Treatment for Cushing’s Syndrome
If you have exogenous Cushing’s syndrome caused by a glucocorticoid medication, your healthcare provider will gradually reduce your dose. Your provider will try to find the lowest dosage that still helps treat any inflammatory conditions you’re experiencing while also minimizing the effect that the drug is having on your Cushing’s syndrome symptoms. In some cases, they may switch you to a different steroid drug altogether.
Generally, you won’t need any other treatments to resolve Cushing’s syndrome in this situation, but it may take you several months to recover, Fleseriu notes. But if you have endogenous Cushing’s syndrome caused by a tumor, surgery to remove the tumor may be recommended in most cases. “Complete resection [removal] of the tumor is the desired goal, but not always possible,” says Fleseriu, especially when it comes to pituitary tumors. “Treatment should be highly individualized.”
Surgery is considered the optimal treatment for a pituitary or adrenal tumor causing Cushing’s syndrome. While 90 percent of pituitary tumor surgeries by an experienced surgeon are successful, they aren’t always a cure and may need to be repeated. If an adrenal tumor is causing your symptoms, in most cases it affects only one adrenal gland. Your surgeon will remove the entirety of that adrenal gland. Rarely, both adrenal glands need to be removed. If they are, you’ll need lifelong medication to replace the hormones the adrenal glands make.
Other treatments are available, however. Medications can help lower the level of cortisol when surgery isn’t an option or doesn’t cure your symptoms. While medications are not a cure, they can help control cortisol and improve symptoms. If your healthcare provider thinks medications are a good option for you, they may prescribe one of the following drugs:
- ketoconazole (Nizoral)
- levoketoconazole (Recorlev)
- metyrapone (Metopirone)
- mifepristone (Korlym)
- osilodrostat (Isturisa)
- pasireotide (Signifor)
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