Difference Between Addison’s Disease and Cushing’s Syndrome

The main distinction between Addison syndrome and Cushing’s disease is that Cushing’s syndrome exhibits an excess of cortisol while Addison’s disease exhibits a hormonal deficiency of cortisol and aldosterone. To correctly diagnose and treat Addison’s disease and Cushing’s syndrome, it’s critical to understand their differences. The hypofunction of the adrenal gland, which may be brought on by primary adrenocortical insufficiency or a lack of pituitary adrenocorticotropic hormone (ACTH) release, is the underlying cause of Addison’s disease. On the other hand, overproduction of the hormone cortisol in the body results in Cushing’s syndrome. Let’s have a glance at both topics in detail.

What is Addison’s Disease?

Addison disease is the term used to describe the adrenocortical insufficiency that results from the destruction or functioning of the adrenal cortex. About 90% of both adrenal cortices have been damaged by the time the clinical symptoms start to show. The adrenal glands don’t produce enough cortisol and aldosterone when you have Addison’s disease, a chronic disorder.

The two small, triangular-shaped adrenal glands, or suprarenal glands, are situated on top of each of your two kidneys. The endocrine system in the body contains them. The body responds to stress, such as the stress of disease, injury, or surgery, with the aid of the hormone cortisol. Also, it supports the maintenance of blood pressure, heart health, immune system, and blood sugar (glucose) levels. Life needs cortisol to function.

Causes of Addison’s Disease

The most common cause of Addison’s disease is an autoimmune reaction, which occurs when your immune system mistakenly targets healthy tissues. When you have Addison’s disease, your immune system attacks the adrenal cortex, the outer layer of your adrenal glands where cortisol and aldosterone are made. 90% of the adrenal cortex can be damaged for months or even years before symptoms start to show.
About 75% of people with Addison’s disease experience an autoimmune reaction. For instance, the uncommon inherited disorders autoimmune polyendocrine syndromes I (APS type-1) and II can result in autoimmunity and Addison’s disease (Schmidt syndrome). In the past, TB was one of the main causes of Addison’s sickness. It continues to be a significant cause of illness in developing countries. Some other common causes of Addison’s disease are as follows:

• Autoimmune diseases
• Tuberculosis
• Neoplasms
• Inflammatory necrosis
• Amyloidosis
• Hemochromatosis
• Waterhouse-Friedrichsen syndrome following the meningococcal septicemia
• Bilateral adrenalectomy

What is Cushing Syndrome?

The Cushing syndrome is a collection of clinical symptoms that frequently co-occur because of excessive glucocorticoid receptor stimulation. When the body consistently produces too much cortisol, Cushing syndrome develops. Taking oral corticosteroid medicine may cause this. Alternatively, the body could make too much cortisol.

Several of the defining characteristics of Cushing syndrome, such as a fatty hump between the shoulders, a round face, and pink or purple stretch marks on the skin, can be brought on by an excess of cortisol. In some cases, type 2 diabetes, high blood pressure, and bone loss are also side effects of Cushing syndrome.

Causes of Cushing Syndrome

• Iatrogenic factors, such as the prolonged use of glucocorticoids
• Pituitary adenomas: The disorder is known as Cushing’s disease when the clinical symptoms are caused by a pituitary adenoma.
• Cancers such small cell lung carcinomas, adrenal carcinomas, and bronchial carcinomas.
• Adrenal tumors.
• Macronodular hyperplasia without ACTH.
• Alcoholism and depressive disorders.
• Initial obesity.

Difference Between Addison’s Disease and Cushing’s Syndrome?

	Addison’s Disease	Cushing’s Syndrome
Definition	Having insufficient cortisol (and aldosterone) results in Addison’s disease.	Having much cortisol results in Cushing’s syndrome (hypercortisolism).
Signs and Symptoms	Sodium and sugar are low (due to low levels of cortisol which is responsible for the retention of sodium and increases blood glucose), and salt cravings. Tired and muscle weakness. Diarrhoea and nausea, Depression. Reproductive changes. Low blood pressure.	Skin fragile Truncal obesity with small arms. Rounded face (appears like the moon). Reproductive issues amenorrhea and ED in males (due to the adrenal cortex’s role in secreting sex hormones). Sugar is extremely high (hyperglycemia).
Predisposing factors	Atrophy of the Adrenal gland. Fungal infections.	Hyperplasia of Adrenal gland Tubercular infection (MILIARY-TB to adjacent organs).
Diagnostics	FBS decreased (N=80-120 mg/dl) Serum Na decreased (N = 135-145) Plasma control decreased.	FBS elevated Elevated Na Decreased K
Causes	Auto immune due to the adrenal cortex  becoming damaged due to the body attacking itself: Tuberculosis/infections Cancer	Glucocorticoid drug therapy ex. prednisone Body causing it: due to tumors and cancer on the pituitary glands or adrenal cortex, or genetic predisposition.

Conclusion

It is crucial to get an early diagnosis of these endocrine abnormalities because they may be the result of dangerous underlying conditions like cancers. The fundamental distinction between Addison’s disease and Cushing’s syndrome is that while Cushing’s syndrome is defined by an excess of cortisol, Addison’s disease is characterized by the hormonal insufficiency of cortisol and aldosterone. To minimize unwanted and preventable consequences like the Cushing syndrome, the patient should be monitored after receiving the anti-inflammatory corticosteroids.

FAQs on Addison’s Disease and Cushing’s Syndrome

Q1. What are the three tests used to diagnose Cushing’s syndrome?

Ans: Measurement of free cortisol in 24-hour urine (UFC), cortisol suppressibility by low doses of dexamethasone (DST), and assessment of cortisol circadian rhythm using late-night serum and/or salivary cortisol are the three first-line diagnostic tests now used to screen for CS.

Q2. What organ is damaged in Addison’s disease?

Ans: Two tiny glands called the adrenal glands are located above the kidneys. They generate cortisol, aldosterone, and adrenaline, which are all necessary hormones. The adrenal gland is harmed in Addison’s disease, which results in insufficient cortisol and aldosterone production.

Q3. Can stress cause Addison’s disease?

Ans: Acute adrenal insufficiency, often known as Addisonian crisis, is what this is. When your body is agitated, this may happen. There are a variety of causes for that, including illness, fever, surgery, or dehydration.

Q4. Who is most affected by Cushing’s disease?

Ans: Only 10 to 15 people per million are affected by the rare disorder Cushing disease each year. Those between the ages of 20 and 50 are most frequently affected, and women are more likely to experience it. The most prevalent cause of Cushing illness is a pituitary adenoma. A pituitary growth called an adenoma is nearly often benign.

Q5. What organ does Cushing’s syndrome affect?

Ans: Overproduction of adrenocorticotropic hormone by the pituitary gland results in Cushing illness (ACTH). An endocrine system organ is the pituitary gland. A manifestation of Cushing syndrome is Cushing disease.