Amy Schumer Has Cushing's Syndrome. What Is It?

Fact checked by Nick Blackmer

Key Takeaways

• Amy Schumer was diagnosed with a rare condition called Cushing’s syndrome.

• Cushing’s syndrome occurs when the body produces too much cortisol due to steroid medications or tumors on the pituitary gland.

• Some of the symptoms include weight gain, redness in the face, irregular periods, depression, high blood pressure, and decreased sex drive.

The actor and comedian Amy Schumer said she was diagnosed with Cushing’s syndrome, a rare hormonal disorder that occurs when the body’s cortisol levels are too high.

After her appearance on “The Tonight Show” earlier this month, Schumer received a slew of comments about her face looking puffier than usual. She said those comments led her to seek a doctor’s input.

In an Instagram post, Schumer revealed that she has endometriosis and is going through “medical and hormonal things.” Later, in an interview with the newsletter “News Not Noise,” she said that she was diagnosed with exogenous Cushing’s syndrome.

What Is Cushing’s Syndrome?

There are two major types of Cushing’s syndrome. Schumer was diagnosed with the most common type, called exogenous Cushing’s, which happens when someone takes too much of a steroid medication that mimics cortisol in the body.

The second kind, called endogenous Cushing’s, happens when the body itself is producing too much cortisol. This disease usually arises due to a tumor on the pituitary gland, which signals the adrenal gland to produce too much cortisol, or from a tumor on the adrenal gland itself.

It’s not clear how many people get Cushing’s from their medication. One study estimates nearly 8% of patients taking oral steroids for asthma could develop Cushing’s, though that hasn’t been verified.

“[Exogenous Cushing’s] is not super rare—it’s very common. A lot of people use steroids, and they develop Cushing’s because of that excess cortisol,” said Ana Paula Abreu Metzger, MD, PhD, co-director of the Brigham Center for Endocrine Genetics at Brigham and Women’s Hospital.

Related: How Long Do Steroids Stay In Your System?

By comparison, about two to eight people per million develop endogenous Cushing’s.

Cortisol is an important hormone that regulates the body’s response to stress. During a traumatic or stressful event, cortisol levels spike, increasing blood flow to the brain, releasing glucose for quick energy, and bolstering the body to respond to the trauma.

However, “chronic excess of cortisol is very, very harmful to a person’s body,” Abreu Metzger said.

Untreated Cushing’s syndrome is linked to health conditions like high blood pressure, prediabetes, increased risk of blood clots, osteoporosis, anxiety, and more.

“If you have an excess of cortisol and there is no way for your body to shut it down, there will be the consequences,” Abreu Metzger said.

What Are the Signs of Cushing’s?

Cushing’s syndrome can be hard to diagnose because many of the symptoms are nonspecific, said Maria Fleseriu, MD, professor of medicine and neurological surgery and Director of the Pituitary Center at Oregon Health & Science University.

About 70% of patients will experience recent weight gain. Other telltale signs include redness in the face, irregular periods or missing, depression, high blood pressure, and decreased libido. Most of these symptoms are seen in some proportions in the general population.

Some of the more specific Cushing’s symptoms include thin skin, easy bruising, muscle weakness, and loss of bone mass, which may lead to fractures. People with Cushing’s syndrome also tend to gain weight centrally—in the abdomen and face—rather than in the arms and legs.

Related: Moon Face Causes and Treatments

“There are some more specific clinical features, and there are some that are very frequent but nonspecific. If a patient has several of them, I think at least screening for Cushing’s would be warranted,” Fleseriu said.

Some people with high cortisol levels due to steroid use will have a quick response to the medication, while others will develop Cushing’s years after they start taking it.

“Amy Schumer got the diagnosis pretty early on. But I’m sure there are a lot of patients who are taking steroids and experiencing some adverse effects, and if they’re not seeing somebody to have a diagnosis, they might not even know they have Cushing’s,” Fleseriu said.

Related: Steroid-Induced Osteoporosis Caused by Prednisone

How Is Cushing’s Diagnosed?

The first thing a provider may ask someone who presents with signs of Cushing’s is whether they take any steroids, Fleseriu said. If the answer is yes, and they have multiple symptoms of the syndrome, it’s easy to move forward with a diagnosis.

Testing whether the body is producing too much cortisol on its own can be much more complicated. Measuring cortisol levels alone is not enough to diagnose someone with endogenous Cushing’s. Because the symptoms often overlap with other metabolic conditions, providers must first rule out several other potential causes and complete some tests.

“Endogenous Cushing’s is one of the most challenging diagnoses in endocrinology,” Abreu Metzger said.

An endocrinologist may ask a patient to collect their urine over 24 hours to measure the levels of cortisol, adrenocorticotropic hormone, and other key hormones.

Most people’s cortisol dips at night and then increases in the morning. An endocrinologist may ask patients to take a saliva or a blood test that measures their hormone levels before bed and again when waking up to see if their cortisol levels remain too high. People who take birth control or other drugs containing estrogen may have to pause their medication to get an accurate reading.

Some people may also have to get an MRI or a CT scan to see if their adrenal or pituitary glands are compromised.

Related: The Dexamethasone Suppression Test

How Is Cushing’s Treated?

Treating endogenous Cushing’s often requires intensive interventions. When someone has a tumor on their adrenal gland or pituitary gland, surgery is usually the only option for removing it and correcting cortisol production.

People who have medication-induced Cushing’s, like Schumer, will see improvement when they stop taking the drug that caused their cortisol to spike.

“Finding out I have the kind of Cushing’s that will just work itself out and I’m healthy was the greatest news imaginable,” Schumer told “News Not Noise.”

However, Fleseriu said it’s not always as simple as cutting out the steroid.

“When I read this quote, I was really worried that some patients will think that the Cushing’s will go away on its own,” Fleseriu said. “It has to be specified that the only one that doesn’t need specific treatment is the exogenous Cushing’s.”

It’s important, too, that people with exogenous Cushing’s see a health provider for support in managing related health conditions. Taking steroids for a long time can cause the pituitary gland to stop producing cortisol. After stopping the medication, some comorbidities may improve. But for some people, the physical symptoms of Cushing’s syndrome remain despite their bodies not producing any cortisol.

Without enough cortisol, blood pressure drops, metabolism shuts down, and people can end up hospitalized or die. To prevent what’s called an adrenal crisis, some patients may need to wean off their glucocorticoid medications slowly or take replacement steroids to get them the right amount of cortisol, Abreu Metzger said.

She added that many providers try to use non-steroidal medications to address a health problem and avoid the risk of Cushing’s. These include inhalers that deliver steroids to the lungs to tamp down inflammation but are not absorbed by the body and antibody treatments for autoimmune disorders.

Some people who have Cushing’s for years can experience serious and long-term health effects, like brain hypertrophy, heart disease, and diabetes.

“Some people think, ‘I’m going to stop steroids, and I’m going to be cured like nothing’s happened,’” Abreu Metzger said. “No, your body was exposed to steroids for a long time, and unfortunately, some of the damage will not be recovered.”

What This Means For You

It can be frustrating not to have an explanation for why you’re experiencing certain health problems like weight gain and anxiety. Endogenous Cushing’s syndrome is rare, and most patients won’t have it. If you’re concerned that you may have Cushing’s, it’s important to see an experienced health professional for an evaluation.

Read the original article on Verywell Health.