Adrenal suppression after steroid injection

The symptoms, disabilities and life-style of a person with Cushing’s Syndrome depend on the degree of cortisol excess, the duration of the disease, the basic health of the person, but especially the type and curability of the Cushing’s Syndrome. If it is cured, all of the features of the disease can resolve, but this may take as long as 2 to 18 months. During that time, most people get annoyed and frustrated by the slow improvements in physical changes and the combination of Cushing’s and adrenal insufficiency signs and symptoms (dizziness, weakness, nausea, loss of appetite) as replacement steroid hormones are tapered and adrenal hormone production slowly improves toward normal. Frequent calls and visits to physicians are necessary.

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The adrenal gland produces hormones that affects growth, development and stress, and also helps to regulate kidney function. There are two parts of the adrenal glands, the adrenal cortex and the adrenal medulla. The adrenal cortex produces mineralocorticoids , which regulate salt and water balance within the body, glucocorticoids (including cortisol ) which have a wide number of roles within the body, and androgens , hormones with testosterone-like function. [2] The adrenal medulla produces epinephrine (adrenaline) and norepinephrine (noradrenaline). [2] Disorders of the adrenal gland may affect the production of one or more of these hormones.

Cushing's syndrome is the result of excessive corticosteroids in the body. The main cause is overproduction of adrenocorticotropin hormone (ACTH) in the pituitary gland. ACTH causes the adrenal glands to produce corticosteroids, so too much of ACTH means too much of corticosteroids. Another main cause is taking long-term external steroids like prednisone (sometimes used in some chronic diseases). In addition, certain lung cancers and other tumors outside the pituitary gland may produce corticotropins. Other causes include benign or cancerous tumors on the adrenal glands. Rarely, Cushing syndrome can be an inherited endocrine disorder. 

Endocrinologists are specialists in hormonal diseases, including adrenal and pituitary conditions that cause secondary adrenal insufficiency. An endocrinologist will have more training and experience in properly diagnosing and treating secondary adrenal insufficiency than most physicians. Most cases of permanent secondary adrenal insufficiency should be managed by an endocrinologist.  In cases of steroid withdrawal for the treatment of medical conditions, endocrinologists often work with the primary physician or specialist in that disease to assess the recovery of pituitary-adrenal reserve and provide guidance about whether long term glucocorticoid therapy is needed.

Adrenal suppression after steroid injection

adrenal suppression after steroid injection

Cushing's syndrome is the result of excessive corticosteroids in the body. The main cause is overproduction of adrenocorticotropin hormone (ACTH) in the pituitary gland. ACTH causes the adrenal glands to produce corticosteroids, so too much of ACTH means too much of corticosteroids. Another main cause is taking long-term external steroids like prednisone (sometimes used in some chronic diseases). In addition, certain lung cancers and other tumors outside the pituitary gland may produce corticotropins. Other causes include benign or cancerous tumors on the adrenal glands. Rarely, Cushing syndrome can be an inherited endocrine disorder. 

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