Addison’s disease occurs when your adrenal glands produce too little cortisol. Cushing syndrome is when you have too much cortisol in your body.

Cushing syndrome is a group of symptoms that occur due to too much cortisol in your body. It most often develops due to long-term use of corticosteroid medications.

Three parts of your body play a role in the development of cortisol:

  • Hypothalamus: Your hypothalamus releases corticotropin-releasing hormone (CRH).
  • Pituitary gland: Your anterior pituitary gland produces adrenocorticotrophic hormone (ACTH) in response to CRH.
  • Adrenal glands: Your adrenal glands produce cortisol in response to ACTH.

Addison’s disease is a condition where your adrenal glands produce too little cortisol, and often, too little aldosterone. Aldosterone helps maintain the fluid balance in your body.

Read on to learn more about the similarities and differences between these conditions.

These are the symptoms of Addison’s disease and Cushing syndrome.

Addison’s disease symptoms

Symptoms of Addison’s disease can include:

These symptoms may get worse over time, and you might also develop:

Cushing syndrome symptoms

Symptoms of Cushing syndrome can include:

  • fat and weight gain
  • thin arms and legs
  • round face (moon face)
  • fatty hump between your shoulders
  • increased fat around the base of your neck
  • easy bruising
  • weak muscles
  • purple stretch marks

These are the potential causes of Addison’s disease and Cushing syndrome.

Addison’s disease causes

Addison’s disease is caused by adrenal gland dysfunction. An autoimmune reaction causes about 80–90% of Addison’s disease in people in the United States.

Less commonly, it can be caused by:

Cushing syndrome causes

Causes of Cushing syndrome include:

  • long-term use of corticosteroids
  • pituitary tumors
  • other tumors that produce excess ACTH
  • adrenal gland tumors

These are the risk factors for Addison’s disease and Cushing syndrome.

Addison’s disease risk factors

Addison’s disease affects about 1 in 7,140–10,000 people.

Risk factors for the autoimmune type of Addison’s disease include:

Cushing syndrome risk factors

People taking corticosteroid medications are at the highest risk of developing Cushing syndrome. It’s most common in people ages 30–50 years old and is three times more common in women than men.

It’s important to get medical attention any time you suspect you might have Cushing syndrome or Addison’s disease. Both conditions are often treatable but can severely affect your quality of life unless the underlying cause is addressed.

Tests you might receive to help diagnose Addison’s disease or Cushing syndrome include:

Here’s a look at the treatment options for Cushing syndrome and Addison’s disease.

Addison’s disease treatment

The treatment for Addison’s disease usually involves taking a medication to replace your low hormones. This medication is taken as a tablet two or three times a day.

Hydrocortisone is most commonly used to replace cortisol. Fludrocortisone is used to replace aldosterone.

If you have an infection like TB, you may be given a course of antibiotics for at least 6 months.

Cushing syndrome treatment

Treatment for Cushing syndrome depends on the underlying cause. It may include:

  • gradually decreasing corticosteroid medications
  • surgery for a pituitary tumor
  • treating underlying cancer
  • surgery to remove an adrenal tumor

Here’s a look at the outlook for people with Addison’s disease and Cushing syndrome.

Life expectancy and outlook for people with Addison’s disease

The outlook for people with Addison’s disease is usually good, but most people have to take medications for the rest of their life. Failing to take your medication can lead to a medical emergency called Addisonian crisis.

If you think you may be experiencing an Addisonian crisis, call 911 or local emergency services.

Life expectancy and outlook for people with Cushing syndrome

The outlook for people with Cushing syndrome is variable depending on the underlying cause. Their outlook tends to be poorest if their condition is caused by a hormone-secreting tumor that can’t be removed with surgery.

Surgery to remove pituitary tumors is successful in more than 90% of people who undergo the procedure.

Addison’s disease often isn’t preventable since it commonly occurs due to an autoimmune reaction. You may be able to lower your chances of developing Cushing syndrome by only taking corticosteroids when they’re medically necessary and avoiding exceeding your prescribed dose.

These are some frequently asked questions people have about Addison’s disease and Cushing syndrome.

What happens when someone with Addison’s disease gets stressed?

The inability to produce enough cortisol during a sudden stressful event is called an Addisonian crisis or acute adrenal crisis. It requires prompt medical treatment to avoid complications like:

  • shock
  • coma
  • death

Does Addison’s disease cause anger issues?

Some people with Addison’s disease may have mood or behavioral changes. Poor sleep in some people may lead to irritability, anxiety, or anger.

Can you drink if you have Addison’s disease?

A doctor or healthcare professional can advise you if it’s safe for you to drink alcohol. In general, it’s recommended to avoid consuming high levels of alcohol.

What are the first symptoms of Cushing syndrome?

Some of the first symptoms of Cushing syndrome can include:

  • weight gain
  • round face
  • hump between your shoulders
  • purple stretch marks

It’s important to see a doctor if you suspect you may have Addison’s disease or Cushing syndrome. Addison’s disease often requires taking medication to replace your low hormone levels. Cushing syndrome treatment depends on the underlying cause but might include gradually decreasing corticosteroids or removing a pituitary tumor.