What Are the Treatments for High Cortisol?

Operating theatre team tending to patient
People are working in an operating room. (Image: Jochen Sand/DigitalVision/Getty Images)

High cortisol levels, or Cushing's syndrome, occur when the body is exposed to high levels of cortisol, according to the National Institutes of Health. Cushing's syndrome can be caused by taking too much corticosteroid medication, or by tumors in the pituitary gland, adrenal glands or some other part of the body. Patients with high cortisol levels may experience weight gain, acne, easy bruising, backache, bone pain, impotence and fatigue. Thus, early treatment of high cortisol is necessary to improve symptoms.

Adjust Medications

According to MayoClinic.com, a patient on high-dose or long-term corticosteroids should decrease steroid use to reduce high cortisol levels. A patient should never immediately discontinue using corticosteroids, but consult a doctor for a regimen to decrease current doses. A sudden decrease in corticosteroid use can result in serious complications. Slowly reducing cortisol levels will allow the adrenal glands to resume making adequate levels of cortisol.

Surgery

If medications are not the cause of high cortisol levels, the source of excess cortisol release in the body needs to be detected. Tumors in the adrenal glands, pituitary glands or other organs can secrete cortisol. Thus, removal of the tumor is necessary to cure high cortisol levels.

In this case, a patient should have the proper tests done to find the source. Then, he should discuss treatments options with his surgeon, which may include surgery. The risks and benefits of each case differ; thus, a patient should thoroughly discuss these with his surgeon. In general, there is a risk of infection, excessive bleeding, soft tissue damage or organ damage. In some cases, lifelong cortisol replacement may be necessary, states MayoClinic.com. Drugs commonly used include ketoconazole, mitotane and metyrapone.

Radiation Therapy

According to MayoClinic.com, radiation therapy may be necessary if a surgeon cannot fully remove a pituitary tumor. In this case, radiation therapy may be necessary after the operation. Radiation is typically given over a six-month period through a technique called stereotactic surgery or gamma-knife radiation. Radiation is isolated to the tumor, and exposure to the surrounding tissues is minimized. A patient should let his surgeon know if he experiences side effects during or after radiation therapy.

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