Cushing Syndrome Diet: What to Know

Medically reviewed on December 10, 2023 by Jillian Foglesong Stabile, MD, FAAFP. To give you technically accurate, evidence-based information, content published on the Everlywell blog is reviewed by credentialed professionals with expertise in medical and bioscience fields.

Table of contents

• What Is Cushing Syndrome?
• Can Diet Cure Cushing Syndrome?
• 4 Guidelines For Eating With Cushing Syndrome
• Creating A Cushing Syndrome Diet
• Support Your Health With Everlywell

Cushing syndrome, also known as hypercortisolism, is a rare metabolic illness that can drastically impair the quality of life for people who have it.[1] Whether you’re dealing with facial swelling, debilitating fatigue, or managing comorbidities like diabetes, it’s crucial to treat Cushing syndrome in partnership with a healthcare professional to minimize health risks associated with this condition.[2]

In addition to medication, diet, and other lifestyle practices can be tremendously supportive for managing Cushing syndrome and its associated symptoms. Habits like avoiding highly salted or stress-inducing foods may help reduce symptoms and greatly enhance your sense of well-being.

If you’re motivated to revise your diet to combat Cushing syndrome, the following guidelines and recommendations can help you jump-start your journey.

What Is Cushing Syndrome?

Cushing syndrome is a rare condition that affects an estimated 40 to 70 people (mostly women) out of every million.[2] Healthcare providers class Cushing syndrome into two categories [3]:

• Exogenous – Exogenous Cushing syndrome results from taking medication that causes a large volume of cortisol to circulate in your system.[3] Corticosteroids are a type of medicine frequently used to treat health conditions like asthma or rheumatoid arthritis. Sometimes, taking them over a long period can result in Cushing syndrome.[2]
• Endogenous – Endogenous Cushing syndrome results from an abnormality, often an adrenal tumor or pituitary tumor in the brain.[1] This tumor causes your body to produce excess cortisol.[2] Notably, many people who have Cushing syndrome are also diagnosed with Cushing’s disease, which is traceable to a pituitary gland tumor.[2]

In addition to Cushing syndrome’s root causes, many people with the condition share a similar physical and mental health background. Patients of Cushing syndrome, or other adrenal gland disorders, frequently report a history of [1]:

• Weakness
• Fatigue
• Weight gain
• Susceptibility to bruising
• Pain in the bones and susceptibility to bone breakage and fracture
• Difficulty regulating mood
• Depression
• Diminished sex drive
• Menstrual irregularity

Note that some of these are also symptoms of PCOS. So, check in with your healthcare provider who can help determine if you have Cushing’s disease vs. PCOS.

A Cushing disease diagnosis is also linked to other health conditions like [2]:

• Type 2 diabetes
• Hypertension (high blood pressure)
• Heart attack
• Blood clots
• Bone breaks and fractures
• Difficulty with focus, concentration, or memory
• Depression

Cushing syndrome can be a difficult condition to live with, with various impacts on both physical and emotional well-being. Regardless of Cushing syndrome’s root cause, maintaining a healthy diet and lifestyle can be an effective way of protecting against health risks and improving your quality of life overall.

Can Diet Cure Cushing Syndrome?

Unfortunately, there’s no scientific evidence to suggest that nutritional or dietary interventions can cure Cushing syndrome. The recommended treatment for Cushing syndrome is surgery or tapering the use of steroid medication, depending on its cause.[1]

However, it is vital to treat any comorbidities that arise with Cushing syndrome, like diabetes, osteoporosis, or even mental health conditions. In this way, modifying diet can be a key factor in supporting both physical and psychological recovery.

4 Guidelines For Eating With Cushing Syndrome

It’s important to note that if you’ve been diagnosed with Cushing syndrome, your healthcare provider is the most important collaborator in managing and treating your condition. They can review your current health and medical history and recommend a dietary protocol suited to you.

