Cushing's syndrome occurs due to prolonged exposure to high levels of cortisol, and its symptoms affect nearly every system in the body. The most common symptoms include:
Weight and Body Fat Changes: Individuals frequently experience rapid weight gain and central obesity, characterized by an accumulation of fat around the abdomen and trunk while the arms and legs remain notably thin. Distinctive fat deposits also appear as a "buffalo hump" on the back of the neck, along the collarbone, and on the face, creating a round, reddened appearance often referred to as a "moon face" (facial plethora).- Skin Alterations: Purple or red stretch marks (striae) commonly develop on the abdomen, hips, thighs, buttocks, breasts, and underarms. The skin often becomes extremely thin and fragile, leading to dryness, easy bruising, and poor wound healing. Additional skin issues include acne, excessive sweating, superficial fungal infections, and dark, velvety skin patches (acanthosis nigricans) or skin tags.
- Musculoskeletal Issues: Patients frequently suffer from proximal muscle weakness, making it difficult to use the hips and shoulders. Because excess cortisol inhibits bone formation, it often leads to weak bones (osteoporosis), bone pain, sore joints, and a significantly increased risk of fractures.
- Metabolic and Cardiovascular Problems: The syndrome shares many features with metabolic syndrome, resulting in persistent high blood pressure (hypertension), elevated cholesterol and triglycerides, and insulin resistance that can progress to Type 2 diabetes. High blood sugar can also cause increased thirst and frequent urination. Electrolyte imbalances, such as low potassium (hypokalemia) and high sodium (hypernatremia), can also occur.
- Reproductive and Hormonal Symptoms: Women may experience hirsutism (excess male-pattern facial and body hair growth), baldness, and irregular or absent menstrual periods, which can result in infertility. Men may experience impotence and a reduced sex drive.
- Psychological and Neurological Effects: The condition commonly causes severe mood changes, including irritability, anxiety, and depression. Patients also frequently report extreme chronic tiredness, sleep disturbances like insomnia, headaches, and cognitive impairments affecting memory and attention.
