Hormonal disorders
Adrenal glands: cortisol, Cushing's syndrome, Addison's disease
Short answer
Cortisol is a hormone made in the cortex of the adrenal gland and known as the “stress hormone.” During stress, it keeps us “on our feet.” Too much of it leads to Cushing's syndrome, and too little to Addison's disease. The doctor notes that in most cases, excess cortisol is caused by the uncontrolled and incorrect use of medications that contain cortisol.
Schematic illustration
General information
- Cortisol's functions: controls the response to stress, stabilizes blood sugar, regulates blood pressure, reduces inflammation.
- When cortisol is high: insomnia and fatigue, weight gain (especially around the abdomen), mood swings and anxiety.
- When cortisol is low: weakness and lack of energy, low blood pressure, loss of appetite and weight loss.
- Prevention: enough sleep, physical activity, stress management (for example, breathing exercises). The cortisol level is checked with a test and, when needed, treated by a doctor.
- Cushing's syndrome.
- What it is: release of more cortisol than normal. Causes: taking hormonal medications, adrenal gland tumors, or overproduction of the hormone ACTH in the pituitary.
- Signs: a rounded face (“moon face”) and facial redness; fat accumulation on the abdomen and waist, while the parts of the arms and legs closest to the torso stay thin; stretch marks (striae); muscle weakness; irregular periods in women; high blood pressure.
- Diseases that join in secondarily: diabetes, weakened immunity, osteoporosis, infertility, hirsutism, acne.
- Treatment depends on the cause: medication, radiation or surgery.
- Stretch marks (striae).
- Depending on color and size, they can point to different diseases.
- Pale stretch marks that can be felt by hand are often linked to gaining and losing weight.
- If a mark is 1 cm or larger and dark red-purple in color, it is time to see a doctor. The cause can range from a simple metabolic disorder to serious diseases, sometimes of the adrenal glands.
- Warning signs: weight gain, marks like these, a change in the shape of the face (rounding), irregular periods in women, unexplained high blood pressure.
- Addison's disease.
- What it is: for certain reasons (infection, an autoimmune process, genetic factors, etc.), the adrenal glands cannot perform their function. The main cause is cortisol deficiency; other hormones can also decrease.
- Signs: lack of energy, fatigue, nausea, vomiting, frequent drops in blood sugar, low blood pressure, loss of appetite, weight loss (sometimes up to 10–15 kg). Also darkening of the skin on the arms and legs, cheeks, gums, nail beds, chest, around the genitals and in skin folds.
- The diagnosis is made with both blood tests and instrument-based examinations. The missing hormones are replaced with medications taken by mouth.
- Blood pressure and hormones (hypertension with an endocrine cause).
- Some causes of high blood pressure are endocrine: hypothyroidism, Cushing's syndrome, pheochromocytoma, primary hyperaldosteronism, etc.
- Examination: measuring blood pressure at home, kidney function (creatinine, urine), blood sugar and lipid profile, ECG, hormone tests when needed.
- Hypertension often has no symptoms, but it increases the risk of heart attack and stroke.
- In people with diabetes, the target blood pressure is usually <130/80 mmHg.
- The doctor's reminder: too much salt affects not just blood pressure but the endocrine system too.
Q&A
Could my excess weight be caused by Cushing's syndrome?
Yes, it can. See an endocrinologist, especially if you have rapid weight gain on the torso, a “moon face,” wide dark red-purple stretch marks, muscle weakness and unexplained high blood pressure.
When should stretch marks be a cause for concern?
If a stretch mark is 1 cm or more wide, is dark red-purple in color, and there are also signs such as weight gain, a rounded face, irregular periods or unexplained high blood pressure.
How can you recognize Addison's disease?
If lack of energy, weight loss, low blood pressure, nausea, frequent drops in blood sugar and darkening of the skin (gums, nail beds, skin folds) occur together, see an endocrinologist.