That said, there are several general principles you might consider incorporating when designing a diet that won’t aggravate your health:

1. Being mindful of foods that spike cortisol levels – People with Cushing syndrome are already circulating large amounts of cortisol. For this reason, it may be beneficial to avoid foods, drinks, and habits that contribute to their elevation (we’ll touch on these later).
2. Supporting healthy blood sugar levels – The cortisol hormone plays a key role in balancing blood glucose levels (blood sugar).[4] Because people with Cushing syndrome have imbalanced cortisol, many develop type 2 diabetes (or diabetes mellitus), a metabolic condition that inhibits cells from retrieving adequate sugars from food.[5]
   If you’ve been diagnosed with type 2 diabetes, it’s critical to work with a healthcare provider to get medication, monitor blood sugar levels, and come up with a suitable diet for your condition. However, keeping an eye on sugar consumption can be an important tactic for people with Cushing syndrome, too.
3. Avoiding too much salt – Cortisol is known to play a major role in balancing salts in your body. Ongoing research suggests a link between high sodium consumption and excessive amounts of cortisol in the body.[6] It’s possible that reduced-sodium diets may be beneficial for people with Cushing syndrome, as limiting intake of highly salted foods may be beneficial for reducing the risk of hypertension and supporting general health.[7]
4. Emphasizing healthy lifestyle habits – Lifestyle can be just as crucial a component of a Cushing syndrome diet as nutrition alone. Not only can lifestyle adjustments combat the physical consequences of the condition, like weight gain, but they can also underwrite improved mental health if you struggle with low moods or frequent mood swings.

Creating A Cushing Syndrome Diet

When it comes to managing Cushing syndrome through diet, knowing which foods to limit or eliminate tends to be just as important as knowing which to eat. With close collaboration alongside a healthcare professional and a sustainable approach to changing your lifestyle habits, the following tips can help you create a diet that supports your physical and mental health.

For Metabolic Balance: Avoiding Caffeine And Alcohol

Certain foods won’t necessarily spike cortisol, but they can contribute to heightened stress—and cortisol is one of your body’s main stress hormones.[8]

Health experts usually recommend aiming for balance when trying to even out stress through nutrition: focusing on nutritious, whole, home-cooked foods.[8] However, you may also want to avoid stress-enhancing substances, like caffeine, which can be found in:

• Coffee
• Teas
• Sodas
• Energy drinks

Alcohol is another common substance that can contribute to heightened levels of stress in some people.[9] A growing body of research shows that regularly using alcohol can activate stress response systems in the long term—even if you typically use alcohol to decompress or unwind.[9]

If you’re a person who drinks alcoholic beverages regularly, it may be beneficial to discontinue or reduce your use for the time being.

For Managing Weight Gain: Avoiding Highly Processed Foods

Carrying excess weight is highly common among people with Cushing syndrome. If you’ve been diagnosed with comorbidities like type 2 diabetes, hypertension, or heart problems, managing your weight can be a vital part of treatment.

To develop a more balanced diet, try focusing on lean proteins, whole (rather than refined) grains, and whole fruits and vegetables. Whenever possible, try to avoid added sugars, saturated fats, and foods that undergo a high degree of manufacturing and processing.

For Overall Health: Avoiding High Salt Foods

Most adults in the US consume much more salt daily (3400mg, on average) than the FDA currently recommends (2300 mg per day).[7] While getting an adequate amount of salt is crucial for health, highly salted foods can lead to fluid retention (bloating) and long-term health risks, such as high blood pressure.

Both of these may aggravate certain symptoms of Cushing syndrome, like weight gain, so reducing your intake may help you feel healthier and happier. When stocking your kitchen, you can exercise mindfulness by:

• Avoiding highly processed foods (a good rule of thumb is to avoid shopping too much in the middle aisles of the grocery store)
• Avoiding foods with excessive amounts of sodium (one of the main constituents in salt)
• Limiting your use of table salt when eating food prepared at home

For Bone Health: Incorporating Calcium And Vitamin D

Many people with Cushing syndrome deal with bone density problems, making calcium and vitamin D key nutrients to prioritize in your diet. Foods that contain high amounts of these two nutrients include [10]:

• Oily fish, such as salmon, tuna, trout, and whitefish
• Fortified foods, like fortified dairy products and cereal
• Vegetables like broccoli, mushrooms, and kale
• Eggs
• Tofu

Research also indicates that certain lifestyle habits can increase the risk of developing osteoporosis, such as having a sedentary lifestyle or drinking more than 1 alcoholic beverage daily. This is another reason why you might consider limiting alcohol intake, as well as emphasizing exercise in your Cushing syndrome health plan (we cover this recommendation in depth below).[10]

