Options include: Reducing corticosteroid use The best treatment for you depends on the cause of the syndrome. Treatments for Cushing syndrome are designed to lower the high level of cortisol in your body. Depression, eating disorders and alcoholism also can partially mimic Cushing syndrome. These tests help your doctor diagnose Cushing syndrome, and they may help rule out other medical conditions, such as polycystic ovary syndrome - a hormone disorder in women with enlarged ovaries. If the ACTH levels are similar between the sinuses and forearm, the root of the problem lies outside of the pituitary gland. If the ACTH level is higher in the sinus sample, the problem stems from the pituitary. Levels of ACTH are measured from the petrosal sinuses and from a blood sample taken from the forearm. For the test, blood samples are taken from the veins that drain the pituitary gland (petrosal sinuses).Ī thin tube is inserted into your upper thigh or groin area while you're sedated and is threaded to the petrosal sinuses. This test can help determine whether the cause of Cushing syndrome is rooted in the pituitary or somewhere else. CT or MRI scans can provide images of your pituitary and adrenal glands to detect abnormalities, such as tumors. By analyzing cortisol levels from a small sample of saliva collected late at night, doctors can see if cortisol levels are too high.
In people without Cushing syndrome, levels of cortisol drop significantly in the evening. Cortisol levels normally rise and fall throughout the day.
Your doctor might also recommend other specialized tests that involve measuring cortisol levels before and after using hormone medications to stimulate or suppress cortisol. Urine and blood samples will be sent to a laboratory to be analyzed. For the urine test, you may be asked to collect your urine over a 24-hour period. These tests measure hormone levels and show whether your body is producing excessive cortisol. If you haven't been using a corticosteroid medication, these diagnostic tests may help pinpoint the cause: Your doctor will conduct a physical exam and look for indications of Cushing syndrome, such as rounding of the face, a pad of fatty tissue between the shoulders and neck, and thin skin with bruises and stretch marks. You'll likely need to see a doctor who specializes in hormonal disorders (endocrinologist). Diagnosing Cushing syndrome can be a long and extensive process. Cushing syndrome from endogenous cortisol production can be difficult to diagnose because other conditions have similar signs and symptoms.
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