If you’re a woman between 25–40 years old and are dealing with myriad symptoms that just won’t seem to go away no matter what you try or what your doctor prescribes, there’s a chance you may have Cushing’s disease. Even if you aren’t in that demographic, you can’t rule this condition out, as it can affect anyone.
Cushing’s disease is a condition caused by an excess of the hormone cortisol and problems with normal adrenal and pituitary gland functions, which can coincide with adrenal fatigue. Although many people experience at least somewhat high levels of cortisol at one time or another, true Cushing’s disease is rare compared to other endocrine disorders. This can make it hard for patients to get an accurate diagnosis.
An estimated 10–15 people per million are affected every year, with the vast majority being women (about 70 percent). Besides being more common in women than in men, Cushing’s disease is most often diagnosed in young to middle-aged adults between 25–40 years old. (1)
Many people suffering from Cushing’s disease are often misdiagnosed or sent from specialist to specialist, without a concrete answer for what’s causing their symptoms. They might be brushed off by their doctors or simply told to “diet and lose weight” in order to feel better. One reason that’s true is because the symptoms of Cushing’s disease can be explained by a host of other disorders. The problem is that misunderstandings about Cushing’s disease can further increase anxiety, self-blame and chronic stress, which only worsens the underlying issue.
The good news is through diet and lifestyle changes, you can naturally treat this adrenal condition.
Cushing’s Disease Symptoms
Symptoms of Cushing’s disease (also called hypercortisolism) are far-reaching because producing too much cortisol impacts many other hormone in the body — including sex hormones like estrogen and testosterone, and insulin, the hormone that controls the uptake of glucose by cells.
Symptoms of Cushing’s disease vary from person to person, since everyone reacts to high cortisol levels somewhat differently. For example, someone’s age, gender, medical history and genetics all play a role in what type of symptoms might emerge. While some people are only able to recover after surgery or use of medications, lifestyle changes like lowering stress, altering medication use, improving nutrient intake and exercising can help many people with Cushing’s disease control their symptoms.
Some of the most common Cushing’s disease symptoms include: (13)
- weight gain (especially in the abdominal area, lower back, upper body or near the neck, which is sometimes called a “buffalo hump“)
- a puffy, rounded face
- skin problems, including redness, facial hair growth, slow healing, stretch marks, dryness and acne
- muscle weakness
- high blood pressure
- high blood glucose (sugar) levels
- changes in mood, including depression and anxiety
- irregular periods and fertility problems
- low sex drive
- abnormal hair growth on the body and face (especially noticeable in women)
- weakened bones and higher risk for fractures or osteoporosis
- digestive problems, including bloating/water retention, kidney stones and constipation
- trouble sleeping
- weight gain and developmental problems in children
One of the biggest signs of Cushing’s disease is unexplained weight gain. According to the Cushing’s Support And Research Foundation: (14)
- The average weight gain in patients with Cushing’s is 55 pounds.
- Only 16 percent report gaining less than 25 pounds.
- 72 percent report losing most of the weight they gained following treatment within two years, many using diet and exercise, but some not needing to at all and still experiencing weight loss due to normalizing hormone levels.
Although Cushing’s disease and Cushing’s syndrome are not the same thing (more on this below), they have similar symptoms since both are caused by high cortisol levels.
The Causes of Cushing’s Disease & Cushing’s Syndrome
Cortisol is one of the body’s primary “stress hormones” created in the adrenal glands, which are located on top of the kidneys. The pituitary gland, which is found at the base of the brain, secretes adrenocorticotropic hormone (ACTH), which stimulates the production of cortisol from the adrenal glands.
The pituitary gland is considered to be the “master hormone gland” since it communicates with other glands, such as the hypothalamus, and helps control the balance of various important hormones. Because of an increase in cortisol, Cushing’s disease can cause various symptoms that mimic other health problems like a thyroid disorder, menstrual problems, menopausal hormonal changes and so on.
Cortisol is a type of glucocorticoid or steroid, which in normal amounts has important roles in the body — keeping us alert, allowing us to respond to stress and changes in our environment, and helping to raising blood sugar levels, for example. (15) But too much can have a serious negative impact. High amounts of cortisol are linked to increased inflammation, reproductive problems, weight gain, sleep disorders and many other conditions.
Cushing’s Disease vs. Cushing’s Syndrome: What’s the Difference?
