Subclinical Cushing Syndrome

Mild autonomous cortisol secretion without overt clinical Cushing features.

Written by: Saygı Hospital Health Guide Editorial Board

Published: February 1, 2026

This content is for general information; please consult your physician for diagnosis and treatment.

References (5)

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Endokrinoloji department. Book Appointment →

What is Subclinical Cushing Syndrome?

Subclinical Cushing syndrome, also called mild autonomous cortisol secretion, describes biochemical evidence of autonomous cortisol production without classic clinical features of Cushing syndrome. It is most often discovered incidentally in patients with an adrenal incidentaloma.

Patients lack the typical moon facies, purple striae and proximal myopathy, but commonly have hypertension, type 2 diabetes, dyslipidemia, central obesity, osteoporosis and increased cardiovascular morbidity and mortality. The metabolic burden may exceed that of patients with similar comorbidities and normal cortisol secretion.

Diagnosis relies on the 1 mg overnight dexamethasone suppression test together with low ACTH, low DHEA-S and elevated late-night salivary cortisol. Adrenal CT, bilateral adrenal vein sampling in selected cases and metabolic and bone health assessment guide the decision between surveillance, medical therapy and adrenalectomy.

Symptoms

Resistant hypertension

Type 2 diabetes or prediabetes

Central obesity

Dyslipidemia

Osteoporosis or fragility fracture

Mild proximal weakness

Subtle mood disturbance

Risk Factors

Adrenal incidentaloma

Bilateral adrenal hyperplasia

Postmenopausal women

Metabolic syndrome

Long-standing hypertension

Family history of adrenal disease

MEN-1 and Carney complex

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

Adrenal incidentaloma on imaging
Difficult to control hypertension
New onset diabetes with central obesity
Unexplained osteoporosis
Progressive cardiovascular comorbidity
Atypical mild Cushingoid features

Treatment Methods

1 mg dexamethasone suppression test

Late-night salivary cortisol measurement

ACTH and DHEA-S evaluation

Adrenal CT and functional imaging

Cardiometabolic and bone risk management

Adrenalectomy in selected patients

Long-term endocrine surveillance

Which Department to Visit?

You can visit our Endokrinoloji department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.