Cushing's disease is a rare type of Cushing’s syndrome caused by a non-cancerous pituitary tumor that leads to excessive production of adrenocorticotropic hormone (ACTH), resulting in high cortisol levels. This disrupts normal cortisol rhythms, potentially causing serious health issues and even early death if untreated.
Surgery is typically the primary treatment, but medications and radiation therapy can also help manage the disease.
However, untreated Cushing’s disease can cause many chronic health issues. At appropriate amounts, cortisol is necessary for our survival, but too much cortisol causes major health problems, including obesity, cardiovascular disease, bone health problems, metabolic conditions like diabetes, chronic mood disorders, and others.
This is where functional medicine practitioners shine. Functional medicine is an individualized approach to healthcare that focuses on identifying and addressing the root causes of disease, considering factors like diet, genetics, and lifestyle. Functional medicine practitioners use specialized lab tests to guide treatment.
Practitioners are licensed healthcare providers, including medical doctors (MD), naturopathic doctors (ND/NMD), doctors of osteopathy (DO), nurse practitioners (NP), chiropractors (DC), and other licensed professionals.
Functional medicine practitioners use an individualized approach, considering factors like diet, genetics, and lifestyle to manage and potentially recover from chronic conditions caused by Cushing’s disease. They use specialized lab tests and personalized treatment plans that include diet, lifestyle, supplements, and other therapies.
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Understanding Cushing’s Disease from a Functional Medicine Perspective
Functional medicine practitioners understand the connection between the body, mind, and lifestyle. They consider factors like stress, diet, and environment that affect health in their patient’s diagnosis and treatment. By viewing patients holistically, they can identify potential root causes, confirm them with testing, and create personalized health plans.
Treating Cushing’s disease involves collaborating with an endocrinologist, surgeon, and other specialists to remove the pituitary tumor causing high cortisol levels. Once cortisol levels are normalized, a functional medicine practitioner can help with long-term assessment and management of health issues caused by excess cortisol.
Cushing’s disease patients can develop many chronic conditions from excessive and prolonged cortisol exposure, including:
- Metabolic diseases (metabolic syndrome, insulin resistance, diabetes, hyperlipidemia)
- Osteoporosis and increased risk of bone fractures
Holistic View of Health
A holistic health view considers the interconnectedness of body, mind, and lifestyle, aiming for balance beyond just the absence of disease.
In Cushing’s disease, maintaining healthy cortisol levels post-tumor removal is necessary for full healing. This requires attention to diet, stress, sleep, and other lifestyle factors. Functional medicine providers use tests like the adrenal stress index, stool, food sensitivity, and melatonin testing to identify health-impacting areas, enabling a collaborative, evidence-based approach to long-term wellness.
The Root Cause Approach
After initial Cushing’s disease treatment, which typically involves surgical removal of the pituitary tumor, cortisol levels are monitored to return to normal. Excessive cortisol exposure can cause long-lasting health issues that persist even after successful treatment.
Functional medicine focuses on identifying and addressing underlying causes of persistent symptoms through comprehensive assessments, including hormone levels, cortisol rhythm, cardiovascular and metabolic health, gut function, and toxin exposure. This approach targets root causes to optimize health and achieve lasting outcomes.
Individualized Care
Functional medicine practitioners use a detailed medical and family history, lifestyle assessment, and diagnostic tests to create personalized treatment plans that consider the individual’s genetic makeup, medical history, and specific symptoms, aligning care with the patient's unique health goals for more effective management of Cushing’s disease complications.
Functional Medicine Diagnosis of Cushing’s Disease
People new to functional medicine often wonder about the process of seeing a functional medicine provider. While each provider has her or his own way of establishing relationships and optimizing their patients’ health, you can expect that these areas will be covered:
Comprehensive Patient History
Expect your provider to spend time asking you questions about your medical history, your family history, and your treatment for Cushing’s disease. They will want to know what other medical conditions you may have, as well as all medications and treatments you’re currently receiving.
They will ask you about your lifestyle, inducing a thorough analysis of your diet, exercise habits, stress levels, and any environmental exposures to chemicals, molds or toxins that may block your body’s ability to fully heal.
Most importantly, they will ask about your health goals. This may be new to you, but knowing your health goals helps your doctor tailor your treatment plan more effectively.
Advanced Diagnostic Testing
Once your functional medicine provider understands your medical history and health goals, they will recommend specific testing to tailor your treatment plan to quickly and effectively reach your goals.
Tests that may be considered include:
The Adrenal Stress Index measures cortisol and DHEA levels throughout the day to evaluate adrenal gland function and stress response. This test is essential for long-term care in people recovering from Cushing's disease because it tracks their diurnal cortisol rhythm and can identify the effects of stress, inflammation, or toxin exposure on cortisol levels.