While they’re often used interchangeably, Cushing’s disease is not the same as Cushing’s syndrome. Cushing’s syndrome refers to “the general state characterized by excessive levels of cortisol in the blood.” When researchers or doctors use the term Cushing’s disease, they’re usually referring to the condition caused by a pituitary tumor that increases production of the hormone ACTH, which then increases cortisol levels. (16)
Cushing’s syndrome is much more common than Cushing’s disease and develops most often due to taking medications that increase cortisol, such as hydrocortisone, prednisone pills, or other medications to treat inflammatory-related diseases or symptoms. Elevated cortisol levels in people with Cushing’s syndrome can also be due to high amounts of stress, depression, a poor diet, alcohol abuse, high amounts of estrogen or eating disorders, such as anorexia.
What causes the pituitary gland to release more ACTH and stimulate production of cortisol than usual?
Cushing’s disease isn’t believed to be an inherited condition but rather occurs due to abnormal tumor growth in the pituitary gland, which can be linked to medication use, stress and other lifestyle factors. That being said, there are certain rare hereditary diseases that can increase a person’s risk of developing a pituitary tumor that leads to Cushing’s syndrome, including: multiple endocrine neoplasia, Carney complex and isolated familial acromegaly.
Cushing’s syndrome (not Cushing’s disease) can develop for a number of different reasons, the most common ones being benign tumor growth on the pituitary gland (a pituitary adenoma), cortisol-like synthetic medication use and the lifestyle factors mentioned above that increase cortisol over time. (17) When excess cortisol is produced due to a tumor developing in the adrenal glands or pituitary gland, it’s called ectopic Cushing’s disease. The majority of people with either Cushing’s disease or syndrome display at least small tumor growths on their pituitary glands.
Cushing’s Disease Caused by Pituitary Adenomas:
According to the UCLA Pituitary Tumor Program, pituitary adenomas are benign (non-cancerous), slow-growing tumors that are present in more than 70 percent of cases of Cushing’s disease in adults and about 60 percent to 70 percent of cases in children and adolescents. Adenomas develop in the pituitary gland when certain cells form tumors that produce an excess of one or more hormones, which is called a “functional adenoma.” This is the case with Cushing’s disease, since it causes the pituitary gland to increase output of ACTH, which then causes an abnormal increase in cortisol.
Pituitary tumors can either produce extra cortisol directly in their own tissue or produce extra ACTH, which then triggers production of more cortisol. The severity of Cushing’s disease caused by pituitary adenomas is determined by factors including the size of the tumor, how much it has progressed before being detected, how quickly it grows, whether it spreads to other parts of the body (called pituitary carcinomas) and how much the tumor secretes hormones.
Cushing’s Syndrome Caused by Medications and Lifestyle:
Another common reason that cortisol levels can rise is due to medications that increase cortisol, which are called glucocorticoids and include commonly prescribed steroids, such as prednisone. People take glucocorticoids most often to treat wounds, heal from surgery or organ transplants, or help conditions including autoimmune disorders, allergies, or asthma and rheumatoid arthritis.
In appropriate doses, these medications can help lower inflammatory responses, but over time they pose the risk of raising cortisol too much, which interferes with normal immune, endocrine, reproductive, digestive and central nervous system functions. Finally, stress is known to increase cortisol levels and make existing hormonal problems even worse. In response to high amounts of stress, the adrenals release even more cortisol than usual as the body experiences a “fight or flight” response and attempts to defend itself from threats. (17)
5 Natural Ways to Manage Cushing’s Disease Symptoms
How serious is Cushing’s disease, and is it treatable?
Individual outcome will depend on the cause (for example, whether it’s Cushing’s syndrome due to high levels of cortisol caused by medications or Cushing’s disease, due to an adrenal tumor, etc.) and treatment. Time to recovery can vary, but the majority of patients have normal life expectancies after being treated and making lifestyle changes.
That being said, people who have a history of Cushing’s are at an increased risk for recurrent symptoms and developing problems, such as diabetes, high blood pressure, high cholesterol and fertility problems — which is why a healthy diet, exercise, reducing stress and getting regular checkups are so important. (2, 3)
Cushing’s disease and Cushing’s syndrome are treated on a case-by-case basis depending on what’s causing cortisol levels to rise. Some of the ways doctors treat Cushing’s disease or syndrome include: (4)
- Discontinuing use of medications that increase cortisol (such as steroids) or taking a lower dose.
- In the case of Cushing’s disease, if a tumor is identified on the pituitary gland or on an adrenal gland, undergoing surgery to remove the tumor or using radiation and/or medications to shrink the tumor. Anti-glucocorticoid and anti-hypertensive medications, along with steroid inhibitors, can be used as adjunctive treatments in addition to surgeries. (5)
- For those with Cushing’s syndrome, lowering cortisol can be at least helped by switching to a whole foods, anti-inflammatory foods diet, reducing stress levels, and changing the level of exercise and physical activity.
