Understanding your health is important, especially when it comes to your adrenal glands, which play a big role in how your body works. It's essential to know how they're examined if something goes wrong. 

In this blog, we'll break down adrenal imaging—how it's done, why it's important, and what to expect. We'll also answer some common questions you might have about the process.

What Are the Adrenal Glands and What Do They Do?

Before jumping into the imaging part, let's get to know the adrenal glands better. Your adrenal glands are small, triangular-shaped glands that sit on each kidney. 

Even though they're small, they have a big job. These glands produce hormones that help control your metabolism (how your body uses food for energy), immune system (how your body fights sickness), blood pressure, and stress response.

This image shows the adrenal glands and their hormones: Cortisol, Adrenaline, and Aldosterone.

Some of the key hormones produced by the adrenal glands include:

Why Is Adrenal Imaging Important?

Adrenal imaging is a way for doctors to examine your adrenal glands to ensure they're healthy closely. Because these glands are so important to your overall health, catching any problems early is crucial. Imaging can help detect tumors, cysts, or other issues that affect how your adrenal glands work.

What Does an Adrenal Scan Show?

An adrenal scan can show important information about your adrenal glands. It can reveal if there are any tumors, cysts, or abnormal growths. 

It can also show the size and shape of the glands, which can help doctors determine if they're functioning properly. In some cases, an adrenal scan can also show how well the glands produce hormones.

What Is the Normal Imaging of the Adrenal Glands?

When doctors look at images of the adrenal glands,  they look like an upside-down "V" or "Y" and are located in front and slightly above the kidneys, in an area behind the abdominal organs. The right adrenal gland is usually near the liver, while the left is closer to the stomach and spleen. 

In normal imaging, the adrenal glands should be similar in size and shape, with no unusual growths or masses.

What Are the Imaging Techniques for Adrenal Lesion Characterization?

This image shows imaging techniques for adrenal lesions: CT Scan, MRI, Adrenal Scintigraphy, and Ultrasound.

There are several imaging techniques used to look at the adrenal glands, each with its strengths:

What Is the Best Imaging for Adrenal Hyperplasia?

Adrenal hyperplasia is a condition where the adrenal glands are larger than normal. The best imaging for diagnosing this condition is usually an MRI scan. 

MRI provides detailed images that can help doctors see the size and structure of the adrenal glands clearly. In some cases, a CT scan might also be used, especially if the MRI is not available.

Signs of Potential Adrenal Gland Issues

This image shows signs of adrenal gland issues: fatigue, high blood pressure, weight changes, and skin changes.

You must talk to your doctor if you notice any of these symptoms. They might order blood or urine tests to check for abnormal hormone levels. If these tests indicate a potential problem, imaging tests like a CT scan or MRI will likely be the next step.

Diagnosing Adrenal Gland Disorders

Diagnosing issues with the adrenal glands usually involves a combination of blood tests, urine tests, and imaging studies. Here's how it typically works:

How to Prepare for Adrenal Imaging

If you have an adrenal imaging test coming up, here are a few tips to help you prepare:

Conclusion

Understanding adrenal imaging is an important part of taking care of your health, especially if you're experiencing symptoms that could be related to your adrenal glands. Whether through a CT scan, MRI, or another type of adrenal imaging, these tests help your doctor see what's happening inside your body and determine the best way to help you.

If you have questions or concerns about your adrenal health, don't hesitate to talk to your healthcare provider. Early detection and proper diagnosis are key to keeping your adrenal glands and whole body healthy. Remember, the more you know about your health, the better you can care for yourself.

Cushing's syndrome and Cushing's disease are medical conditions that result from high levels of cortisol, a hormone produced by the adrenal glands. These conditions can lead to a variety of symptoms that may significantly impact a person's quality of life. 

In this blog, we’ll explore what Cushing's syndrome and disease are, discuss the symptoms, and explain the testing procedures used to diagnose them. Early diagnosis and treatment are key to managing these conditions and preventing serious complications.

Understanding the Basics Between Cushing Syndrome and Cushing Disease

Adrenal Imaging

Cushing's syndrome occurs when there is an excessive amount of cortisol in the body, regardless of the cause. This can happen due to prolonged use of corticosteroid medications, such as prednisone, or because of an adrenal gland tumor that produces too much cortisol.

On the other hand, Cushing's disease specifically refers to a condition where a pituitary gland tumor secretes too much adrenocorticotropic hormone (ACTH), which in turn stimulates the adrenal glands to produce excessive cortisol.

While Cushing's syndrome refers to the broader problem of excess cortisol, Cushing's disease is a specific cause of that excess due to an issue with the pituitary gland. Understanding the difference between these two is important, as it influences the approach to treatment and management.

Signs and Symptoms

Recognizing the symptoms of Cushing's syndrome and Cushing's disease early can make a big difference in treatment outcomes. Some common symptoms include:

These symptoms can develop gradually, making them easy to overlook at first. However, they can lead to severe health problems if not addressed. It’s important to be aware of these signs and seek medical advice if they persist.

How is Cushing Syndrome and Disease diagnosed?

Cushing's Disease/Syndrome is diagnosed through tests like the Overnight Dexamethasone Suppression Test (DST), the 24-Hour Urine Free Cortisol Test, and the Late-Night Salivary Cortisol Test, which measure cortisol levels to confirm the condition.

Early diagnosis is key to managing the condition and preventing serious health complications, such as osteoporosis, hypertension, diabetes, and cardiovascular issues.

