Moon Facies ( Cushing Syndrome)

Cushing syndrome fat

Last Updated December 20th, 2021

Overview

Accumulation of fat in the facial region can give the face a rounded moon-like appearance. This can occur as a result of obesity. It may also be associated with Cushing syndrome, a disorder characterized by elevated levels of certain chemical substances known as glucocorticoids in the body. The body naturally produces glucocorticoids in the form of hormones like cortisol which influences vital activities such as metabolism and heart function. An excess of glucocorticoids can also occur as a result of taking certain medications.

 

What Is Cushing Syndrome?

Cushing syndrome is a rare endocrine disorder characterized by changes in fat deposit patterns and symptoms such as a persistent headache, high blood pressure, and blood sugar, muscle weakness, irregular periods in women and sexual dysfunction in men. The cause for this is prolonged exposure of the body tissues to abnormally high levels of glucocorticoids. This may be in the form of the hormone cortisol which is produced by the adrenal glands.

The level of glucocorticoids may also be raised artificially by taking certain medications. Cortisol is a vital hormone that helps maintain homeostasis. It regulates metabolism and inflammatory response and maintains the levels of blood sugars and water in the body. Hence, an excess of cortisol causes a disturbance in crucial physiological processes, producing a variety of symptoms throughout the body.

 

Causes

Cushing syndrome cortisolThe source of excess glucocorticoids may be an external one or intrinsic to the body. Generally, the external source is in the form of steroid medications. Within the body, the glucocorticoid hormone cortisol is produced by the adrenal glands. There can be a number of reasons for overactivity of the adrenal gland.
Causes of Cushing syndrome include:

  • Taking high dosages of glucocorticoid medications over a prolonged period of time.
  • A benign tumor of the pituitary gland causing it to produce an excess of adrenocorticotropic hormone (ACTH). This hormone keeps the adrenal gland in a state of hyperactivity leading to an overproduction of cortisol.
  • ACTH secreting tumors can arise in other glands such as the thyroid or pancreas. They can even appear in the lungs. The excess of ACTH leads to overstimulation of the adrenal glands.
  • Having a tumor that causes excess secretion of corticotropin-releasing hormone (CRH). Normally, CRH is produced by the hypothalamus in order to stimulate the pituitary to secrete ACTH which in turn activates cortisol production in the adrenal gland.
  • A tumor of the adrenal cortex, causing the gland to secrete excess cortisol. Both benign and malignant tumors can be responsible for this but the latter is less common.
  • Having a family history of Cushing syndrome caused by tumors of the endocrine system.
  • Being obese increases the risk of having Cushing syndrome.
  • Having type 2 diabetes is another risk factor.
  • Having hypertension is also associated with a higher risk.
  • Women are more likely to develop this disease than men.
  • This disorder is most likely to develop between the ages of 20 and 50.

 

Symptoms

The symptoms of Cushing’s syndrome appear gradually and manifest differently in different individuals. Some people show only mild indications while others may suffer severe symptoms including:

  • Excess accumulation of fat in the trunk and in the area between the shoulders and above the collarbones.
  • Rounded face or moon face. The face may also show some reddening.
  • Loss of fat from arms, legs, and buttocks.
  • Elevated blood pressure.
  • Irritability and anxiety.
  • A headache.
  • Fatigue.
  • Feeling thirsty more often.
  • Frequent urges to urinate.
  • Reduced growth in children.
  • Fragile skin that can get easily bruised.
  • Acne.
  • Purplish stretch marks on the breasts, abdomen, and thighs. The skin is forced to stretch because of abnormal fat deposition.
  • Darkening of the skin on the neck.
  • Recurrent infections.
  • A backache.
  • Swelling around the ankles.
  • Osteoporosis
  • Bone pain.
  • A weakness of muscles of the hips and shoulders.
  • Hirsutism or excess growth of body hair. Women may develop excessive facial hair.
  • Loss of hair from the scalp.
  • Irregular menstrual cycle.
  • Lowered libido.
  • Erectile dysfunction.
  • Enlargement of the clitoris.
  • Mood swings.

 

Types of Cushing Syndrome

Cushing syndrome fatThere are two types of Cushing syndrome:

Endogenous Cushing syndrome: This occurs as a result of the overproduction of cortisol by the adrenal glands. There can be a number of different reasons for this. The activity of the adrenal glands is controlled by ACTH, a hormone produced by the pituitary gland. Tumors arising in the pituitary itself or other endocrine glands can cause a rise in the level of ACTH, leading to overstimulation of the adrenal glands. The pituitary adenoma is one of the most common causes of Cushing disease in women. Alternatively, there may be a tumor in the adrenal gland itself, causing it to secrete an excess of cortisol.