For Supporting Mental Well-Being: Practicing Healthy Habits

While the process can take time and effort, it is possible to recover from Cushing syndrome.[11] Fundamental to this recovery process is creating healthier lifestyle habits, which may include all or some of the following [11]:

• Start spotlighting daily movement – It’s not necessary to start a thorough and intense exercise regimen when you’re diagnosed with Cushing syndrome. Instead, regular, measured activities—like gentle weight training, gentle nature hikes, or speed-walking—can be an excellent entry point into moving daily.
• Try mindful eating exercises – It’s not always easy to stick to a new diet plan, particularly if your eating habits have been built over time. Aiming to eat at a moderate pace, or taking small sips of water between bites, is one way to ensure you’re not eating too much.[12]
  Another method for discouraging overeating is to try eating most of your meals with others, as opposed to having them alone. This may have the added benefit of combating any feelings of isolation or depression by fostering a sense of social connection.

As a condition that impacts multiple areas of your mind and body, treating Cushing syndrome requires a similarly comprehensive approach. By making sensible dietary changes and focusing on your total well-being, you can protect your physical health and work towards building a higher quality of life down the line.

Support Your Health With Everlywell

Whether you’ve been diagnosed with Cushing syndrome or are simply concerned about your cortisol levels, at-home testing with Everlywell can give you a more accurate picture of your well-being.

If you’re experiencing symptoms of Cushing’s syndrome, or would like more information on how to manage it, browse women’s health online at Everlywell. Through this telehealth service, you’ll be connected with a clinician who can talk to you about your symptoms and help you establish the best treatment moving forward.

Start taking a conscious approach to your journey to well-being with Everlywell.

Related Content

Types Of Adrenal Gland Disorders

Addison’s Disease vs. Cushing’s Syndrome: What's the Difference?

Cushing's Disease vs. PCOS: What's the Difference?

References

1. Cushing syndrome - statpearls - NCBI bookshelf. (n.d.). URL. Accessed November 10, 2023.
2. Professional, C. C. medical. (n.d.). Cushing syndrome: Causes, symptoms & treatment. Cleveland Clinic. URL. Accessed November 10, 2023.
3. Corticosteroids - statpearls - NCBI bookshelf. (n.d.-a). URL. Accessed November 10, 2023.
4. Mayo Foundation for Medical Education and Research. (2023, June 7). Cushing syndrome. Mayo Clinic. URL. Accessed November 10, 2023.
5. Mayo Foundation for Medical Education and Research. (2023a, March 14). Type 2 diabetes. Mayo Clinic. URL. Accessed November 10, 2023.
6. Chen, A. X., Haas, A. V., Williams, G. H., & Vaidya, A. (2020, November). Dietary sodium intake and cortisol measurements. Clinical endocrinology. URL. Accessed November 10, 2023.
7. Gilmerm. (2023, September 19). Signs you’re eating too much salt. Cleveland Clinic. URL. Accessed November 10, 2023.
8. Gilmerm. (2023a, March 1). How to reduce cortisol and turn down the dial on stress. Cleveland Clinic. URL. Accessed November 10, 2023.
9. U.S. Department of Health and Human Services. (n.d.). Interactions between stress and alcohol. National Institute on Alcohol Abuse and Alcoholism. URL. Accessed November 10, 2023.
10. Mayo Foundation for Medical Education and Research. (2022, December 3). How to keep your bones healthy. Mayo Clinic. URL. Accessed November 10, 2023.
11. Mayo Foundation for Medical Education and Research. (2023b, June 7). Cushing syndrome. Mayo Clinic. URL. Accessed November 10, 2023.
12. Mindful eating. The Nutrition Source. (2023, July 14). URL. Accessed November 10, 2023.

Jillian Foglesong Stabile, MD, FAAFP is a board-certified Family Physician. Since completing her residency training in 2010, she’s been practicing full-scope family medicine in a rural setting. Dr. Foglesong Stabile’s practice includes caring for patients of all ages for preventative care as well as chronic disease management. She also provides prenatal care and delivers babies. Dr. Foglesong Stabile completed a teaching fellowship in 2020 and teaches the family medicine clerkship for one of her local medical schools. Dr. Foglesong Stabile’s favorite thing about family medicine is the variety of patients she sees in her clinical practice.