The Standard Tests for Cushing's Disease/Syndrome

Adrenal Imaging
  1. Overnight Dexamethasone Suppression Test (DST):
    • Procedure: For this test, a patient takes a small dose of dexamethasone (a synthetic steroid) at night. The next morning, blood is drawn to measure cortisol levels.
    • Purpose: The idea is that dexamethasone should suppress cortisol production in people without Cushing's syndrome. If cortisol levels remain high, it suggests the presence of Cushing's syndrome.
    • Interpretation: If cortisol levels are not sufficiently suppressed, it may indicate Cushing's syndrome or disease. Further testing is usually required to determine the specific cause.
  2. 24-Hour Urine Free Cortisol Test:
    • Procedure: The patient collects all urine produced over a 24-hour period. The urine is then analyzed to measure the amount of cortisol.
    • Purpose: This test helps determine if there is an excessive amount of cortisol being produced over an extended period.
    • Interpretation: Elevated cortisol levels in the urine strongly suggest Cushing's syndrome. However, this test alone cannot distinguish between Cushing's syndrome and Cushing's disease.
  3. Late-Night Salivary Cortisol Test:
    • Procedure: A small sample of saliva is collected late at night, typically around midnight.
    • Purpose: Cortisol levels naturally drop in the evening. In people with Cushing's syndrome, these levels may remain high even late at night.
    • Interpretation: High cortisol levels in the late-night sample can indicate Cushing's syndrome or disease.
  4. Other Potential Tests:
    • Imaging Tests: If initial tests suggest Cushing's disease, imaging tests like MRI or CT scans may be used to locate tumors on the pituitary or adrenal glands.
    • ACTH Levels: Measuring the level of ACTH in the blood can help differentiate between Cushing's syndrome and Cushing's disease. High ACTH levels typically indicate Cushing's disease, while low levels suggest an adrenal cause.

Conclusion

Cushing's syndrome and Cushing's disease are serious conditions that require careful diagnosis and management. Understanding the symptoms and undergoing the right tests are essential steps in getting the proper treatment. 

At Natural Endocrinology Specialists, we are committed to providing comprehensive, personalized care that addresses your unique health needs. With the right approach, it is possible to manage these conditions effectively and improve your quality of life.

When to Seek Medical Help?

If you or someone you know is experiencing symptoms that might indicate Cushing's syndrome or Cushing's disease, it’s crucial to consult a healthcare provider. If left untreated, these conditions can lead to serious health issues such as severe hypertension, type 2 diabetes, osteoporosis, and increased risk of infections.

If you’re experiencing any symptoms or have concerns about your health, don’t hesitate to reach out to us.

Are you stressed out?

Who does not have stress? It's inevitable. You are human and you will experience this symptom.

The thing is that stress is not a bad thing, what is bad is having poor coping skills and letting it affect your health in a negative way.

Without stress, we cannot survive, it is essential to learn how to manage it so it can work in your favor instead of against you.

When stress becomes a chronic response, that is when it starts to affect your body in a negative way. Elevated cortisol levels are linked with a poor immune response, insomnia, anxiety, poor health, cardiovascular risk, and more.

Did you know you can get this response measured to see where you are at that is the best thing you can do to get on top of it now!

How we can help you with your cortisol levels

Awareness is key. Once you can identify your stress response, you can learn new actions to take to get it back on track.

At NES™, we offer a 4-point salivary cortisol test to help us better understand the secretion of this hormone throughout the day and to get a deeper understanding of your circadian rhythm.

The downside of doing this in a simple blood test is that you can only get one reading and that may look normal.

A full day picture is a better analysis of how cortisol is being released in your body by the adrenal glands. There are different types of rhythms and the most optimal one is when you are thriving and in the zone based on the circadian slope.

You can have other conditions where your cortisol may be below in the morning and high in the evenings, or you can either run high cortisol all day or low cortisol all day.

Once this is better understood, a specific treatment plan will be recommended for you to get your adrenal health in excellent shape and back on the nice curve.

A normal and optimal cortisol curve shows a high level in the morning and a low level at night. Ask us more about cortisol testing!

Woman with arms in air happy because her cortisol was regulated correctly

What to expect from us

At your doctor's appointment, a take-home salivary cortisol test may be recommended for you to better understand and evaluate your adrenal health.

Your adrenal gland release cortisol and do so in a circadian pattern, high in the mornings, low at night. It mimics the light and dark cycle; it should be the highest during the hours of sunrise and lowest during the hours of sunset.

This test is a salivary cortisol test that requires you to collect 4 saliva samples at specific times during the day. The kit comes with prepaid mailing instructions and is to be completed and shipped out by the patient upon completion. The results will be sent directly to your doctor.

At your next scheduled follow-up appointment, the results will be reviewed and if a treatment should be required, it will usually be discussed at this visit. 

A repeat test will typically be required so that a pre and post-analysis of your cortisol levels can be determined to see if therapy and results are improving symptoms.

Examples of HIGH and LOW Serum Cortisol Levels:

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Dr. Linda Khoshaba is the Leading Integrative Health and Hormone Doctor in Scottsdale, Arizona. She has extensive experience working in the field as a Hormone Specialist and Natural Endocrinologist.

Phone: 480-687-0054
Fax: 833-605-1101
Email: contact@nesaz.com
Address: 
Suite A 109
7500 E. Pinnacle Peak Rd. 
Scottsdale, AZ 85255

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Mon: 8:30 AM - 4:30 PM
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