Bruises 

Happy Thanksgiving!   

This month we are talking about black and blue discolorations. Bruises, also called contusions, form when an injury damages your blood vessels and makes them leak. It can happen to anyone at any age, and it typically takes a hard blow or a serious fall to generate enough pooling blood to create purple, blue, or black bruises. 

If you’re getting bruises easily from seemingly minor bumps, it’s time to figure out why. A few medical conditions make bruising more likely. For example, bleeding disorders, vitamin C or K deficiencies, low blood platelet count, liver disease, and cancer can make you more prone to bruising. 

Some medications, such as blood thinners and even OTC pain relievers, if you take them often, are also known to increase bruising. 

One of the lesser-known conditions responsible for excessive bruising is Cushing’s syndrome. Our team at Palmetto Endocrinology can help you take a closer look at Cushing’s syndrome, what causes it, and how treat it. 

Cushing’s syndrome 101 

Cushing syndrome occurs when your body produces too much of the hormone cortisol. Cortisol is a heavy lifter that’s responsible for: 

• Keeping inflammation at bay 
• Regulating your blood pressure 
• Making sure your heart and vascular system function properly 
• Converting proteins, carbs, and fats into usable energy 

Cortisol also helps you respond to stressful situations by enabling your body to flee from danger or stay and fight. In short spurts, heightened cortisol levels are essential for survival. But over time, elevated cortisol can cause health issues such as: 

• Unexplained weight gain, especially in your face, midsection, and upper back 
• Increased stretch marks 
• Slow-healing wounds 
• Acne 
• Bruising and thin, fragile skin 

As time goes on, untreated Cushing’s syndrome can lead to severe fatigue and muscle weakness, mental health issues, hypertension, Type 2 diabetes, infections, and bone loss.  

Causes of Cushing’s syndrome 

Several conditions can throw your cortisol production out of whack, which is why you need our team to diagnose the underlying cause. Here are some of the most common culprits: 

Corticosteroid medications 

If you take an oral steroid to treat an inflammatory disease like arthritis or asthma, the medication may be triggering an overproduction of cortisol. Injectable corticosteroids for back and joint pain can have the same effect.  

Pituitary adenoma 

A tumor on your pituitary gland, which is located at the base of your brain, may trigger a flood of adrenocorticotropic hormone (ACTH). This pituitary disorder sends a message to your adrenal glands to pump out more cortisol.  

This tumor, a pituitary adenoma, is a specific type of Cushing’s syndrome called Cushing’s disease. While the similar-sounding names can be confusing, the difference is quite simple. 

Cushing’s syndrome can stem from internal or external sources of excess cortisol, and Cushing’s disease specifically involves a tumor on the pituitary gland. 

Primary adrenal gland disease 

Sitting just above your kidneys, your adrenal glands produce both cortisol and sex hormones. An adrenal disorder can stimulate excess cortisol and result in Cushing’s syndrome. Sometimes, benign tumors cause this type of adrenal disorder; in rare cases, adrenal tumors are cancerous.  

ACTH-producing tumor 

Although it rarely happens, it is possible for a tumor, either benign or malignant, to form in your thyroid, lungs, pancreas, or thymus gland and begin producing ACTH, even though the organs it’s invading don’t naturally produce it. If this happens, it can result in Cushing’s syndrome. 

Treating Cushing’s syndrome 

Depending on what’s causing your Cushing’s syndrome, we may treat it with prescription medication to improve your symptoms or by reducing your usage of corticosteroids.  

When Cushing’s syndrome involves the presence of a tumor, you may need surgery to have it removed. In some cases, we may recommend radiation therapy instead of or in addition to surgery to minimize the tumor.  

To find out if your frequent bruising may be a sign of Cushing’s syndrome or Cushing’s disease, schedule an appointment with us. Call to book a consultation today. 

Author

Joseph Mathews, MD, FACP, FACE, ECNU, CCD Joseph W. Mathews M.D., a board certified Endocrinologist and Medical Director of Palmetto Endocrinology, was born and raised in South Carolina. He earned his Bachelor of Science in Biology from the College of Charleston, Cum Laude. He then achieved his M.D. at the Medical University of South Carolina where he also completed his residency in Internal Medicine and a Fellowship in Endocrinology, Diabetes, and Metabolism. Dr. Mathews is also a Fellow of both the American College of Endocrinology and the American College of Physicians, holds an Endocrine Certification in Neck Ultrasound (ECNU) and is a Certified Clinical Densitometrist (CCD). He has extensive experience performing ultrasound guided fine needle aspiration biopsies. His practice includes a range of specializations including prescribing and fitting patients with insulin pumps. Dr. Mathews' practice has drawn patients from out of state to benefit from his expertise in thyroid disorders, diabetes, cortisol problems and their Endocrine disorders.