CVD & Diabetes Prevention Comprehensive:
This test assesses cardiovascular risk factors, including cholesterol levels, inflammation markers, and blood sugar regulation, to identify and help prevent heart disease and diabetes.
Patients in Cushing’s disease recovery face an increased risk of cardiovascular problems and metabolic disorders due to the long-term effects of high cortisol levels, so establishing a baseline cardiovascular risk assessment is essential.
Comprehensive Hormone Assessment:
Testing such as the DUTCH PLUS test provides a detailed analysis of hormone levels, including cortisol, estrogen, progesterone, and testosterone. Cushing’s patients often suffer from other symptoms of hormone imbalance, including menstrual irregularities and high androgens (male hormones) in women and low libido and erectile dysfunction in men.
Stool Testing:
Stool testing such as the GI MAP test analyzes the gut microbiome and identifies pathogens, bacteria, and markers of inflammation in the gastrointestinal tract. Gut health can be compromised by chronic high cortisol levels.
Nutritional Testing:
Micronutrient testing evaluates levels of essential vitamins, minerals, amino acids, and antioxidants in the body. Nutritional testing is important for people recovering from Cushing's disease because nutrient deficiencies can affect energy levels, immune health, and overall recovery, especially after prolonged high cortisol exposure.
Metabolic Testing:
Metabolic testing, such as the Metabolomix+ test from Genova Diagnostics, assesses metabolic pathways, including energy production, detoxification, and oxidative stress. This test assesses metabolic function, which is necessary for energy production and recovery from Cushing’s disease.
Thyroid testing measures levels of thyroid hormones to assess thyroid gland function. Thyroid imbalances can be common due to disrupted hormonal regulation, which further impacts metabolism, cardiovascular and mental health, and hormone balance.
Toxin Testing:
Toxin testing identifies the presence of harmful substances such as heavy metals, pesticides, molds, and chemicals in the body, which can disrupt normal biological functions. Detecting and eliminating these toxins can help regulate cortisol levels by reducing the body's stress response and lowering chronic inflammation.
Genetic testing may also be performed to provide an additional layer of personalized care.
Genetic and Epigenetic Factors
Genetics refers to the study of specific genes, which we inherited from our parents and cannot be changed. Epigenetics, on the other hand, involves changes in gene expression caused by environmental and lifestyle factors without altering the DNA sequence itself.
In the context of Cushing’s disease recovery, understanding a patient’s genetic predispositions through genetic testing can tailor her treatment using epigenetic modifications, such as diet, lifestyle, or targeted supplementation, to reduce her risk of developing or worsening chronic illness.
Functional Medicine Treatment Strategies for Cushing’s Disease
Several functional medicine techniques can be helpful for managing Cushing's Disease:
Lifestyle and Dietary Interventions
After initial treatments for Cushing’s disease have stabilized cortisol levels, optimizing patient health and reducing chronic disease risk with a functional medicine approach should be the focus.
Anti-Inflammatory Diet
There are many versions of the anti-inflammatory diet out there, but they all focus on a few central guidelines:
- Avoid processed foods, which are high in artificial additives, preservatives, and trans fats
- Avoid refined sugars and carbohydrates
- Eat plenty of whole foods, including fruits, vegetables, whole grains, lean proteins, and healthy fats like omega-3 fatty acids found in fish and nuts
Focusing on these whole, nutrient-dense foods that reduce inflammation in the body, while minimizing the intake of inflammatory processed foods, sugars, and trans fats, is foundational for hormone health.
Chronic inflammation can disrupt the body’s stress response and lead to elevated cortisol production. By reducing inflammation, the anti-inflammatory diet helps maintain balanced cortisol levels, supporting overall hormonal health and stress management.
Stress Management Techniques
Reducing chronic stress is essential for overall health. Prolonged stress is a well-known cause of physical and mental health problems, including anxiety, depression, and cardiovascular disease.
Techniques such as mindfulness, meditation, and breathwork or yoga practices help individuals become more aware of their stress responses, reduce cortisol levels, and promote a sense of calm and balance.
Incorporating stress management strategies into daily routines can enhance resilience to stress, improve emotional regulation, and support overall well-being, ultimately reducing the risk of stress-related health issues.
Exercise and Movement
Regular exercise and movement are essential for managing cortisol levels and promoting overall health, but it’s important to tailor these activities to avoid overtaxing the body, which can actually elevate cortisol levels.
Moderate, regular exercise such as walking, yoga, swimming, or strength training helps maintain balanced cortisol by reducing stress, improving mood, and enhancing sleep quality.
It’s important to work with a professional to create a personalized exercise program catering to your fitness level, stress load, and overall health. This ensures that the benefits of physical activity are maximized without causing excessive physical strain, supporting both mental and physical well-being.