It’s important to see a doctor if you suspect you have Cushing’s disease because, in some cases, someone might have many of the symptoms described above, which are hallmarks of having high cortisol, but actually have another disorder. Their initial test results might even point to Cushing’s disease or syndrome, but further test results might show that they’re actually suffering from something like alcohol dependence, depression or other psychiatric disorders, inflammation due to obesity, pregnancy side effects, or even diabetes. This is called “pseudo-Cushing’s syndrome.”
To be diagnosed with Cushing’s disease or syndrome, test results need to show chronic hypercortisolism, usually demonstrated using tests including:
- 24-hour urine free cortisol measurement
- Cortisol saliva testing
- Blood ACTH test, which can suggest the presence of an adrenal tumor
- MRI scan and computed tomography scan — aka CT scan — to identify benign or malignant tumors on the pituitary gland or adrenal glands
While surgery is considered the leading treatment approach to remove a tumor causing Cushing’s disease, this can come along with side effects, as can radiation therapy and use of medications that affect the adrenals. (6) These treatments might be the only option for people with Cushing’s disease that has progressed, but for others with Cushing’s syndrome, or just symptoms of high cortisol, lifestyle changes can help too. (7)
The diet and lifestyle changes below can help manage symptoms and boost treatment of Cushing’s disease and Cushing’s syndrome:
1. Consume an Anti-Inflammatory Diet
People with Cushing’s disease are at an increased risk for other health problems, including: bone loss, high blood pressure, diabetes, high cholesterol, sex hormone imbalances and more. Cortisol stimulates your sympathetic nervous system and decreases your digestive secretion, sometimes making it hard to fully digest foods, absorb nutrients properly and go to the bathroom normally.
A nutrient-dense, unprocessed diet can help prevent complications and ease symptoms by balancing hormones naturally, improving digestion and lowering inflammation. Eating foods with calcium, vitamin D, vitamin K and magnesium is important for bone health, while lowering intake of artificial ingredients, processed grains, caffeine, alcohol, sugar and sodium also helps.
Some of the best foods for fighting the effects of high cortisol include these adrenal fatigue diet foods:
- Healthy fats and omega-3 fatty acids — Cold-water, wild-caught fish like salmon or sardines can reduce inflammation and help stabilize moods. Healthy fats support brain health and allow us to make important hormones. Aside from seafood, include nuts/seeds, avocado, olive oil and coconut oil in your diet regularly.
- Foods high in B vitamins — We need B vitamins in order convert nutrients to energy and to support brain functions. Include raw or cultured dairy products, cage-free eggs, grass-fed beef, wild-caught fish, poultry, brewer’s yeast, and green leafy vegetables in your meals.
- Foods with calcium, potassium and magnesium — Electrolytes are natural muscle relaxers and important for overall health. They also help lower symptoms like headaches, trouble sleeping, aches, high blood pressure and more. Try eating more unsweetened organic yogurt, wild-caught salmon, beans/legumes, leafy green veggies, cruciferous veggies like broccoli, avocados and nuts to prevent an electrolyte imbalance.
- High-protein foods — Foods with protein provide amino acids that are needed for proper neurotransmitter functions, while also helping to control appetite and fighting fatigue.
2. Get Support and Help
Many people with Cushing’s disease suffer from symptoms of anxiety and depression. It helps to speak with a professional, such as a therapist or counselor, and get support from family, friends and people going through the same problem. One of the best ways to bust stress naturally and feel happier is to connect with other people. An easy way to do this is online, where you can join a support group from home that helps you learn about living with the condition, such as the one created by the Cushing’s Support & Research Foundation.
If your rather work with a professional, studies have found that cognitive behavioral therapy (CBT) is among the most effective ways of reducing stress. CBT includes “identifying sources of stress, restructuring priorities, changing one’s response to stress, and finding methods for managing and reducing stress.” (8)
3. Help Balance Hormones with Exercise
When done in a moderate, healthy way, exercise can be a great way to lower stress, control cortisol and manage your weight. Cushing’s disease is associated with weight gain, muscle weakness, bone loss and fatigue, which exercise is great for reducing naturally. Another benefit of exercise is it’s an effective distraction from stressful events, blunts the harmful effects of blood pressure and protects the heart.
