ve been building up.
Coping With Cushing’s Syndrome Obviously, a healthy diet with lots of plants and whole foods is the cornerstone in staying healthy.
This goes double for when you’re suffering from a hormonal problem.
To counter the likely weight gain here are a few strategies you can implement to speed your recovery and feel better.
- Eat lots of different greens and colored vegetables: weithis will lower your body’s inflammation levels and support general health.It will also help prevent blood sugar issues and diabetes that can result from Cushing’s Syndrome. And it’ll keep the fat off.
- Consume healthy, omega-3 fats:good sources of healthy fat are essential for proper hormonal health and are also powerful anti-inflammatory foods. Think salmon, nuts and the occasional avocado.
- Increase your intake of calcium and vitamin D3:Cushing’s Syndrome can wreak havoc on your bone health.Consuming these bone supporting nutrients will strengthen your bones and keep you from breaking anything. Be sure to take some supplements and get out in the sun whenever possible.
- Increase protein intake: this counters the muscle breakdown that comes with Cushing’s.
- Take adaptogen herbs: adaptogens are substances that make your body more resilient against stress. They’re also proven to reduce fatigue and improve energy levels. Try out ashwagandha, Rhodiola Rosea, Eleuthero, reishi and Korean ginseng for natural support.
- Exercise: Exercise helps strengthen your muscles and bones and is key to good health. Go for a brisk, fast walk each day or do a short, intense workout.
- Get enough sleep: our body needs sleep to be in optimal health. That goes double when you’re suffering from an illness. Get your daily 8 hours of sleep and take a nap during the day when you’re very fatigued.
These natural strategies will definitely help you cope with the negative effects of Cushing’s Syndrome.
Nevertheless, be sure to follow your own doctor’s recommendations at all times.