We have two adrenal glands, each about the size of a grape. Each sits on top of one of our kidneys, one on each side of the body. Each adrenal gland has two parts - the central core, called the medulla, and the outer layer, called the cortex. The medulla produces two hormones: epinephrine (adrenaline) and norepinephrine (noradrenaline), which play an important part in controlling heart rate and blood pressure. The cortex produces three groups of steroid hormones that control a wide range of other body processes. The most important include aldosterone, hydrocortisone, and the sex hormones — androgens, estrogen, and progesterone — which influence sexual development.
In Cushing's syndrome, there is an excess of steroid hormones in your blood. In the majority of cases, it is caused by large doses of such hormones, like prednisone, that are being taken for another illness, such as an autoimmune disease or asthma. Rarely, Cushing’s syndrome is caused because the cortex of one or both of the adrenal glands is producing too much hydrocortisone; such over-production could be due to a tumor in the gland or a tumor elsewhere in your body that is over-stimulating the gland. If the tumor is in the pituitary gland, the condition is called Cushing's disease rather than Cushing's syndrome.
Commonly Prescribed (On-Label) Drugs: Aminoglutethimide, Dexamethasone, Trilostane
Off-Label Prescription Drugs Breakthrough Options: Ketoconazole, Mifepristone, Mitotane
Hyperaldosteronism is a rare disease caused by an excess production of the aldosterone by the adrenal gland. This hormone is responsible for sodium and potassium balance, which then directly controls water balance to maintain appropriate blood pressure and blood volume. Primary hyperaldosteronism is caused by an abnormality within the gland. Secondary hyperaldosteronism is caused by something outside the gland that mimics the primary condition.
Hyperaldosteronism causes high blood pressure and a low serum potassium level.
Commonly Prescribed (On-Label) Drug: Spironolactone
Off-Label Prescription Drugs Breakthrough Options: Amiloride, Captopril, Triamterene
Pheochromocytoma is a tumor of the adrenal gland that arises in the medulla, the center of the adrenal gland. 80% are found in only one adrenal gland. Ten percent occur on both kidneys, and 10% occur outside the adrenal glands. Pheochromocytomas can cause headaches, sweating, rapid changes in blood pressure — up and down — rapid heartbeat, and other symptoms. Those that arise in the medulla can cause a serious rise in blood pressure.
Commonly Prescribed (On-Label) Drugs: Iobenguane I-131, Metyrosine, Phenoxybenzamine, Phentolamine, Propranolol
Off-Label Prescription Drugs Breakthrough Options: Doxazosin, Prazosin, Clonidine
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