Adrenal gland

Novel PET Imaging Technique Accurately Diagnoses Adrenal Gland Disorder.

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A novel imaging approach, 68Ga-pentixafor PET/CT, has been shown to accurately identify sub-types of primary aldosteronism, an adrenal gland disorder, outperforming conventional methods for diagnosis. Reported in The Journal of Nuclear Medicine, this detailed imaging technique provides a clearer picture of the adrenal glands, helping doctors decide more confidently whether surgery is the right option for patients.

Primary aldosteronism is an endocrine disorder that occurs when the adrenal glands produce too much of the hormone aldosterone, frequently caused by the presence of nodules on the glands. High aldosterone levels cause the body to retain too much sodium and not enough potassium. This imbalance can lead to high blood pressure, putting patients at an increased risk of stroke and heart disease.

“In primary aldosteronism, it’s important for physicians to differentiate between surgically eligible and ineligible forms so that they can develop the best treatment plan. This is usually done with adrenal CT and adrenal venous sampling. However, is rather challenging and often imprecise to diagnose adrenal micronodules with these methods,” said Li Huo, MD, PhD, professor and chair in the Department of Nuclear Medicine at the Chinese Academy of Medical Sciences and Peking Union Medical College Hospital in Beijing, China. “To more clearly image these micronodules, we combined PET/CT with a unique tracer that targets specific receptors in the adrenal glands and evaluated its performance.”

In the study, 123 patients with adrenal micronodules identified by adrenal CT were examined using 68Ga-pentixafor PET/CT, and 104 patients who underwent surgery or successful adrenal venous sampling were included in the analysis. Nuclear medicine physicians evaluated the 68Ga-pentixafor PET/CT data for sensitivity, specificity and accuracy of visual analysis. This information was then compared to adrenal CT and adrenal venous sampling results.

68Ga-pentixafor PET/CT showed superior sensitivity, specificity and accuracy (90.2 percent, 72.7 percent and 86.5 percent, respectively) in identifying surgically eligible primary aldosteronism patients compared with adrenal CT (73.1 percent, 53.8 percent and 68.3 percent, respectively). It was also able to predict surgical outcomes better than adrenal venous sampling (82.4 percent vs. 68.86 percent).

“The significance of this work lies in its potential to change how we diagnose and treat primary aldosteronism patients with tiny adrenal nodules. For patients, this means an improved chance of getting the right treatment, especially when it comes to deciding whether surgery is necessary. Accurate diagnosis is crucial because it leads to more effective treatments, less unnecessary surgery and overall better health outcomes. It’s about offering patients a more personalized and precise medical approach,” stated Huo.

Adrenal fatigue symptoms and seven ways to support and heal your adrenal glands.

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In our modern world, adrenal fatigue is extremely common and estimated by some experts to affect approximately 80 percent of the population to some degree. Adrenal fatigue is caused by all types of stress – physical and emotional – and if left unchecked, it can lead to other illnesses such as type 2 diabetes, thyroid disease and heart attack.

fatigue

The symptoms caused by adrenal fatigue are numerous and varied. The following are some of the more common ones:

  • Anxiety
  • Panic attacks
  • Diarrhea
  • Frequent urination
  • Thyroid issues
  • Salt cravings
  • Sugar cravings
  • Insomnia
  • Waking tired
  • Needing caffeine to ‘get going’ in the morning
  • Feeling stressed
  • Inability to handle stress
  • Overthinking (having a brain that won’t turn off)
  • Dizziness when rising from seated or lying position
  • Fluid retention in feet and ankles
  • Low blood pressure


As you can see, adrenal fatigue can cause many symptoms and eventually lead to many health challenges. However, the good news is that there are plenty of things we can do to support our adrenal glands to help return them to a healthy state.

Reduce or eliminate stimulants

Stimulants such as caffeine, alcohol, nicotine and drugs cause a stress response in the body and, if used chronically, will wear out the adrenal glands. Those who feel that they need their morning coffee should understand that, although it might feel as though caffeine is helping, it is actually stealing their health by exacerbating their adrenal fatigue.

Practice meditation

Meditating daily can help reduce stress levels. Finding even 10 or 15 minutes a day to quiet the mind by meditation has been proven to be of benefit for reducing stress.

Clean up your diet

Eating a highly processed diet creates stress in the body. Many people don’t consider the stress caused to the body by eating processed foods. Processed foods contain chemicals that have no place in the body, such as preservatives, colors, stabilizers and more. These chemicals can have negative effects on the various systems of the body and add additional waste products that need to either be eliminated or stored.

Make good use of adaptogenic herbs

There are a number of adaptogens that are useful for the adrenal glands. These herbs can be taken in the form of teas, tinctures, powders or capsules and include:

  • Rhodalia
  • Ashwaganda
  • Tulsi, or Holy basil
  • Korean Ginseng
  • He Shou Wu
  • Licorice (Note: Licorice can raise blood pressure)

 

Make time to relax

Take time to chill out and make the time to do the things that you love doing and make you happy.

Eat more salt

Adrenal glands love salt. Buy a good quality, unprocessed salt, such as Celtic sea salt or Himalayan salt, and use it liberally.

Try this adrenal cocktail

Try taking this adrenal cocktail either before bed if you suffer from insomnia or upon rising if you have trouble getting going in the morning. It really works!

1/2 cup orange juice (or another form of vitamin C)
1/2 teaspoon cream of tartar
1/2 teaspoon Celtic sea salt
Mix and drink.

Finally, don’t watch horror movies and don’t do things that get your adrenaline pumping. They will simply cause more stress for your already overworked adrenal glands, leaving you feeling tired and wired.

Ipilimumab-induced autoimmune adrenalitis.

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A 56-year-old woman presented with fatigue and headache after receiving four doses of ipilimumab, a monoclonal antibody against cytotoxic T-lymphocyte antigen 4, for the treatment of metastatic melanoma. Low morning serum concentrations of corticotropin (<1·1 pmol/L [reference range 2·2—13·2 pmol/L]) and cortisol (41·4 nmol/L [reference range 165·5—662·2 nmol/L]), combined with pituitary enlargement, were consistent with hypophysitis-related secondary adrenal insufficiency.

adrenal

Treatment with a replacement dose of hydrocortisone was initiated. Before ipilimumab treatment, her adrenal glands (circled) were normal in size (figure A). A subsequent surveillance CT scan of the abdomen showed bilateral enlargement of adrenal glands (figure B). Her serum cortisol and aldosterone concentrations did not respond to cosyntropin stimulation, which indicated primary adrenal insufficiency. 6 weeks later, her adrenal glands normalised in size (figure C). The dynamic size change of the adrenal glands suggests ipilimumab-related autoimmune adrenalitis. Although secondary adrenal insufficiency is a fairly common endocrinopathy related to ipilimumab treatment, the identification of primary adrenal insufficiency that could coexist with secondary adrenal insufficiency is important.

Source: Lancet