Cushing’s Syndrome

Basically, Pituitary corticotrope adenomas account for 70% of patients with endogenous causes of Cushing’s syndrome.

However, it should be emphasized that iatrogenic hypercortisolism is the most common cause of cushingoid features.[1]

Causes of Cushing’s Syndrome

1.Firstly,  ACTH excess i.e.: –

• Cushing’s disease Ectopic ACTH secretion
• Carcinoma of lung (especially small cell)
• Carcinoid tumors of either thymus or lung
• Medullary carcinoma of thyroid
• Carcinoma of colon
• Pheochromocytoma

2.Secondly, Non-ACT dependent i.e.: –

• Primary unilateral adrenocortical tumors (either adenoma or carcinoma)
• McCune-Albright syndrome: Bilateral tumor (e.g. Gsα mutation)
• Primary pigmented nodular dysplasia

3. Thirdly, ACTH – independent i.e.: –

• Macronodular adrenal hyperplasia Spontaneous Cushing’s syndrome

Sign & Symptoms of Cushing’s Syndrome

[1]

Diagnosis of of Cushing’s Syndrome

• In general, These tests may include increased 24-h urinary free cortisol excretion in three separate collections, failure to appropriately suppress morning cortisol after overnight exposure to dexamethasone, also evidence of loss of diurnal cortisol secretion with high levels at midnight, the time of the physiologically lowest secretion.
• Tests indicating cortisol overproduction i.e.-
  • 24-hour urinary cortisol excretion
  • Overnight dexamethasone suppression test
  • Low-dose dexamethasone suppression test
  • High-dose dexamethasone suppression test
  • Corticotrophin-releasing hormone test [1]

Treatment of of Cushing’s Syndrome

• Basically, Antiglucocorticoid drug.
• Moreover, In ACTH-independent disease, treatment consists of surgical removal of the adrenal tumor.
• The treatment of choice is selective removal of the pituitary corticotrope tumor, usually via an endoscopic transsphenoidal approach.
• Besides this, If pituitary disease recurs, there are several options, including second surgery, radiotherapy, stereotactic radiosurgery, also bilateral adrenalectomy.
• Lastly, In some patients with very severe, overt Cushing’s (e.g., difficult to control hypokalemic either hypertension or acute psychosis), it may be necessary to introduce medical therapy to rapidly control the cortisol excess during the period leading up to surgery. [1]

Homoeopathic Treatment of of Cushing’s Syndrome

Homeopathy treats the person as a whole. It means that homeopathic treatment focuses on the patient as a person, as well as his pathological condition. The homeopathic medicines selected after a full individualizing examination and case-analysis.

 Which includes

•  The medical history of the patient,
• Physical and mental constitution,
• Family history,
• Presenting symptoms,
• Underlying pathology,
• Possible causative factors etc.

 A miasmatic tendency (predisposition/susceptibility) also often taken into account for the treatment of chronic conditions.

 What Homoeopathic doctors do?

A homeopathy doctor tries to treat more than just the presenting symptoms. The focus is usually on what caused the disease condition? Why ‘this patient’ is sick ‘this way’?

The disease diagnosis is important but in homeopathy, the cause of disease not just probed to the level of bacteria and viruses. Other factors like mental, emotional and physical stress that could predispose a person to illness also looked for. Now a days, even modern medicine also considers a large number of diseases as psychosomatic. The correct homeopathy remedy tries to correct this disease predisposition.

The focus is not on curing the disease but to cure the person who is sick, to restore the health. If a disease pathology not very advanced, homeopathy remedies do give a hope for cure but even in incurable cases, the quality of life can greatly improve with homeopathic medicines.

Medicine for Cushing’s Syndrome:

Calcarea carbonica:

• Fair, fat, flabby and perspiring also cold, damp and sour. Additionally, Apprehensive.
• Craving for indigestible things – chalk, coal, peanuts.; also, for eggs, salt also sweets. Milk disagrees.
• Ravenous hunger. Besides this, Repugnance to hot food. Wants cold drinks.
• All in all, Loss of appetite when overworked. Palpitation. Weakness. Worse – especially; at night, after eating.

