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How is Cushing's syndrome diagnosed?

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Doctors primarily diagnose Cushing syndrome with a physical exam, during which they check patients for common physical signs of the condition, such as a rounded face, thin skin that easily bruises and develops stretch marks, and a fatty deposit in between the neck and shoulders, explains Mayo Clinic. They may also run urine, blood and saliva tests to measure cortisol levels as well as imaging tests to check for abnormalities of the pituitary and adrenal glands.

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Because cortisol levels fluctuate throughout the day, doctors sometimes request that patients collect multiple urine samples over a 24-hour period, notes Mayo Clinic. It is also useful to analyze a saliva sample taken late at night, a time when cortisol levels are especially likely to be high in patients with Cushing syndrome. It is sometimes challenging for doctors to diagnose Cushing syndrome because there are numerous conditions that mimic its symptoms. For this reason, doctors may also run tests to rule out conditions with similar symptoms, such as depression, polycystic ovarian syndrome, alcoholism and eating disorders.

Symptoms of Cushing syndrome vary somewhat in men and women, states Mayo Clinic. Women may experience abnormal menstrual cycles or an increase in body and facial hair growth. Men with the condition may have decreased libido, erectile dysfunction or reduced fertility. Weight gain, stretch marks, acne and thinning of the skin are common in both sexes.

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