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Cyclical Cushings Symptoms

According to the European Journal of Endocrinology, cyclical Cushing's disease (also referred to as cyclical hypercortisolism) is relatively rare. The condition is characterized by your body overproducing cortisol in a in a fluctuating pattern with a specific rhythm. You may have episodes of excessive cortisol levels intermingled with times of normal cortisol production. In order to be formally diagnosed, your doctor must ascertain three peak times of cortisol production along with two troughs.

  1. The Facts

    • Most patients with cyclic Cushing's syndrome have the clinical symptoms of Cushing's syndrome. The European Journal of Endocrinology indicates that approximately 95 percent of patients with cyclical Cushing's syndrome have at least two of the typical signs and symptoms associated with Cushing's syndrome. Symptoms may be permanent or may be intermittent in accordance with your cyclical condition. Some patients, however, have no clinical signs or symptoms which would point to Cushing's syndrome.

    Symptoms

    • Typical symptoms of Cushing's syndrome include obesity of the upper body, abnormal fat around the neck area, a rounded face and comparatively slender legs and arms. Children with the condition typically are obese and grow at a slow rate. Additional signs of Cushing's syndrome are visibly apparent as your skin becomes more fragile and thin, easily bruises and does not heal well. You may notice pink or purple stretch marks on your thighs, stomach, arms, breasts or buttocks. The condition affects your bones, weakening them and resulting in frequent backaches and fractures of the spinal column and ribs (even from performing everyday activities like lifting or bending).

    Additional Symptoms

    • According to The European Journal of Endocrinology, cyclical Cushing's syndrome patients commonly have disorders like acne, mood disturbances, glucose intolerance, hirsutism (excessive hair growth) and menstrual irregularities (amenorrhea). The mood disturbances may be severe and include psychosis, memory problems, neurosis, depression and irritability.

      Women with Cushing's syndrome typically have excess hair which grows on the thighs, chest, stomach, neck and face. Additionally, women may experience irregular or halted menstrual cycles. Men may also experience reduced sex drive, erectile dysfunction and decreased fertility.

    Diagnosis

    • Diagnosis of cyclical hypercortisolism usually requires protracted studies of the patient in order to detect the three peaks and two troughs in cortisol production. 24-hour urinary studies and saliva samples are two typical means for measuring cortisol levels and patterns over an extended period of time.

    Treatment

    • According to the Cushing's Support & Research Foundation, the cycles typically have lengths from 12 hours to 85 days. Treatment with medications like bromocriptine (a dopamine agonist) or cyproheptadine (a serotonin antagonist) has been relatively unsuccessful. Traditional Cushing's syndrome treatments like surgery, radiation therapy or medications which reduce excess production of cortisol (like ketoconazole, metyrapone or mitotane).

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