Key Takeaways
- Understanding exogenous cushing syndrome seniors is important for seniors and their caregivers.
- Most people with Cushing syndrome have:
- Your health care provider will perform a physical exam and ask about your symptoms and the medicines you are taking.
- The treatment is to decrease and eventually stop taking any corticosteroids.
- Slowly tapering the medicine that is causing the condition can help reverse the effects of adrenal gland shrinkage (atrophy).
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Exogenous Cushing syndrome is a form of
Cushing syndrome
that occurs in people taking glucocorticoid (also called corticosteroid, or steroid) hormones.
What Are the Common Causes and Risk Factors?
Understanding exogenous cushing syndrome seniors is important for seniors and their caregivers. cushing syndrome is a disorder that occurs when your body has a higher than normal level of the hormone cortisol. This hormone is normally made in the
adrenal glands
.
Exogenous means caused by something outside the body. Exogenous Cushing syndrome occurs when a person takes man-made (synthetic) glucocorticoid medicines to treat a disease. These medicines act like cortisol in the body. Prednisone, dexamethasone, and prednisolone are examples of this type of medicines.
Glucocorticoids are given for many diseases, such as lung diseases, skin conditions, inflammatory bowel disease, cancer, brain tumors, and joint disease. These medicines come in many forms, including pill, intravenous (IV), injection into a joint, enema, skin creams, inhalers, and eye drops.
What Are the Symptoms and Warning Signs?
Most people with Cushing syndrome have:
-
Round, red, full face (
moon face
)
- Slow growth rate (in children)
- Weight gain with fat accumulation on the trunk, but fat loss from the arms, legs, and buttocks (central obesity)
Skin changes that are often seen include:
- Skin infections
-
Purple stretch marks [1/2 inch (in) or 1 centimeter (cm) or more wide], called
striae
, on the skin of the abdomen, thighs, upper arms, and breasts
- Thin skin with easy bruising
Muscle and bone changes include:
- Backache, which occurs with routine activities
-
Bone pain or tenderness
- Collection of fat between the shoulders and above the collar bone
-
Rib and spine fractures caused by
thinning of the bones
- Weak muscles, especially of the hips and shoulders
Body-wide (systemic) problems may include:
-
Type 2 diabetes
- High blood pressure
-
High blood cholesterol
and triglycerides (hyperlipidemia)
Women with Cushing syndrome may have:
- Excess hair growth on the face, neck, chest, abdomen, and thighs
- Periods that become irregular or stop
Men may have:
- Decreased or no desire for sex (low libido)
-
Erection problems
Other symptoms that may occur include:
-
Mental changes, such as
depression
, anxiety, or changes in behavior
-
Fatigue
- Frequent infections
- Headache
- Increased thirst and urination
📖 What Are Exams and Tests?
What Are Exams and Tests?
Your health care provider will perform a physical exam and ask about your symptoms and the medicines you are taking. Tell your provider about all medicines you have been taking for the past several months. Also, tell your provider about shots that you received at a provider’s office.
If you use hydrocortisone (cortisol), prednisone, or other corticosteroids, the following test results may suggest exogenous Cushing syndrome:
-
Low
ACTH level
-
Low
cortisol level
(or high cortisol level) in the blood or urine, depending on the medicine you are taking
-
Abnormal response to a
cosyntropin (ACTH) stimulation test
-
Higher than normal
fasting glucose
level
-
Low
blood potassium
level
-
Low bone density, as measured by
bone mineral density test
- High blood 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.
📖 How Is It Treated?
How Is It Treated?
The treatment is to decrease and eventually stop taking any corticosteroids. This may be done slowly or quickly, depending on why you are being treated with corticosteroid. Do not stop taking any medicine without first talking to your provider. Suddenly stopping corticosteroids after taking them for a long time (usually more than 2 weeks) can result in a life-threatening condition called
adrenal crisis
.
If you cannot stop taking the medicine because of the disease it is treating (for example, you need glucocorticoid medicine to treat severe asthma), follow your provider’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 medicines.
-
Taking medicines to prevent bone loss. This can help reduce the risk for fractures if you develop
osteoporosis
.
