The health care provider will perform a physical exam and ask about your symptoms and the medicines you are taking. Tell the provider about all medicines you have been taking for the past several months.
If you use cortisone, prednisone, or other corticosteroids, the following test results may suggest exogenous Cushing syndrome:
High cholesterol, particularly high triglycerides and low high-density lipoprotein (HDL)
A method called high performance liquid chromatography (HPLC) can show a high level of the suspected medicine in the urine.
Treatment is to slowly decrease and eventually stop taking any corticosteroids. Do not stop taking any medicine without first talking to your health care provider. Suddenly stopping corticosteroids after taking them for a long time can results in an adrenal crisis.
If you cannot stop taking the medicine because of disease (for example, you need steroids to treat severe asthma), follow your doctor's instructions on how to reduce the possibility of developing complications, including:
Treating high blood sugar with diet, oral medicines, or insulin.
Treating high cholesterol with diet or medications.
Taking medicines to prevent bone loss. This can help reduce the risk of fractures if you develop osteoporosis.
Slowly tapering the medicine that is causing the condition can help reverse the effects of adrenal gland shrinkage (atrophy). This may take as long as a year. During this time, you may need to restart or increase the dosage of your steroids in times of stress or illness.
Damage to the eyes, kidneys, and nerves due to untreated high blood sugar
These complications can generally be prevented with proper treatment.
When to Contact a Medical Professional
Call for an appointment with your health care provider if you are taking a corticosteroid and you develop symptoms of Cushing syndrome.
If you take a corticosteroid, know the signs and symptoms of Cushing syndrome. Getting treated early can help prevent any long-term effects of Cushing syndrome. If you use inhaled steroids, you can decrease your exposure to the steroids by using a spacer and by rinsing your mouth after breathing in the steroids.
Stewart PM, Krone NP. The adrenal cortex. In: Melmed S, Polonsky KS, Larsen PR, Kronenberg HM, eds. Williams Textbook of Endocrinology. 12th ed. Philadelphia, PA: Elsevier Saunders; 2011:chap 15.
Susmeeta TS, Nieman LK. Cushing's syndrome: all variants, detection, and treatment. Endocrinol Metab Clin N Am. 2011;40:379-91. PMID: 21565673 www.ncbi.nlm.nih.gov/pubmed/21565673.
Brent Wisse, MD, Associate Professor of Medicine, Division of Metabolism, Endocrinology & Nutrition, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Bethanne Black, and the A.D.A.M. Editorial team.