Symptoms:

• Abdomen that sticks out and thin arms and legs (central obesity)
• Acne or skin infections
• Collection of fat on the back of the neck (buffalo hump)
• Depression
• Diabetes
• Easy bruising
• Excessive facial hair growth in females
• Headache
• Impotence
• Increased urination
• Moon face (round, red, and full)
• Osteoporosis
• Purple stretch marks on the abdomen, thighs, and breasts
• Stopping of menstruation
• Weakness
• Weight gain

Signs and tests:

Tests are done to confirm there is too much cortisol in the body, then to determine the cause.

These tests confirm too much cortisol:

• 24-hour urine cortisol
• Dexamethasone suppression test (low dose)

These tests determine cause:

• Brain MRI
• Dexamethasone suppression test (high dose)
• Serum ACTH levels
• Test of corticotropin-releasing hormone, which acts on the pituitary gland to cause the release of ACTH (CRH test)
• Test that measures ACTH levels in the veins that drain the pituitary gland (petrosal sinus sampling)