Cushing syndrome: Symptoms and treatment

September 5, 2025

Providence Health Team

[6 MIN READ]

Cushing syndrome is a rare hormonal disorder that occurs as a result of large amounts of cortisol (the stress hormone) building up in your body.
Cushing syndrome signs and symptoms include unexpected weight gain, especially in the face, belly and top of the back; slow wound healing; muscle weakness; and bruising easily.
There are two main types of causes for Cushing syndrome: endogenous, which means the cause comes from within your body, and exogenous, which means the cause comes from outside your body, such as through steroid injections.

Cushing syndrome: Signs, symptoms and treatment

In early 2024, the rare hormonal disorder Cushing syndrome made headlines when comedian Amy Schumer revealed she suffered from it. Since then, the disorder has been trending as more people have been taking medications that could cause it to surface.

We talked with Providence endocrinologist Chih-Han Lee, M.D., who sees patients in Burbank, California, about Cushing syndrome signs and symptoms, what causes these signs and symptoms, and how the disorder can be treated.

What is Cushing syndrome?

Cushing syndrome occurs when your body has been exposed to large amounts of cortisol over a long period of time. Cortisol is a hormone that your body releases during times of stress, increasing your heart rate, blood pressure and muscle tension.

There are two main causes of Cushing syndrome:

Endogenous is when the causes come from within your body — typically a tumor in the pituitary gland or one of the adrenal glands.
Exogenous is when you develop the disorder because of the side effects of steroid medications, such as prednisone or hydrocortisone, that you take to treat other conditions. This is the type of Cushing syndrome that Schumer has.

Signs and symptoms of Cushing syndrome

Some of the main physical signs and symptoms of Cushing syndrome include:

Unexpected weight gain, especially around the belly
Irregular menstrual cycles
Muscle weakness
Fractures
Slow wound healing
Feeling tired
Bruising easily
A red, round and puffy face — sometimes called moon face
A fatty lump between the shoulders that some people call buffalo hump
Wide pink or purple stretch marks on the belly
High blood pressure
High blood sugar

In addition to the physical signs, there can be psychological symptoms of Cushing syndrome, including:

Depression
Anxiety
Irritability
Cognitive impairment
Mood and behavior disorders

What causes these signs and symptoms?

The symptoms of Cushing’s disease largely depend on whether the cause is endogenous or exogenous.

Endogenous causes

Cushing disease is a type of Cushing syndrome, and it involves a benign tumor in the pituitary gland that releases too much adrenocorticotropic hormone (ACTH). It is by far the most common cause of Cushing syndrome — it accounts for about 70% of the cases.

Another endogenous cause of Cushing syndrome is a tumor on the adrenal gland itself. Such tumors are usually benign, but they can sometimes be an adrenal cortical carcinoma, which is a rare type of adrenal cancer.

In a few situations, Cushing syndrome can result from lung, pancreas, thyroid and thymus tumors. This is called ectopic ACTH syndrome, and it occurs when tumors that develop outside the pituitary gland produce ACTH. These tumors are usually cancerous.

Exogenous causes

The main exogenous cause of Cushing syndrome is the use of glucocorticoid medications. These medications are used to treat autoimmune diseases such as chronic asthma, lupus, sarcoidosis and rheumatoid arthritis.

Schumer received steroid injections to treat the scars from her breast reduction and cesarean section surgeries. The injections led to her developing Cushing syndrome.

How is Cushing syndrome diagnosed?

According to Dr. Lee, Cushing syndrome can be hard to diagnose because symptoms vary, and can range from mild to severe, depending on how much extra cortisol is in the body.

“We can make a diagnosis when a person shows signs and symptoms of the condition and lab tests confirm high levels of cortisol,” Dr. Lee says. “However, several other conditions, such as obesity, pregnancy, severe stress, poorly controlled diabetes, eating disorders, depression, alcoholism, polycystic ovary syndrome (PCOS), sleep apnea, chronic kidney disease and certain medications, can also raise cortisol levels. Because of these conditions, testing for Cushing's syndrome is recommended when there is a strong suspicion for it.”

Common tests to check cortisol levels include:

Dexamethasone suppression test – you take a dose of the substance dexamethasone, and then you have a blood sample taken the next morning to measure the amount of cortisol in your blood
Late-night salivary cortisol – measures the amount of cortisol in a saliva sample taken late at night
Late-night blood cortisol – measures the amount of cortisol in a blood sample taken late at night
24-hour urine cortisol – you collect urine in a container for 24 hours

Your doctor can confirm a diagnosis of Cushing syndrome when cortisol levels are high on at least two of these tests, and you also have symptoms.

Treatment options for Cushing syndrome

Treatment for Cushing syndrome, says Dr. Lee, depends on the cause. “If corticosteroid medications are the cause,” he says, “lowering the dose or slowly stopping the medication may help. If a tumor is the cause, surgery to remove the tumor is often the best treatment.”

If you need to wait for surgery, or if it’s not possible, you can use medications to lower your cortisol level.

Cushing syndrome can be cured, but if the tumor cannot be removed, then it may become a long-term condition. Some people develop the disorder because they need corticosteroid medications for other conditions, such as autoimmune or inflammatory diseases, or to prevent organ rejection after a transplant. If they need high doses of corticosteroid medications for a long time, they might develop Cushing syndrome, which could be lifelong if the medication dose cannot be lowered.

When to see a doctor for Cushing syndrome symptoms

You should see a doctor if you notice any of the above Cushing syndrome signs and symptoms. In particular, you should watch out for unusual weight gain (particularly in the abdomen, face or upper back), skin that bruises easily, muscle weakness or mood swings.

“Since many other conditions can also raise cortisol levels,” says Dr. Lee, “testing should only be done if there is a strong reason to suspect Cushing syndrome based on your symptoms, medical history and a physical exam.”

Complications of untreated symptoms

If you don’t get the right treatment for Cushing syndrome, it can cause multiple complications, including:

Type 2 diabetes
High blood pressure, which can lead to heart problems and other serious issues
Loss of muscle mass and strength
Osteoporosis
Infections

Find expert care at Providence

You can find treatment for Cushing syndrome and other similar conditions at the Providence Brain and Spine Institute.

Contributing caregiver

Chih-Han Lee, M.D., is a Providence endocrinologist who sees patients in Burbank, California.

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