Cushing’s and Conn’s Syndrome: 5 Common Signs and When to See a Doctor

Cushing’s and Conn’s Syndrome: 5 Common Signs and When to See a Doctor

Clinically Reviewed by Dr. Andrew Stein MD, Consultant Physician. Last updated: April 2026

While both Cushing’s and Conn’s syndromes involve the adrenal glands, they are driven by entirely different hormones. Cushing’s is defined by an excess of cortisol, while Conn’s is caused by an overproduction of aldosterone.

Because the adrenal glands sit right on top of your kidneys and regulate everything from metabolism to blood pressure, even a small hormonal shift can have a massive impact on your health.

1. Cushing’s Syndrome: The “Stress Hormone” Overload

Cushing’s Syndrome occurs when your body is exposed to high levels of cortisol for a long time. Cortisol is the body’s “fight or flight” hormone, but in excess, it begins to break down muscle and redistribute fat.

5 Common Signs of Cushing’s

1. Central Obesity: Unexplained weight gain specifically around the abdomen, while arms and legs remain thin.

2. Moon Face: The face becomes rounded, puffy, and often red in appearance.

3. Buffalo Hump: A distinct fatty deposit develops between the shoulder blades (dorsocervical fat pad).

4. Purple Stretch Marks (Striae): Wide, deep purple or reddish marks appearing on the stomach, thighs, and breasts.

5. Skin Thinning and Bruising: The skin becomes “paper-thin” and bruises easily even with no known injury.

Primary Causes

• Exogenous Steroids: The most common cause is the long-term use of high-dose oral corticosteroid medications (like prednisone) used to treat asthma or arthritis.

• Pituitary Adenomas: A benign tumor on the pituitary gland (Cushing’s Disease) that signals the adrenals to make too much cortisol.

• Adrenal Tumours: A tumor directly on the adrenal gland itself.

2. Conn’s Syndrome: The “Silent” Pressure Builder

Conn’s Syndrome (Primary Aldosteronism) is often called a “silent” condition because its primary symptom—high blood pressure—is something you cannot feel. It is one of the most common “curable” causes of hypertension.

5 Common Signs of Conn’s

1. Resistant Hypertension: High blood pressure that does not come down even when taking three or more different medications.

2. Muscle Weakness and Cramps: Caused by low potassium levels (hypokalaemia) as the body flushes potassium out through urine.

3. Excessive Thirst and Urination: High sodium levels trick the body into needing constant hydration.

4. Fatigue: A general sense of exhaustion often linked to electrolyte imbalances.

5. Heart Palpitations: Low potassium can interfere with the electrical signals in your heart, causing “fluttering” sensations.

Primary Causes

• Adrenal Adenoma: A small, non-cancerous tumor in one of the adrenal glands that leaks aldosterone.

• Bilateral Hyperplasia: Both adrenal glands become overactive and enlarged for unknown reasons.

• Genetic Factors: Rare inherited conditions that cause the adrenal glands to over-produce hormones from birth.

When to See a Doctor

Hormonal imbalances can be tricky to diagnose because symptoms often appear gradually. You should request a blood test or a referral to an Endocrinologist if:

• For Cushing’s: You notice rapid weight gain in the torso and face despite no changes in diet or exercise, or if you have developed dark purple stretch marks.

• For Conn’s: You are under 40 and have high blood pressure, or if your blood pressure remains high despite taking multiple medications.

• Routine Check: If a standard blood test shows low potassium (hypokalaemia) alongside high blood pressure, this is a major red flag for Conn’s Syndrome.

Comparison Table: Cushing’s vs. Conn’s Syndrome