When a Medical Rarity Becomes the Norm
In 1912, Dr. Harvey Cushing, father of neurosurgery, described a cluster of symptoms — obesity, abnormal hair growth, and lack of menstruation — in a 23 year old woman, and posited that these symptoms were caused by a pituitary tumor. This condition — a pituitary gland tumor which produces an excess of a key hormone which in turn stimulates the adrenal glands to produce excess cortisol — is named after the man who described the condition: Cushing’s disease. When the same cluster of symptoms occurs with in patients without the pituitary tumor, the condition is termed Cushing’s syndrome.
At the time, this collection of symptoms and findings was remarkable, rare enough to be the subject of medical papers. True Cushing’s disease — the pituitary tumor — is still quite rare. But the collection of symptoms and physical findings corresponding with Cushing’s syndrome are now commonplace.
The typical features of Cushing’s syndrome are obesity, high blood pressure, fatigue, poor immune function, poor concentration and memory, excess hair growth in women, and irritable mood. People with Cushing’s syndrome can also have diabetes, easy bruising, muscle weakness, acne, insomnia, erectile dysfunction, depression, and insomnia.
Sound like anyone you know? It probably does, because an enormous percentage of the US population has one or more of the features of Cushing’s syndrome. Over one third are obese and nearly that number have high blood pressure. More than ten percent of the population has diabetes and many more may have prediabetes. Medications to treat depression and insomnia occupy space on the top twenty prescribed medications year after year. More than $2 billion are spent on medications to erectile dysfunction each year. And at least one in every five doctors visits is for fatigue.
The cluster of symptoms which was rare in Dr. Cushing’s time is now commonplace. It’s the new normal.
The root cause of all of the “Cushingoid” findings is an excess of cortisol, one of the key stress hormones. It doesn’t matter if your body has a tumor which produces the cortisol, or if you take cortisol-containing medications, or if you produce the cortisol on your own as the result of prolonged stress. The end result is the same.
We in the midst an epidemic of illness caused by chronic exposure to stress hormone. It’s not all in our heads. Our bodies — how they look and how they function — have been radically changed by excess cortisol. The evidence surrounds us; it may be as close as our own bathroom mirror.
If we are going to ensure our health and the health of future generations, we need to think about health differently. Ask questions which get to the root of our health problems and look for answers beyond textbooks. We need to create a culture of health which combats the epidemic of stress which surrounds us. In future posts I’ll discuss why doctors don’t recognize the epidemic for what it is, how the healthcare system isn’t prepared to deal with this epidemic (and may be making it worse), and what steps you can take on your own which can treat cortisol excess more powerfully, and with fewer side effects, than medication. Read on with me and let me know what you think.
