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Adrenal Disease and Adrenal Carcinoma

What is the adrenal gland

The adrenal glands are located on top of each kidney and normally produce three classes of hormones: glucocorticoids, mineralocorticoids, and androgens. Adrenal disease occurs when the adrenal glands produce an excess or insufficient amount of one or more of these classes of hormones. The adrenal glands can also develop cancer. Occasionally these are genetic / hereditary cancers that will require specialized training to manage for the patient and at risk family members.

Types of adrenal diseases:

Adrenal insufficiency

This is where the adrenal gland produces inadequate hormones for the requirements of the body. This is usually an autoimmune condition but can occur after long term glucocorticoid therapy or after an insult to the adrenal gland.

How is adrenal insufficiency treated?

Treatment may require supplementation with glucocorticoid medication such as Hysone. If the adrenal insufficiency is due to autoimmune disease (Addison’s disease), additional mineralocorticoid therapy with Florinef is also required. In some cases androgens are also replaced.

Cushing’s syndrome

This can be a result of excess glucocorticoid (steroid) from the adrenal gland. This can result in central weight gain, hypertension, diabetes and osteoporosis.

How is cushing’s syndrome treated?

Adrenal Cushing’s syndrome is generally treated surgically with removal of the affected adrenal gland. This is best done by a high volume adrenal surgeon.

Hyperaldosteronism

Excess aldosterone produced by the adrenal gland generally results in an elevated blood pressure. If left untreated long term it can affect the heart and cardiovascular system. Once identified, your doctor will need to work carefully to establish the type of hyperaldosteronism. This can include a number blood, radiology and genetic tests.

How is hyperaldosteronism treated?

Once the type of hyperaldosteronism is identified, the treatment is generally surgical, though life long therapy with medication to block the effects of aldosterone may be required depending on the subtype of hyperaldosteronism.

Pheochromocytoma

Pheochromocytoma is a rare neuroendocrine tumor that can occur in families. It generally presents with elevated blood pressure but can be found incidentally on scanning the abdomen.

Treatment of pheochromocytoma

Treatment of Pheochromocytoma is surgical once medical control of blood pressure has been achieved. Genetic testing of the patient is now regularly performed to ensure no genetic cause is present. Specialist endocrinologists will help you with this process.