Fucous vesiculosus:

• Especially indicated medicine “For obesity and non – toxic goiter.”
• Furthermore, Digestion is furthered and flatulence is diminished, Obstinate constipation.
• Forehead feels as if compressed by iron ring.
• Lastly, Thyroid enlargement in obese subjects.

Graphites:

• Generally, Stout, fair complexion with tendency to skin affections also constipation, fat, chilly and costive.
• Moreover, Tendency to obesity. Aversion to meat. Besides this, Sweets nauseate.
• Hot drinks disagree. Additionally, Burning in stomach causing hunger.
• Worse – warmth, night, during also after menstruation. On the other hand, Better – dark, from wrapping up.

Mercurious:

• Good medicine for Cushing’s Syndrome.
• Bruised pain in small of back, especially when sitting. Tearing pain in coccyx, better pressing on abdomen.
• Extremities – Weakness of limbs, bone-pain alsonin limbs, worse night.
• Patient very sensitive to cold. Additionally, Oily perspiration.
• Trembling extremities, especially hands, paralysis agitans. Specifically, Lacerating pains in joints.
• Cold, clammy sweat on legs at night. Lastly, Dropsical swelling of feet also legs.

Phosphorus:

• Back- Burning in back; especially, pain as if broken, heat between the shoulder blades, Weak spine.
• Extremities- Weakness and trembling from every exertion.
• Can scarcely hold anything with hands. Tibia inflamed also becomes necrosed.
• Arms, hands become numb. All in all, Can lie only right side, joints suddenly give way.

Thyroidinum:

• Specifically indicated medicine for Cushing’s Syndrome.
• Most importantly, Thyroid exercises a general regulating influence over the mechanism of the organs of nutrition, growth and development.
• Another key point is that, Thyroid weakness causes decided craving for large amounts of sweets.
• At last, Excessive obesity. Best with pale patients. Weak; tachycardia; Palpitation from least exertion.

Silicea:

• Back Weak spine, very susceptible to draughts on back. Additionally, Pain in coccyx, diseases of bones of spine.

Capsicum:

• Lax fiber, weak; diminished vital heat. Generally, Fat, indolent, opposed to physical exertion.
• General uncleanliness of body. Especially in Homesickness.
• Worse – while eating, from heat. Whereas; Better – open air, uncovering, draughts.[2]

• Reducing sodium intake
• Increasing calcium and vitamin D intake
• Reducing cholesterol
• Controlling blood sugar
• Reducing or eliminating alcohol and tobacco [3]

Frequently Asked Questions

What is Cushing’s Syndrome?

Cushing’s syndrome refers to the clinical manifestations induced by, chronic exposure to excess corticosteroid.

Homeopathic Medicines used by Homeopathic Doctors in treatment of Cushing’s Syndrome?

• Calcarea carbonica
• Fucous vesiculosus
• Graphites
• Mercurious
• Phosphorus
• Thyroidinum
• Silicea
• Capsicum

What are the symptoms of Cushing’s Syndrome?

• Weight gain
• Central obesity
• Rounded face, fat pad on back of neck (in other words, “buffalo hump”)
• Facial plethora
• Thin also brittle skin
• Osteopenia, Osteoporosis
• Weakness
• Proximal myopathy
• Hypertension
• Hypokalemia
• Edema
• Atherosclerosis
• Irritability, Motional lability, also Depression

What are the causes of Cushing’s Syndrome?

• Ectopic ACTH secretion
• Carcinoma of lung
• Carcinoid tumors of either thymus or lung
• Medullary carcinoma of thyroid
• Carcinoma of colon
• Pheochromocytoma
• adenoma
• McCune-Albright syndrome
• Primary pigmented nodular dysplasia
• Macronodular adrenal hyperplasia