Cushing's syndrome - Symptoms of Cushing's syndrome

The pattern of symptoms in Cushing’s syndrome can be highly unpredictable.

In some cases, the symptoms can develop quickly and be very severe. In other cases, the symptoms can develop gradually and be much milder.

Weight gain and fat deposits

Weight gain is the most common symptom of Cushing's syndrome, particularly on the chest, stomach and face. It occurs because cortisol causes fat to be redistributed to these areas.

People with Cushing's syndrome tend to have:

• slim arms and legs compared with their chest and stomach
• fat deposits on the back of the neck and shoulders; this is known as a 'buffalo hump'
• a red, puffy and rounded face

Children who develop Cushing’s syndrome tend to be obese and have slow growth rates.

Skin changes

Symptoms that affect the skin include:

• thin skin that bruises easily because cortisol causes proteins in the skin to break down and tiny blood vessels to become weak
• reddish-purple stretch marks on the thighs, stomach, buttocks, arms, legs or breasts because cortisol makes the skin fragile
• spots on the face, chest or shoulders
• darkened skin on the neck
• swollen ankles due to a build-up of fluid (oedema)
• heavy sweating (hyperhidrosis)
• bruises, cuts, scratches and insect bites can take a long time to heal

Bones and muscles

People with Cushing's syndrome often have muscle weakness in their hips, shoulders, arms and legs.

Too much cortisol can also cause the bones to become brittle (osteoporosis). This may lead a bone breaking during normal day activities, such as bending and lifting.

Depression and mood

Depression is common in people with Cushing’s syndrome. It is also common to feel unusually tired all the time, which can contribute to feelings of depression.

Many people with Cushing’s syndrome also experience rapid mood swings and have emotional reactions that may seem inappropriate, such as laughing or crying for no apparent reason.

Other symptoms

Other symptoms of Cushing’s syndrome include:

• kidney stones
• high blood pressure (hypertension)
• increased blood sugar levels
• excessive facial and/or body hair (hirsutism), in women 
• loss of libido (sex drive)
• erectile dysfunction – an inability to get or maintain an erection
• infertility, in men
• irregular periods or absent periods, in women