That being said, too much exercise can sometimes worsen the problem and interfere with hormones in a negative way, so always get your doctor’s opinion and discuss how you’re feeling. Work with your doctor to come up with an exercise plan that combines cardiovascular/aerobic activities, strength training and stress management techniques. Start slowly, and avoid very strenuous exercise that wears you out. Instead focus on finding activities you enjoy, including group classes, walking outdoors, swimming, cycling, lifting weights, yoga or tai chi.
4. Get Enough Rest and Lower Stress
Getting adequate sleep is important for controlling cortisol and other hormones. A lack of sleep disturbs normal hormonal functions, increases cortisol, can alter your appetite, and can lead to chronic fatigue, weight gain, moodiness and other symptoms. If you can’t sleep, make it a priority to get seven to nine hours of sleep every night, ideally waking and going to bed around the same times every day.
The same can be said for chronic stress, which is associated with higher levels of inflammation, lower immune function, reproductive problems and much more. According to the University of Maryland Medical Center, “stress affects most people in some way and leads to rapid changes throughout the body. Almost all body systems (the heart and blood vessels, immune system, lungs, digestive system, sensory organs, and brain) gear up to meet perceived danger … Relaxation lowers blood pressure, respiration, and pulse rate, releases muscle tension, and eases emotional strain.” (9)
To help fight stress and therefore rising cortisol levels, try some of the following natural stress relievers:
- Meditation: This helps reduce the stress response without impairing alertness, concentration or memory. It’s easy to do from home and costs absolutely nothing. Recent studies have shown that mindfulness-based stress reduction (MBSR) techniques are effective stress relievers and result in significant reductions in stress levels in the majority of participants, while also improving quality of life and possibly benefiting functions of the hypothalamic-pituitary-adrenal or HPA axis. (10)
- Acupuncture: Treatments can improve physical factors associated with both stress and health problems, including lowering pain, improving sleep and improving heart functions.
- Hypnosis: This seems to help people with severe stress and can help alleviate symptoms, including digestive problems, addictions and trouble sleeping.
- Deep breathing exercises: Taking deep breaths helps turn down the sympathetic nervous system and kick in the body’s natural relaxation response.
- Massage therapy: A massage, or other forms of touch, can help release oxytocin (a “feel good” hormone) and decrease cortisol levels naturally, while also lowering pain and other symptoms of stress. A study published in the International Journal of Neuroscience found that in stressed patients, massage therapy has stress-alleviating effects that decrease cortisol by an average of 31 percent, while also increasing serotonin and dopamine, which are associated with well-being. (11)
5. Try Adaptogen Herbs
Adaptogen herbs are completely natural and help lower cortisol by boosting your ability to deal with stress. Many also have energizing qualities, antioxidant effects, antidepressant effects, and can help naturally lower fatigue, blood pressure and blood sugar levels. If you’re dealing with Cushing’s disease, it’s best to talk to your doctor before using any herbal treatments, especially if you’re taking medications, but in general these plants have been used safely for thousands of years with little side effects.
There are at least 16 different proven adaptogenic herbs that can help lower cortisol, including:
- licorice root
- holy basil
- medicinal mushrooms, including reishi and cordyceps
Essential oils are also helpful for fighting stress, such as lavender, myrrh, frankincense and bergamot. These are capable of lowering cortisol, reducing inflammation, improving immunity, balancing hormones, and helping with sleep and digestion. (12)
- An estimated 10–15 people per million are affected every year, with the vast majority being women (about 70 percent). Besides being more common in women than in men, Cushing’s disease is most often diagnosed in young to middle-aged adults between 25–40 years old.
- Many people suffering from Cushing’s disease are often misdiagnosed or sent from specialist to specialist, without a concrete answer for what’s causing their symptoms. The problem is that misunderstandings about Cushing’s disease can further increase anxiety, self-blame and chronic stress, which only worsens the underlying issue.
- One of the biggest signs of Cushing’s disease is unexplained weight gain. The average weight gain in patients with Cushing’s is 55 pounds.
- While they’re often used interchangeably, Cushing’s disease is not the same as Cushing’s syndrome. Both refer to excessive levels of cortisol, but the cause is different. In Cushing’s disease, the cause is due to a tumor on the pituitary gland, or sometimes, a tumor on an adrenal gland. Cushing’s syndrome is due to outside influences increasing cortisol levels, such as taking corticosteroid medications.
5 Ways to Help Manage Cushing’s Symptoms
- Consume an anti-inflammatory diet.
- Seek emotional support.
- Help balance hormones with exercise.
- Get enough rest and lower stress.
- Try adaptogen herbs.