Sometimes tumors on the pituitary or adrenal glands can contribute to a condition known as Cushing syndrome , which is characterized by high levels of cortisol in the blood. Individuals with Cushing syndrome will experience rapid weight gain in the face, abdomen, and chest. Often doctors will notice this because of the individual's slender arms and legs compared to the heavy weight in the core of the body. Cushing syndrome also causes a flushed face, high blood pressure, and changes in the skin. Osteoporosis and mood swings are also a factor considered with Cushing disease.
During conventional pharmacologic dose corticosteroid therapy, ACTH production is inhibited with subsequent suppression of cortisol production by the adrenal cortex. Recovery time for normal HPA activity is variable depending upon the dose and duration of treatment. During this time the patient is vulnerable to any stressful situation. Although it has been shown that there is considerably less adrenal suppression following a single morning dose of prednisolone (10 mg) as opposed to a quarter of that dose administered every six hours, there is evidence that some suppressive effect on adrenal activity may be carried over into the following day when pharmacologic doses are used. Further, it has been shown that a single dose of certain corticosteroids will produce adrenal cortical suppression for two or more days. Other corticoids, including methylprednisolone, hydrocortisone, prednisone, and prednisolone, are considered to be short acting (producing adrenal cortical suppression for 1¼ to 1½ days following a single dose) and thus are recommended for alternate day therapy.