Evaluation and Treatment of Adrenal and Pituitary Problems

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Adrenal gland disorders include Addison’s disease, adrenal cancer, adrenal incidentaloma, congenital adrenal hyperplasia, Conn’s syndrome and Cushing’s disease. There is either overworking of the adrenal gland or underworking sometimes with a cancerous growth of the gland. The causes of adrenal problems include genetic predisposition, autoimmune diseases, tumour growths like pheochromocytomas, steroid drugs, etc. 

Symptoms of adrenal gland diseases are of various types including low appetite, nausea, loss of weight, excessive hair growth in women, dizziness, low blood pressure, low blood glucose, infertility, testicular tumours, mood swings, indigestion, etc. Visit our diabetes centre in Yeshwanthpur, Bangalore.

The diagnosis of adrenal gland disorders includes the following types of tests.

  • Insulin tolerance test.

  • Blood tests measure the production of cortisol by the body.

  • Blood tests to measure the levels of sodium and potassium.

  • Urine sample testing after 24 hours.

  • Computed Tomography (CT) scan of the adrenal glands.

  • Magnetic Resonance Imaging (MRI) of the pituitary glands.

  • Meta Iodobenzylguanidine (MIBG) scan to detect pheochromocytomas.

Treatment of adrenal gland problems may be done with drugs or with certain surgical measures like adrenalectomy. Some types of treatments are discussed below.

  • Adrenal insufficiency or Addison’s disease can be treated by hormone replacement therapies like Hydrocortisone or Prednisone. These drugs substitute the cortisol in the body which is otherwise not produced in sufficient quantities. Aldosterone is another hormone that may be replaced by Fludrocortisone in this illness. Book an appointment to have the best treatment.

  • Pheochromocytomas can be surgically removed with minimally invasive procedures depending on the size of the tumour growth. Once the tumours are removed surgically, the patient normally does not need more treatments. The blood pressure and blood glucose levels ought to be controlled precisely during these procedures. The tumours may also be treated with chemotherapy or with radiation. 

  • Adrenal cancer is normally removed through a surgical procedure so that it does not spread to the other parts of the body. 

  • Adrenal incidentalomas are treated based on their severity. If the size is large, surgical procedures are carried out to remove them. 

An Adrenalectomy procedure is done in the following ways.

  • Open Procedure

This procedure is performed when the tumour is cancerous and large. A big incision is made in the abdomen region to remove the adrenal glands.

  • Laparoscopic adrenalectomy

Laparoscopic adrenalectomy is performed by making small incisions through a minimally invasive procedure. A laparoscope is a fine tube with a camera attached at one end. This is inserted into the body by the surgeon to view the procedure. The surgery may be either performed from the back (posterior surgery) or from the side (lateral). 

  • Unilateral adrenalectomy involves the removal of only one adrenal gland.

  • Bilateral adrenalectomy involves the removal of both adrenal glands. 

Treatment for Pituitary tumours includes either surgical removal, radiation therapy or medications to shrink the tumours. 

  • Transsphenoidal surgery involves the removal of the tumour from the nasal cavity with an endoscope or microsurgery. Only small tumours are removed with this approach with the help of computerized imaging. Since it is a minimally invasive procedure, the patient can leave the hospital two to three days after the surgery.

  • Transcranial surgery is for larger tumours that cannot be extracted with the transsphenoidal approach.

  • Radiation is used to shrink tumours with high-energy X-rays. Proton beam, standard external beam or stereotactic approaches may be used here.

  • Medications involve the use of drugs like Cabergoline, Bromocriptine, Dopamine, etc. 

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