Endocrinologists at Cedars-Sinai specialize in caring for adrenal disorders, such as adrenal insufficiency, hormone producing and non-producing benign adrenal tumors and adrenal cancer. Our approach includes sophisticated imaging tests, medications and surgery when necessary. We focus on your needs to help you live life to the fullest.
What Is Adrenal Disease?
You have two adrenal glands that are located just above your kidneys. The adrenal glands produce hormones that regulate:
- Carbohydrate, protein and fat metabolism
- How your body uses energy
- Weight, blood pressure and heart rate
- Response to stress and inflammation
- Muscle, tendon, skin and hair health
- Cognition, nervous system activity and mental well-being
High or low levels of adrenal hormones (including steroid hormones like cortisol and non-steroid hormones like adrenaline) can make you feel sick. In some cases, they cause serious medical problems, such as adrenal crisis. Adrenal disease also includes tumors and cancer. For more information, read our adrenal disorder patient guide.
Our Approach to Adrenal Care
Our experts are endocrinologists with additional training in adrenal gland disorders. Our team also includes experienced adrenal surgeons. We stay up to date on the latest research, so you receive the best available care.
Highlights of our program include:
Adrenal experts work alongside other Cedars-Sinai specialists, including cardiologists, oncologists, radiologists, genetics counselors and pathologists. We discuss test results and consider all of your care options before coordinating the therapies that are right for you.
Care That Meets Your Needs
We provide expert care for people with all adrenal conditions. These conditions can be caused by adrenal damage or by another condition that affects the adrenal glands.
We are one of the few adrenal programs in the country offering robotic surgery. Using sophisticated technology, our surgeons perform procedures through tiny incisions, with a higher degree of precision than other techniques. Read more about adrenal gland surgery.
Expertise with Rare Conditions
We diagnose and treat diseases that are difficult to detect such as pheochromocytoma. Our research efforts give you access to new treatments, some of which are only available in top programs such as ours. Learn more about the conditions we treat.
Adrenal Gland Disorder Testing and Counseling
We perform tests so we can arrive at an accurate diagnosis. Tests may include:
- Hormone testing: These tests determine which steroid hormone levels are abnormal. Find out more about hormone testing.
- Adrenal vein sampling: We take blood samples from veins near the adrenal glands to evaluate problems such as aldosteronism (hyperaldosteronism). This test helps us determine whether excess levels of the steroid aldosterone are coming from one or both adrenal glands.
- Genetic testing and counseling: We may recommend genetic counseling if you have an inherited adrenal disease, adrenal gland tumors or cancer. We explain how these conditions may affect your health, and we help you make important care decisions. Learn more about our genetic testing and team of counselors.
- Imaging tests: We use imaging studies such as CT scans or adrenal MRIs to evaluate the size and shape of adrenal tumors.
- IV saline suppression test: We inject saline (sodium chloride 0.9%) into the vein over four hours and measure aldosterone levels before and after the infusion. This test helps us confirm or rule out primary hyperaldosteronism.
- Clonidine suppression test: You take a clonidine pill (a medication used to treat hypertension) and we measure metanephrine levels (products of epinephrine and norepinephrine) before and a few hours after you take the pill. This test helps us confirm or rule out pheochromocytoma or paraganglioma.
Adrenal Disease Treatments
Our adrenal disease experts develop a personalized treatment plan that reflects the latest care practices. We consider your diagnosis as well as other medical problems, so you receive the most appropriate treatments.
Your care may include:
- Hormone or medication therapy: Therapies can be used to replace hormones that are not being properly produced and help you maintain appropriate levels of adrenal hormones. Medications can also slow the rate at which your body produces adrenal hormones and help manage symptoms. Read more about medical and hormone replacement therapy for endocrine disorders.
- Monitoring steroid side effects and steroid taper: Taking certain prescription steroid medications for a long time increases your risk for problems such as Cushing’s syndrome, which is associated with weight gain, high blood pressure, high lipid levels, osteoporosis and diabetes. We will monitor and treat these side effects. Long-term use of these steroid treatments can also result in adrenal insufficiency. Because it's not safe to suddenly discontinue steroids, we recommend a taper. We gradually reduce the dose and eventually stop the medication or switch you to one that's safer to take long term.
- Surgery: We use surgery to remove tumors from adrenal glands. Most patients have minimally invasive procedures, where we use tiny incisions that heal quickly.
- Other procedures: We use radiation and ablation of tumors when needed.
Preventing and Treating Adrenal Insufficiency Complications: Adrenal Crisis
Adrenal insufficiency occurs when your body does not produce enough of the hormone cortisol. When illness or injury strikes, you need even more of this hormone, and you could be at risk for adrenal crisis, which can be life-threatening.
Our experienced team at Cedars-Sinai will provide care to help lower your risk of adrenal crisis. We meet with you regularly, so we can adapt your care plan to your changing needs. If you do experience adrenal crisis, our emergency department stands ready to help you any time, day or night.