- Taking other medicines to decrease the amount of glucocorticoid medicine that you need.
📖 What Is Outlook (Prognosis)?
What Is Outlook (Prognosis)?
Slowly tapering the medicine that is causing the condition can help reverse the effects of adrenal gland shrinkage (atrophy). This may take months to 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.
📖 What Are Possible Complications?
What Are Possible Complications?
Health problems that may result from exogenous Cushing syndrome include any of the following:
- Low immune system function, which may lead to frequent infections
- Damage to the eyes, kidneys, and nerves due to untreated high blood sugar
-
Diabetes
- High blood cholesterol levels
- Increased risk for heart attack from untreated diabetes and high cholesterol
- Increased risk for blood clots
- Weak bones (osteoporosis) and increased risk for fractures
These complications can generally be prevented with proper treatment.
📖 When to Contact a Medical Professional?
When to Contact a Medical Professional?
Contact your provider if you are taking a corticosteroid and you develop symptoms of Cushing syndrome.
📖 How Is It Prevented?
How Is It Prevented?
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.
Cushing syndrome – corticosteroid induced; Corticosteroid-induced Cushing syndrome; Iatrogenic Cushing syndrome; Exogenous Cushing’s syndrome
Auchus RJ, Pandey CEF. The adrenal cortex. In: Melmed S, Auchus RJ, Goldfine AB, Rosen CJ, Kopp PA, eds.
Williams Textbook of Endocrinology
. 15th ed. Philadelphia, PA: Elsevier; 2025:chap 13.
Fragaso MCBV, Berthon A, Bertherat J. Adrenocorticotropic hormone-independent Cushing syndrome. In: Robertson RP, ed.
DeGroot’s Endocrinology
. 8th ed. Philadelphia, PA: Elsevier; 2023:chap 97.
Nieman LK. Adrenal cortex. In: Goldman L, Cooney KA, eds.
Goldman-Cecil Medicine
. 27th ed. Philadelphia, PA: Elsevier; 2024:chap 208.
Updated by: Sandeep K. Dhaliwal, MD, board-certified in Diabetes, Endocrinology, and Metabolism, Springfield, VA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
-
Cushing’s Syndrome
Frequently Asked Questions
Key Takeaways
Your health care provider will perform a physical exam and ask about your symptoms and the medicines you are taking. The treatment is to decrease and eventually stop taking any corticosteroids.
What Are the Common Causes and Risk Factors?
adrenal glands
.
What Are the Symptoms and Warning Signs?
Round, red, full face (
moon face
)
Slow growth rate (in children)
Weight gain with fat accumulation on the trunk, but fat loss from the arms, legs, and buttocks (central obesity)
Skin changes that are often seen include:
Skin infections
Purple stretch marks [1/2 inch (in) or 1 centimeter (cm) or more wide], called
striae
, on the skin of the abdomen, thighs, upper arms, and breasts
Thin skin with easy bruising
Muscle and bone changes include:
Backache, which occurs with routine activities
Bone pain or tenderness
Collection of fat between the shoulders and above the collar bone
Rib and spine fractures caused by
thinning of the bones
Weak muscles, especially of the hips and shoulders
Body-wide (systemic) problems may include:
Type 2 diabetes
High blood pressure
High blood cholesterol
and triglycerides (hyperlipidemia)
Women with Cushing syndrome may have:
Excess hair growth on the face, neck, chest, abdomen, and thighs
Periods that become irregular or stop
Men may have:
Decreased or no desire for sex (low libido)
Erection problems
Other symptoms that may occur include:
Mental changes, such as
depression
, anxiety, or changes in behavior
Fatigue
Frequent infections
Headache
Increased thirst and urination
📖 What Are Exams and Tests?
What Are Exams and Tests?
How Is It Treated?
About the Author: This article was researched and written by the SilverWell Hub editorial team. It was medically reviewed by Dr. Sarah Mitchell, MD, Geriatrics.
Sources: This article is adapted from MedlinePlus, a service of the National Library of Medicine.
Disclaimer: This information is for educational purposes only. See our full Medical Disclaimer.
Published: July 21, 2026 | Next review: January 2027
