Glands out of synch with body

This article appears in the print edition of the Irish Times at http://www.irishtimes.com/newspaper/health/2009/0106/1230936690420.html

MARION KERR

CHECK-UP: What happens when the body is exposed to increased levels of cortisol?

A new work colleague has told me she suffers from Cushing's syndrome. I don't want to ask her too many questions but can you tell me what this is and how would she have got it?

Cushing's syndrome is a condition that occurs when the body is exposed to increased levels of a hormone called cortisol. Under normal circumstances, the hypothalamus in the brain triggers a chain of events that causes the adrenal glands to release cortisol into the bloodstream. The adrenal glands, located on the top of the kidneys, usually release only the right amount of the hormone to provide for the body's daily needs.

But problems can arise when signals from the hypothalamus, adrenal glands or other glands such as the pituitary glands are out of synch with what the body needs. This can result in too much cortisol circulating in the blood stream. There are a number of conditions that may precipitate Cushing's syndrome including problems with the adrenal or pituitary glands. It can develop when a person is prescribed medication which influences the amount of the hormone produced by the body or where medication contains cortisol which makes the hormone rise above normal levels.

For some sufferers there is a genetic component to the condition.

What are the symptoms?

Symptoms include upper body obesity, with a characteristic round face and neck but thin arms and legs. Skin problems may develop as can muscle and bone weakness. High blood pressure and high blood sugar may also be a problem. In children with the condition slow growth rates may be noted. Changes in mood such as depression, irritability and moodiness may affect some.

Women with the condition may experience increased hair growth with menstrual irregularities while men may become less fertile and notice a reduced sex drive.

Can it be treated?

The type of treatment prescribed will very much depend on why there is extra cortisol in the body. If the body is making too much cortisol, then treatment may include oral medication, surgery, radiation or a combination of these therapies to reduce these levels.

Where the condition has been caused by the use of medicines containing cortisol to treat another condition, a change of medication may be the answer.