Hormonal imbalance can affect the entire body and mind. We explain it here.
Hormones have vital functions in our body, since they help us to signal processes and coordinate the action of different vital systems. What happens when a hormone does not stop expressing itself? How serious can hormonal dysregulation be?
In this article we will talk about Cushing’s Syndrome , a hormonal pathology that affects between 40 and 80 people per million inhabitants annually, the majority of these women (3 out of 4 affected) and we will discover some of the effects that hormones in our body.
What is Cushing’s Syndrome?
Cushing’s syndrome manifests itself when the affected person is constantly exposed to amounts of glucocorticoids (steroid hormones) higher than those generated by our body under normal conditions. This causes imbalances in many systems of our body, since these hormones have a large number of tissues with which they interact to vary their function.
In patients with Cushing’s syndrome we will find a high presence of cortisol, a steroid hormone secreted by the adrenal glands, which is the cause of the symptoms. In most cases, this occurs due to a mismatch in the organ that is responsible for controlling the production of cortisol: The hypophysis , also known as the pituitary gland, which is located in the skull next to the hypothalamus.
The role of the pituitary in this case is to control the production of cortisol, through the adrenocorticotropic hormone (hereinafter HACT, in English ACTH), which stimulates the adrenal glands so that they in turn release cortisol. The pituitary gland is responsible for keeping cortisol production regulated in accordance with circadian rhythms, with HACT production being greater when we wake up than when we go to bed.
Under normal conditions, we can also see an increase in cortisol production when we are exposed to stress. In contrast, a person with Cushing’s syndrome will consistently have much higher levels of cortisol in their blood , which can end up causing a wide range of symptoms, which we discuss below.
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Symptoms
The clearest and most visible symptoms of Cushing’s Syndrome are those related to rapid weight gain that follows a central distribution pattern, that is, it mainly affects the head, neck and torso of patients.
This results in the so-called “moon face”, or a fattening of the face of patients, as well as the accumulation of fat in the upper part of the back, causing a kind of hump.
Being a hormonal syndrome, we can observe a wide variety of symptoms, including:
- Systemic : Tiredness, weight gain
- From hair, fat and skin : Hair loss, hair growth (hirsutism), stretch marks
- Psychiatric : Anxiety, depression, memory impairment
- Infectious : Immune system depressed by cortisol
- Metabolic : Diabetes, kidney stones
- Cardiovascular : Hypertension, Increased tendency to form thrombi
- Reproductive : Impotence, infertility
- Musculoskeletal : Weakness in proximal muscles, back pain, bone decalcification
Causes
As we have previously mentioned, the cause of the symptoms in Cushing’s syndrome is the presence of excessive amounts of cortisol in the blood . This can occur through exogenous or endogenous pathways (produced by our body) depending on the origin of the corticosteroids.
1. Exposure to exogenous glucocorticoids
Patients receiving steroid medication to decrease the effects of the immune system, such as transplant recipients or those who need anti-allergy medication.
Recently, attention has been drawn to skin whitening creams , common in Asia and Africa, as they may contain corticosteroids. The use of these creams is constant and in large areas of the skin, which increases the risk of increasing the amount of glucocorticoids in the blood.
2. Tumors that increase the amount of cortisol in the blood
They are tumors that can directly affect the pituitary gland or the adrenal glands, causing dysregulation of the different hormones.
Pituitary tumors are usually too small to have a negative effect on patients and are relatively common, but large ones are capable of leading to Cushing’s syndrome. There are also tumors capable of secreting HACT or cortisol, without having to be associated with the organs that commonly generate these hormones.
The different pathways and possible causes of Cushing’s Syndrome, as well as the different morphologies of the causative tumors, give rise to a wide range of symptoms of greater or lesser severity in different patients.
Treatment
Cushing’s syndrome is treatable in most cases, provided that the amount of glucocorticoids to which the patient is exposed can be decreased. For this, it is necessary to clearly identify the origin of the syndrome through tests that allow ruling out the rest of the possible causes and choosing the most appropriate treatment.
One of the ways to elucidate the origin of the syndrome is the analysis of the patient’s saliva between 11:00 p.m. circadian to perform its functions, we can see if the cause of the syndrome is an overactive pituitary gland (or a tumor capable of synthesizing HACT) or other less common causes, such as adrenal tumors.
When hormones are produced in our own body, intervention to remove the tumor causing the hormonal surge is necessary for the patient’s improvement. On the other hand, if the hormonal source is external, a greater control of the medication or the elimination of the factor that introduces exogenous hormones into the body of the affected person may suffice for it to improve.
In those cases in which it is not possible to eliminate the cause of the syndrome, such as inoperable tumors, medication may be necessary to reduce the generation of these steroid hormones.
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Bibliographic references
- Gotch PM. Cushing’s Syndrome From the Patient’s Perspective. Endocrinology and Metabolism Clinics of North America.
- Raff H, Webon Findling JW. (2003). A physiologic approach to diagnosis of the Cushing syndrome. Ann Intern Med.
- Yetunde M. Olumide. (2008). Complications of chronic use of skin lightening cosmetics. International Journal of Dermatology
To the classic question “what do you do?” I always answer “basically I am a psychologist”. In fact, my academic training has revolved around the psychology of development, education and community, a field of study influenced my volunteer activities, as well as my first work experiences in personal services.
