Cushing's Syndrome

Cushing's Syndrome Overview:

Cushing's syndrome should not be confused with Cushing's disease. Cushing's syndrome refers to the manifestation of hypercortisolism from any cause. One of the major causes of this condition is excessive use of corticosteroid medications.

 

Aetiology:

+ Cushing's Disease

Cushing's disease is separate from Cushing's syndrome. It involves the excessive production of ACTH from the pituitary.

Excessive ACTh can also be the result of non-pituitary, ectopic, ACTh-secreting tumors such as renal or lung cancers.

+ Cushing's Syndrome

Exogenous corticosteroid use can lead to symptoms very similar to cushing's disease, but is iatrogenic in nature rather than as a result of pituitary malfunciton.

Reducing the dosage of corticosteroids is often all that's needed to releive symptoms, but is not always possible as this may result in insufficient immunosuppression for the patient.

Cushing's syndrome can cause a breakdown of muscle, skin and bone to feed gluconeogenesis, and causes an accumulation of abdominal adiposity.

 

Symptoms:

Hyperglycemia

Hypertension

Frequent Infection

Hirsutism

Muscle Weakness

Skin Bruising

Leg Ulcers

Abdominal Adiposity

Severe Depression

High Cortisol

 

Diagnostic Considerations:

  • Cushing's syndrome is diagnosed by demonstrating pathologic hypercotrisolemia.
  • History of corticosteroid mtherapy
  • Distinguish ACTH independant disease
  • Pituitary or adrenal imaging
  • Cardiovascular and diabetic screening tests

Typical Lab Findings

  • Dyslipidemia
  • Renal calculi (due to boen remineralisation)
  • urinary free cortisol levels over 150 micrograms in 24 hours
  • Hyperglycemia
  • Hypernatremia
  • Hyperkalemia
  • Hypercalcemia
  • Metabolic alkalosis
  • Increased lymphocytes
 

Therapeutic Aims:

1. Improve Stress Adaptation & Neuroendocrine Function

Caution with this step. Depending on the level of Cushing's the patient is experiencing, and the dosage schedule of corticosteroid use, this may have an opposite effect.

  • Adaptogens(Panax quinquefolius, Centella asiatica, Withania somnifera, Eleutherococcus senticosus, Rhodiola rosea)
  • Adrenal Trophorestoratives(Glycyrrhiza glabra, Rehmannia glutinosa)

2. Improve Mood

  • Thymoleptics(Melissa officinalis, Turnera diffusa, Lavandula officinalis)
  • Anxiolytics(Piper methysticum, Valeriana officinalis)
  • Nervine Relaxants(Scutellaria lateriflora, Passiflora incarnata)
  • Nervine Trophorestoratives(Avena sativa)
  • Antidepressants(Hypericum perforatum)

3. Improve Sleep Quality

  • Sedatives(Humulus lupulus, Valeriana officinalis)
  • Nervine Relaxants(Eschscholtzia californica, Scutellaria lateriflora, Passiflora incarnata)

4. Improve Cognitive Function

  • Nootropics(Camellia sinensis, Centella asiatica, Ginkgo biloba, Vinca major, Bacopa monieri)

5. Reduce Fluid Load & Increase Potassium Ions

  • Diuretics(Taraxicum officinalis)
  • Nutritional(Potassium Supplementation)

6. Support Connective Tissue Health

  • Nutritional(Vitamin C, Flavonoids)
  • Connective Tissue Tonics(Centella assiatica, vitis vinefera, Pinus pinasta)

7. Address The Underlying Condition That Required Corticosteroid Use To Begin With (If Applicable)

 

Differential Diagnosis:

  • Cushing's disease
  • Pituitary tumors
  • Renal or lung cancers
  • Diabetes
  • Depression
 

Cautions:

Herbs with glucocorticomimetic activity (such as licorice) needs to be used cautiously alongside exogenous corticosteroids to avoid negative interaction. Concomitant use may exacerbate symptoms of Cushing's syndrome. Always start with a low dose and gradually increase or avoid these substances altogether.

 

Herbs For Cushing's Syndrome

  • Curcuma longa
  • Codonopsis pilosula
 

Nutrients For Cushing's Syndrome

  • Chromium
  • Quercetin
  • Omega 3
  • Magnesium
  • B vitamins
  • Antioxidants
 

Author:

Justin Cooke

The Sunlight Experiment

Updated: June 2018


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