If you suspect that there’s something “off” about how you’re feeling, but you can’t quite put your finger on what’s causing it, you might need to take a closer look at your hormone levels. Two conditions in particular, Cushing’s syndrome and Addison’s disease, are issues that manifest from hormonal imbalances. Like many issues that stem from abnormal hormone levels, both conditions have general, nonspecific symptoms but can lead to serious consequences if left unexplored.
So testing your hormones — and more specifically in these cases, your cortisol levels — is one of the first places you can check to better understand what’s going on. Here’s what you need to know about the difference between Addison disease vs. Cushing syndrome, and how you can get to the bottom of your own hormonal disturbances.
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Addison’s disease vs. Cushing syndrome: How they’re similar
Both Cushing syndrome and Addison’s disease are adrenal disorders. This means that they are both conditions that are related to your adrenal glands, two glands located above your kidneys that are responsible for making a variety of important hormones that play roles in your metabolism, stress response, and immune response.
Most particularly here, both Addison’s disease and Cushing syndrome are defined by abnormal levels of the “stress hormone” cortisol. Cortisol is a steroid hormone that is produced by your adrenal glands. It gets its reputation as the “stress hormone” because your body produces more of it in response to stressful situations, a result of your ancestral “fight or flight” instinct. Circulating cortisol makes it easier for your body to access blood sugar, which it can then use for energy so that it can make a quick getaway if the situation calls for it.
But in addition to its role as a fight or flight mediator, cortisol also has other important jobs in your body like regulating your metabolism and influencing your immune response. So while cortisol’s original job is to keep you safe from harm and able to respond to intensely stressful situations, issues with adrenal disorders or chronic stress can have major consequences on your health down the line. This is why monitoring your cortisol levels is so important: whether or not you’re dealing with a true adrenal disorder like Cushing or Addison’s, knowing where your cortisol levels stand can help you understand your adrenal health in the moment.
Key differences between Addison’s disease vs. Cushing syndrome
So we’ve established Addison’s disease and Cushing’s syndrome fall under the same “adrenal disorder” umbrella. Now, let’s talk about how they’re different.
Even though Addison’s disease and Cushing syndrome are both defined by abnormal cortisol levels, they’re actually on opposite ends of the spectrum. Someone who has cushing syndrome will have abnormally high cortisol levels, while someone suffering from Addison’s disease will be combatting abnormally low cortisol levels.
Cushing syndrome equals high cortisol levels
Cushing syndrome is also sometimes fittingly referred to as “hypercortisolism” due to the excessive levels of circulating cortisol that define this condition. Some cases of Cushing are endogenous, meaning that they stem from issues inside of your body like tumors on your pituitary or adrenal glands that lead to an increased production of the cortisol hormone. However, Cushing syndrome is most often caused by outside factors like the use of corticosteroid medications, which are synthetic hormones that are used to treat a variety of illnesses like inflammatory bowel diseases, certain cancers, and more. Glucocorticoids have a similar structure and therefore act very similarly to cortisol once inside of your body.
No matter where the Cushing syndrome stemmed from, the symptoms are similar. Remember, cortisol is partially responsible for the management of your metabolism. This responsibility means that the abnormally elevated cortisol levels present under Cushing syndrome conditions can eventually lead to higher blood sugar levels, promotion of insulin resistance, and increased protein breakdown. As a result, someone who suffers from Cushing syndrome might experience symptoms like:
- Unexplained weight gain but thin arms and legs
- A fatty hump between the shoulders or increased fat around the base of your neck
- Weakened muscles
- In women: excess hair growth on the face, neck, chest, abdomen, and thighs
- In men: decreased fertility or lowered libido
- Purple bruising and stretch marks
- Slow wound healing
Addison’s disease indicates abnormally low cortisol levels
On the other hand, someone who had Addison’s disease is dealing with an adrenal insufficiency. In other words, their adrenal glands are not producing enough cortisol to carry out their metabolic and energy needs as normal.
Addison’s disease is relatively rare, and when it does occur, it’s generallybecause of damage to the adrenal glands from autoimmune disorders that cause your immune system to attack your own cells. However, Addison’s disease is also sometimes linked to other infections like HIV, AIDS, and tuberculosis.
When you’re dealing with a severe lack of cortisol in Addison’s disease, it can manifest in common symptoms like:
- Chronic, extreme fatigue
- Hyperpigmentation of your skin
- Unexplained weight loss, low appetite
- Gastrointestinal discomfort
- Low blood pressure and/or blood sugar
- Low libido
Addressing your adrenal issues
If you suspect that you’re dealing with Addison’s disease, Cushing syndrome, or any other issues stemming from abnormal hormone levels, one of the first things that your doctor will do is analyze your hormone levels. And while checking in with your doctor is always the best thing to do if you’re concerned about a serious health issue like these two conditions, there are also at-home tests, like the kind offered through Base’s improvement programs, that you can try if you’re curious about where your hormones stand. It’s also a good first stepping stone for narrowing down whether your “feeling off” stems from hormones or nutrition deficiencies.
An important note here: if you do find that your hormone levels are outside of their normal range, it’s possible to address minor hormonal imbalances with diet, lifestyle, and supplement tweaks. But if your blood tests indicate that your cortisol levels are high enough to indicate Cushing’s or low enough to suggest Addison’s disease, the best course of action at that point is to talk to your doctor. They can then run additional tests and determine the correct medical course of action for treatment, which will depend on what is causing the problems with your adrenal glands in the first place.
Treating Cushing syndrome
If you’re diagnosed with Cushing syndrome and need to lower your cortisol levels, your doctor may recommend:
- adjustment of corticosteroid medication
- tumor removal if applicable
- radiation therapy to shrink tumors if applicable
Treating Addison’s disease
Meanwhile, if you have Addison’s disease, your doctor might prescribe a corticosteroid medication as hormone therapy to replace the cortisol that your body is not making on its own.
Bottom line: Your cortisol levels are important markers of your overall health.
Cortisol is so much more than just your “stress hormone.” When levels are chronically too high, it might be an indicator of Cushing syndrome, which manifests in symptoms like unexplained weight gain throughout your body, weakness, slow wound healing, and lowered fertility. But if they’re too low for too long, it could be a sign of Addison’s disease, which can lead to issues with unexpected weight loss, fatigue, and low blood pressure. No matter which end of the spectrum you’re dealing with, getting a handle on your cortisol levels with blood testing can help give you answers, uncover underlying issues, and get you on the path to better health.
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Take the Base quiz to get a personalized hormone test recommendation and improvement plan.
