Adrenal Gland Disorders

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Overview

Duke endocrinologists diagnose and treat adrenal gland disorders, including pheochromocytoma, Cushing's syndrome (elevated cortisol), and Conn’s syndrome (elevated aldosterone), all of which involve the overproduction of adrenal hormones. We also treat adrenal cancer, rare neuroendocrine tumors called paragangliomas, and a rare genetic condition called congenital adrenal hyperplasia, which affects the gland’s ability to produce hormones.

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Treatments

Treatments Overview

We develop personalized hormone replacement plans to keep your crucial hormone levels in balance if there is a deficiency. Additionally, we are experts in hormone-blocking techniques when hormones are in excess. Surgery may be recommended to treat conditions related to an adrenal tumor.

Medications

Description

May block the effects of excessive hormone levels or control symptoms associated with adrenal disorders, such as the high blood pressure caused by pheochromocytoma or hyperaldosteronism. Medications may be your primary treatment if you are not eligible for surgery.

Hormone Replacement Therapy

Description

Hormone replacement therapy may be prescribed to supplement inadequate hormone levels. It may also be prescribed if you undergo surgery to remove your adrenal glands. If you have Addison’s disease, corticosteroids and mineralocorticoids provide your body with cortisol and aldosterone and return your hormone levels to normal. Hormone replacement therapy is most often done with oral medication.

Posterior Retroperitoneoscopic Adrenalectomy

Description

Small incisions are made in your back to remove one or both of your adrenal glands. This is called an adrenalectomy. The procedure may be recommended to treat pheochromocytoma, Cushing’s syndrome, or Conn’s syndrome caused by an adrenal tumor. Removing adrenal glands through the back -- rather than through your abdomen -- means we do not have to move or touch any abdominal organs. You experience fewer risks, minimal scarring, and faster recovery. If you are not a candidate for this procedure, we also perform traditional transabdominal laparoscopic or open surgery for adrenalectomy.

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Duke Health offers locations throughout the Triangle. Find one near you.

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Tests

Urine and Blood Tests

Description

These tests measure your hormone levels and can include:

24-hour urine testing for cortisol
aldosterone and adrenaline tests
testing to confirm overproduction of hormones from the adrenal glands

Cortisol Stimulation Test

Description

Measures cortisol levels in your blood before and after you receive an injection of adrenocorticotropic hormone (ACTH). If your adrenal glands do not produce cortisol in response, they may not be working properly. This may indicate Addison’s disease or other adrenal insufficiencies.

CT and MRI Scans

Description

Produce detailed, high-quality, 3D pictures of your adrenal glands. Your doctor will use these scans to look for abnormalities.

MIBG (metaiodobenzylguanidine) Scan

Description

This imaging test combines a substance called MIBG with a radioactive tracer to help detect pheochromocytoma (adrenal-producing tumors). MIBG gathers in certain types of tumors, which lets them show up more clearly on images taken with the scanner.

Provocative/Suppression Test

Description

Drugs or hormones artificially stimulate production of -- or prevent your body from producing -- certain hormones so your doctor can see how your body reacts.

Saliva Test

Description

Measures cortisol levels in a sample of your saliva collected at night, when levels normally drop.

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Why Choose Duke

Content

Expert Care for Adrenal Disorders
Our specialists use the most advanced tests, surgeries, and treatments available today, as well as minimally invasive surgical options that can result in less pain, fewer complications, minimal scarring, and a shorter hospital stay.

Treatment for Rare Conditions
We remove rare endocrine tumors called paragangliomas and adrenal cancers that are often difficult to treat. We also treat adrenocortical carcinoma and a rare genetic condition called congenital adrenal hyperplasia, which affects the gland’s ability to produce hormones.

Personalized Care
Hormone imbalances associated with adrenal disorders can cause high blood pressure, cardiovascular problems, and metabolic issues. We develop personalized treatment plans tailored to your body’s needs and hormone levels.

Surgical Access Through Your Back
Our surgeons use a minimally invasive approach to access your adrenal glands through tiny incisions in your back. This direct access to your adrenal glands is in contrast to the traditional surgical approach, which uses an incision in your abdomen and requires surgeons to work around your liver, spleen, pancreas, and colon. Using small incisions speeds recovery and minimizes scarring and risk of injury to abdominal organs. We use this technique to remove cancerous masses that may have spread to the adrenal gland from other organs, such as isolated lung cancer, colon cancer, or ovarian cancer metastases.

Best Hospital for Endocrinology and Diabetes in NC

When it comes to your care, you want the very best. Duke University Hospital is proud of our team and the exceptional care they provide. They are why our diabetes and endocrinology program is rated as high performing among the nation's top hospitals, and the highest-ranked program in North Carolina, according to U.S. News & World Report for 2022–2023.

This page was medically reviewed on 12/17/2019