Exogenous Cushing syndrome: The source of excess glucocorticoids is external to the body. Glucocorticoid medications may be prescribed for a number of conditions such as back pains, skin problems or chronic inflammatory diseases such as rheumatoid arthritis or lupus. Taking these medications in high doses over prolonged periods of time can lead to Cushing syndrome. Oral or injectable medications are more likely to cause this disease than topical or inhaled versions.

 

Clinical Complications

Patients are at an increased risk of fractures as a result of osteoporosis. They may suffer recurrent infections and are also likely to develop type 2 diabetes. Persistence of hypertension over the long term can lead to cardiac complications. If untreated, this disease can be fatal. As a result of obesity and fatigue, patients also have a tendency to become isolated and depressed.

 

Diagnosing Cushing Syndrome

cushing syndrome facial hairUpon physical examination of the patient, indicators such as fat accumulation between the shoulders, moon face, stretch marks and hirsutism can raise a suspicion of Cushing disease. However, not everyone who exhibits these features is necessarily suffering from the disease. This complicates the process of diagnosing it. Further, symptoms such as irregular periods and hirsutism in women may also appear in those with polycystic ovary syndrome. It is important to rule out these other possibilities.

In those suffering from Cushing syndrome, blood tests will typically reveal elevated levels of white blood cells and blood sugar and reduced levels of potassium. Urine and blood samples would show abnormally high cortisol content. Testing saliva can help to asses cortisol levels.

If the patient’s medical history reveals the use of glucocorticoid-based medications, it is easier to make a diagnosis. Certain urine tests can help to confirm this.

However, endogenous Cushing syndrome is more challenging to diagnose accurately. The computerized tomography (CT) and magnetic resonance imaging (MRI) help study the condition of the pituitary and adrenal glands and reveal the presence of any abnormalities such as tumors or overgrowth of the adrenal gland. A blood sample from the petrosal sinuses may be drawn under anesthesia. This is compared with a sample from the forearm. If the former sample shows a higher content of ACTH, then it confirms the pituitary gland as the source of the problem. If not, further tests may have to be conducted to locate the cause.

 

Treatment & Prevention

The treatment of Cushing syndrome involves:

  • Medications to decrease cortisol production by the adrenal glands.
  • Drugs that suppress the ACTH production in the pituitary gland.
  • Surgical removal of cancerous growths formed as a result of Cushing syndrome.
  • Radiation therapy or chemotherapy for treating cancer.

Cushing Syndrome can be prevented if one is able to identify the typical symptoms of the disease early on (if he/she is undergoing corticosteroid medication).

  • Keep getting regularly checked for Cushing Syndrome if you are on corticosteroids.
  • Consume a diet that is nutritious, well-balanced, and makes your bones stronger.
  • Get plenty of vitamin D and calcium.
  • Keep yourself stress-free and mentally active.

 

Facts

  • This condition is also called as hypercortisolism and mostly affects people within the age group of 20-50 years.
  • If you are diabetic and/or have a high blood pressure, you have an increased chance of developing this condition.

Facts

  • Cortisol is produced by the adrenal glands, which are located on top of the kidneys. The pituitary gland is responsible for its secretion.
  • The hormone cortisol protects the body from the effects of stress and also impacts protein and carbohydrate metabolism.

Facts

  • It is a relatively rare disease that occurs in only 10-15 people in a million every year and id more frequently diagnosed in women than in men.

Related Conditions

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Dos and Don'ts

Dos
  • Include a lot of antioxidants, whole grains, and healthy fats in your diet.
  • Start with low-impact exercises and gradually build your stamina.
  • Talk to your therapist if you notice symptoms of depression. Depression is quite common among Cushing Syndrome patients.
Don'ts
  • Be hard on yourself and on your body. It takes time to recover from this condition so it’s important to get ample amount of rest.
  • Miss out on follow-up appointments or lead a sedentary life.
  • Have high steroid consumption, through medicines or otherwise, as this can single-handedly increase cortisol levels.

 

 

 

