Adrenal gland disorders
Adrenal gland experts in Duke’s nationally ranked endocrinology program use the latest diagnostic tests and treatments to manage adrenal gland disorders including Cushing's syndrome, Conn's syndrome and adrenal cancers. We are among the few surgeons in the country that removes adrenal tumors through your back with very small incisions, which avoids painful abdominal incisions. We specialize in the use of personalized hormone replacement therapy for Addison’s disease, which occurs when the adrenal gland does not produce sufficient steroid hormones. Our goal is to help you manage your adrenal disorder and improve your quality of life.
Nationally ranked care for adrenal disorders
Adrenal gland disorders can be difficult to diagnose. If left untreated, they can cause life-threatening complications. Our nationally ranked endocrinology team is dedicated to diagnosing and treating adrenal gland disorders, including pheochromocytoma (excessive adrenaline), Cushing's syndrome (excessive cortisol) and Conn’s syndrome (excessive 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. We develop personalized hormone replacement plans to keep your crucial hormone levels in balance.
If your adrenal disorder is caused by an adrenal tumor, we use sophisticated tests to determine if surgery is needed. We remove rare endocrine tumors called paragangliomas and adrenal cancers that are often difficult to treat. We are one of the few centers in the country with surgeons skilled in removing tumors through small incisions which speeds recovery and minimizes scarring and risk of injury to abdominal organs. We use this technique to remove cancerous masses which may have spread to the adrenal gland from other organs, such as isolated lung cancer, colon cancer or ovarian cancer metastases. We also treat adrenocortical carcinoma and a rare genetic condition called congenital adrenal hyperplasia, which affects the gland’s ability to produce hormones.
Choose Duke for treatment of your adrenal disorders because we offer:
- Reputation for excellence. We rank among the top hospitals in the country for endocrinology care by U.S. News & World Report. That means our specialists offer expert care for adrenal disorders using 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 shorter hospital stays.
- Personalized care. If left untreated, the 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.
- Advanced techniques for adrenalectomy. Our highly-specialized 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 requires an incision in your abdomen and requires surgeons to work around your liver, spleen, pancreas and colon.
ADRENAL GLAND DISORDERS
Treatments
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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.
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Supplement inadequate adrenal hormone levels. Hormone replacement therapy may also be prescribed if you undergo surgery to remove your adrenal glands. If you have Addison’s disease, corticosteroids provide your body with cortisol and aldosterone, and return your hormone blood levels to normal. May be given orally or by injection.
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Minimally invasive removal of one or both of your adrenal glands through small incisions in your back (adrenalectomy). May be recommended to treat pheochromocytoma, Cushing’s and Conn’s syndrome caused by an adrenal tumor. It may also be used to remove other tumors, such as large benign tumors, cysts or metastases from other organs. Removing adrenal glands from 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.
ADRENAL GLAND DISORDERS
Tests
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Measure your hormone levels. These tests can include 24-hour urine testing for cortisol, and testing for levels of aldosterone and adrenaline, as well as testing to confirm overproduction of hormones from the adrenals.
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Measures cortisol levels in your blood before and after you receive an injection of ACTH (adrenocorticotropic hormone). If your adrenal glands do not produce cortisol in response, they may not be working properly. This may indicate Addison’s disease.
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CT scans or MRI tests produce detailed, high-quality, 3-D pictures of your adrenal glands your doctor uses to look for abnormalities.
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Imaging test that 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.
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Drugs or hormones artificially stimulate or prevent you from producing certain hormones so your doctor can see how your body reacts.
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Measures cortisol levels in a sample of your saliva collected at night when levels normally drop.