Nutritional and Herbal Support
Appropriate nutritional and herbal supplementation can facilitate the recovery process from Cushing’s disease, especially those that target the hypothalamic-pituitary-adrenal (HPA) axis.
Adaptogenic Herbs
Adaptogens are natural herbs known for their ability to help the body adapt to stress and maintain balanced cortisol levels. These adaptogens work by modulating the body's stress response system via the HPA axis and by promoting proper cellular and mitochondrial function.
Some examples of traditional adaptogenic herbs include:
- Ashwagandha: known for reducing stress and anxiety, Ashwagandha supports adrenal health by modulating the HPA axis, lowering cortisol and DHEA levels.
- Rhodiola Rosea: this adaptogen dampens cortisol via the HPA axis and improves stress symptoms.
- Holy Basil (Tulsi): used in Ayurveda for its adaptogenic properties, Holy Basil regulates cortisol and supports the nervous system’s interaction with the HPA axis. It also has antioxidant, anti-inflammatory, and blood sugar regulation benefits.
Nutritional Supplements
Magnesium helps regulate stress hormones, which may promote relaxation and reduce symptoms of anxiety and fatigue associated with adrenal dysfunction. It can also promote cardiovascular health and improve blood sugar control.
Omega-3 fatty acids have anti-inflammatory properties that can lower cortisol levels and improve mood, contributing to better stress management and slowing early aging.
B vitamins are essential for adrenal gland function, helping to convert food into energy, support neurotransmitter production, and balance the stress response.
Detoxification and Gut Health
The liver and digestive tract are essential detoxification organs. Supporting liver detoxification and gut health is necessary to reduce the body's toxic load and improve hormone regulation.
The liver filters out toxins and metabolizes hormones, including cortisol. Ensuring it functions optimally helps prevent the buildup of excessive hormones or of harmful substances that can disrupt hormonal balance.
A healthy gut supports the elimination of toxins through regular bowel movements and houses beneficial bacteria that assist in metabolizing and recycling hormones.
Mind-Body Practices
Therapies like acupuncture, yoga, and biofeedback are increasingly used to promote healing and balance in the body by addressing both physical and mental well-being.
Acupuncture involves the insertion of fine needles into specific points on the body to stimulate energy flow and alleviate pain, stress, and inflammation.
Yoga combines physical postures, breath control, and meditation to enhance flexibility, strength, and relaxation, reducing cortisol levels and improving overall health.
Biofeedback helps individuals gain awareness and control over physiological functions, such as heart rate and muscle tension, through real-time feedback, empowering them to manage stress, anxiety, and other health conditions effectively.
The Role of Collaboration in Functional Medicine
Collaboration between conventional and functional medicine providers is ideal for patients in recovery from Cushing’s disease.
Integrating Conventional and Functional Approaches
After initial Cushing's disease treatment, collaboration between functional medicine practitioners, endocrinologists, and other specialists provides comprehensive care for patients recovering from its complications.
Functional medicine practitioners can collaborate with endocrinologists and other specialists to address the root causes of the condition and optimize patient health through a holistic treatment plan that includes nutritional support, stress management, and lifestyle modifications.
Ongoing Monitoring and Adjustments
Ongoing monitoring and adjustments are essential in long-term Cushing's management. Regular follow-ups allow healthcare providers to track patient progress, assess hormone levels, and adjust treatment plans as needed to help the patient continue to move toward her desired health goals.
Challenges and Considerations
A collaborative approach to Cushing’s disease treatment and long-term management acknowledges the value and the roles of each provider involved.
Recognizing the Limitations
Functional medicine can offer valuable support in managing Cushing's disease, but it has limitations. In severe cases or when rapid symptom control is needed, conventional treatments like surgery, medication, or radiation may be necessary to effectively manage the condition.
Long-term management of Cushing’s requires regular cortisol assessments and monitoring for recurrence, should be done by an endocrinologist.
Importance of Patient Commitment
The success of functional medicine approaches for Cushing’s disease largely depends on the patient's commitment to making and maintaining lifestyle and dietary changes. Consistent adherence to these changes, even through small daily steps, is important for improving outcomes and managing symptoms effectively.
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Key Takeaways
- Functional medicine uses an individualized approach to manage chronic conditions resulting from Cushing's disease. This includes personalized treatment plans that consider diet, genetics, lifestyle, and specialized lab tests.
- People healing from Cushing’s disease who are ready to optimize their health should explore functional medicine as a complementary approach to managing their symptoms with its holistic, individualized care.
- With a holistic, personalized approach to care, functional medicine offers hope and support for patients ready to overcome the chronic conditions associated with Cushing's disease.
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