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Eating Disorders: Lifestyle choice or a psychological condition? Is eating disorder just a harmless bad habit? Or does it represent grim psychological disorders? Do you want…
Carb Cycling: Weighing the pros vs the cons of this diet routine Completely discarding carbs from your life will do you more harm than good. Read more about carb cycling,…
sodium chloride
Halotherapy: How inhaling salt can work wonders for your body Halotherapy is quickly gaining popularity amongst those with respiratory diseases. It has shown promise in its treatment.
Ear pain model
Easy and safe tips for ear wax removal you can do at home Cerumen impaction generally occurs when an external object like cotton swabs are used to remove the ear wax.…
colposcopy
Colposcopy Colposcopy is a simple, quick and non- invasive diagnostic tool to look closely inside the vulva, vagina, and…
thyroid_scan
Thyroid Scan Thyroid scan is a diagnostic procedure that aims to view the thyroid gland and detect any growths or…
valproic acid test
Valproic Acid Test Valproic acid test is performed to generally check for psychiatric and even neurological conditions such as bipolar disease…
vdrl test syphilis
VDRL Test The VDRL test is a blood test that is used to diagnose sexually transmitted or venereal diseases, primarily…
liver detox facts
7 liver detox facts and why ignoring these could kill you! Are you taking care of this organ that handles over 500 different vital functions in your body? Your…
High Fiber Diet – Fire up your fiber intake for these health benefits! Regular bowels, healthy detox, higher immunity, and guaranteed weight loss - a high fiber diet can bring all…
Did you know drinking alkaline water could be the healthier choice for you? Ever wondered how safe is your drinking water in terms of pH? Recent studies have revealed that Alkaline…
Piaget stages: Do they accurately describe the way the human brain develops?  A common assumption was that children are less competent thinkers as compared to adults, but this was refuted…
phenytoin test
Phenytoin test Phenytoin is a drug that is administered mainly to epilepsy patients. The phenytoin blood test measures the level…
rosacea-treatment--before-_-after
The best and safest ways to treat rosacea Rosacea is a skin disease that is characterized by reddish hives and rashes on the face. Read more…
Optavia diet
The features of an Optavia diet The Optavia diet endorses pre-packaged meals and snacks called "fuelings" that are tasty, low in calorie, and incorporates…
dance health benefits
5 unbelievable effects of dance on your overall health! You enjoy dancing, but did you know what else it does to your body? Dancing is not only…
What to eat, what not to eat in the South Beach Diet? The South Beach Diet is one among the most popular weight loss programs that have been the talk…
CBC blood test
CBC (Hemogram 6-part diff) blood test CBC (Hemogram 6-part diff) blood test refers to the test that measures the number of RBCs, WBCs, etc…
BoneMarrow-Biopsy
Bone Marrow Biopsy Bone marrow biopsy is a diagnostic procedure where a small amount of bone marrow is extracted from hip…
beta hcg test
Beta hCG Test A Beta hCG test measures the level of human gonadotropin hormones present in the blood that is primarliy…
myelogram
Myelography Myelography is an important diagnostic tool that is used to investigate and identify abnormalities in the spine and…
blood ketone test
Blood Ketone (D3HB) Test The Blood Ketone Test measures and monitors the levels of ketone in the blood which is usually performed…
piles,fistula,fissures
Difference between piles, fissures, and fistula Click to know the difference between piles, fistula and fissure and the best ways to get effective treatment…
L-theanine attention
L-Theanine: Better sleep, higher focus, and many other benefits Did you know that L-theanine found in green tea can make you sleep better and be focused at…
Is it possible to achieve full body detox with Master Cleanse? Master cleanse is a diet consisting of a lemonade based beverage, a salt water drink and a herbal…
Astaxanthin: Why experts believe it could be 550x more potent than vitamin E! What is astaxanthin and why is this new supplement on the block touted as the most powerful antioxidant…
Vitamin b12
Vitamin B12 Test Vitamin b12 is an essential nutrient required for healthy functioning of the nervous system and also development of…
LFT-test
Liver Function Test – LFT LFT or Liver Function Test is a blood test used to determine the levels of hepatic enzymes which…
C-Reactive Protein Test A CRP or c-reactive protein blood test is an important diagnostic tool used to determine the risk of…
Strep throat pain
Anti-Streptolysin-O Test The ASO or Anti-Streptolysin-O is a blood test designed to check for the presence of streptococcus bacterial infection…
about mediterranean diet
Why you should be adopting a Mediterranean style of diet today Ever wondered why the Mediterranean diet is so healthy? One simple solution to lowering risk of several deadliest…
Jicama: A fiber-rich tuber for your weight loss goals Pronouced as HEE-kah-ma, Jicama is the "new kid on the block" that has taken the world by the…
sugar toxic health
Sugar: 7 new shocking truths revealed about the sweet poison Can drinking soda bring you closer to death? Is sugar slowly poisoning you and your family? You would…
nutritional yeast bread
Nutritional Yeast : How can a fungi culture be good for your body? Nutritional yeast: How a simple culture of fungi can transform your skin, digestion, immunity , and much more.…
Cayenne: The remarkable benefits of these red hot chili peppers These may make you rush for a glass of water, but cayenne pepper is actually a healthy additive…
Epley maneuver: Why is this the best protection from the symptoms of vertigo? Epley maneuver is an exercise that can treat the symptoms of benign paroxysmal positional vertigo (BPPV).  It was…