Overactive Adrenal Glands/Cushing's Syndrome
Corticosteroids help the body respond to stress. Elevated levels of these hormones are often found in pregnant women, athletes, and people suffering from depression, alcoholism, malnutrition, and panic disorders.
When adrenal glands produce excessive amounts of certain hormones, they are called "overactive." Symptoms and treatment depend on which hormones are being overproduced:
- Androgenic steroids (androgen hormones). An overproduction of androgenic steroids, such as testosterone, can lead to exaggerated male characteristics in both men and women, such as hairiness of the face and body, baldness, acne, deeper voice, and more muscularity.
- Corticosteroids. An overproduction of corticosteroids can lead to Cushing's syndrome (see below).
- Aldosterone. An overproduction of the aldosterone hormone can lead to high blood pressure and to those symptoms associated with low levels of potassium, such as weakness, muscle aches, spasms, and sometimes paralysis.
The symptoms of overactive adrenal glands may resemble other conditions or medical problems. Always consult your doctor for a diagnosis.
In addition to a complete medical history and medical examination, diagnostic procedures for overactive adrenal glands may include:
- Specific blood tests to measure levels of hormones
- Urine tests to measure levels of hormones
- Radiologic tests, such as computed tomography (CT) scan, magnetic resonance imaging (MRI), ultrasound or X-ray
Treatment of overactive adrenal glands depends on the cause of the disease and source of the overproduction of cortisol.
Treatment may include surgical removal of growths or the adrenal gland(s) itself. If external steroid use is determined to be the cause, gradual tapering and removal of the steroid may be recommended. Certain drugs that block the excessive production of certain hormones may also be administered.
Cushing's syndrome is the result of excessive corticosteroids in the body. The main cause is overproduction of adrenocorticotropinhormone (ACTH) in the pituitary gland. ACTH causes the adrenal glands to produce corticosteroids, so too much of ACTH means too much of corticosteroids. Another main cause is taking long-term external steroids like prednisone (sometimes used in some chronic diseases). In addition, certain lung cancers and other tumors outside the pituitary gland may produce corticotropins. Other causes include benign or cancerous tumors on the adrenal glands. Rarely, Cushing syndrome can be an inherited endocrine disorder.
The following are the most common symptoms of Cushing's syndrome. However, each individual may experience symptoms differently. Symptoms may include:
- Upper body obesity
- Round face
- Increased fat around neck or a fatty hump between the shoulders
- Thinning arms and legs
- Fragile and thin skin
- Stretch marks on abdomen, thighs, buttocks, arms, and breasts
- Bone and muscle weakness
- Severe fatigue
- High blood pressure
- High blood sugar
- Irritability and anxiety
- Excess facial and body hair growth in women
- Irregular or stopped menstrual cycles in women
- Reduced sex drive and fertility in men
The symptoms of Cushing's syndrome may resemble other conditions or medical problems. Always consult your doctor for a diagnosis.
In addition to a complete medical history and medical examination, diagnostic procedures for Cushing's syndrome may include:
- 24-hour urinary test to measure for corticosteroid hormones
- Computed tomography (CT or CAT scan). A noninvasive diagnostic procedure that uses a combination of X-rays and computer technology to produce horizontal, or axial, images of the body to detect any abnormalities that may not show up on an ordinary X-ray.
- Magnetic resonance imaging (MRI). A noninvasive procedure that produces two-dimensional views of an internal organ or structure.
- Dexamethasone suppression test. This test differentiates whether the excess production of corticotropins are from the pituitary gland or tumors elsewhere.
- Corticotropin-releasing hormone (CRH) stimulation test. This test differentiates whether the cause is a pituitary tumor or an adrenal tumor.
- Other laboratory tests
Treatment for Cushing's syndrome depends on its cause. Surgery may be needed to remove tumors or the adrenal glands. Other treatment may include radiation, chemotherapy, and use of certain hormone-inhibiting drugs.
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