The adrenal glands sit above the kidneys and make several hormones, including the essential steroid cortisol.
It is common to find nodules on the adrenals when one has a CT or MRI scan of the abdomen. Mostly these nodules are incidental findings that do not require any treatment but it is important that these are properly assessed to ensure that they have no features of concern (fortunately adrenal cancer is a very rare cancer) and to make sure that they are not overproducing any of the adrenal hormones. This is most relevant if you also have high blood pressure.
Overactivity is usually associated with a nodule as above and includes the conditions:
Conn’s syndrome (or primary hyperaldosteronism)
Congenital adrenal hyperplasia – This is an important but uncommon condition that, if serious, usually presents in childhood. It can also present later in life with problems such as excess hair growth.
The most common reason for finding low cortisol in the blood is when someone has been taking prescribed steroids (e.g. for asthma). An uncommon cause is Addison’s disease – a condition where one loses adrenal function due to the destruction of the adrenal glands. It is important to correctly assess adrenal function and essential to correctly replace the missing hormones if they are absent.
Treatment for Adrenal Disorders
All nodules will be assessed for overactivity and if excess hormone production is found, medical treatment options aimed at blocking the hormone excess will be considered and the possibility of surgery to remove that adrenal gland will be discussed. If the adrenal nodule has any features of concern, the option of surgery will also be discussed.
If there is an excess of hormones from an adrenal gland, it is important to start medical treatment to block the harmful effects of that hormone. This can lead to relief from symptoms and better control of blood pressure which will be important even if the ultimate treatment is the surgical removal of the gland.
Two adrenal hormones (cortisol and aldosterone) are essential for life. Correct physiological replacement of these hormones, if they are absent, is, therefore, necessary for good health. It is also essential to adjust the doses of these hormones if one is unwell. Our specialists are experts at ensuring that endocrine replacement is as close to normal/previous levels as possible and will take on the monitoring of your condition to ensure good health is maintained.