Adrenal surgery is a complex and highly specialized procedure that requires the expertise of an experienced surgeon. At th...

Adrenal surgery is a complex and highly specialized procedure that requires the expertise of an experienced surgeon. At the Carling Adrenal Center, we are proud to be the destination of choice for patients traveling for adrenal surgery from across the United States and around the world. With more than half of our patients coming from outside of Florida—and over 10% from other countries—we under...

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High aldosterone, or hyperaldosteronism, is a condition where the adrenal glands produce too much aldosterone, a hormone r...

High aldosterone, or hyperaldosteronism, is a condition where the adrenal glands produce too much aldosterone, a hormone responsible for regulating blood pressure by balancing sodium and potassium in the blood. The most common form of this condition is primary hyperaldosteronism, also known as Conn’s Syndrome. This disorder can lead to persistent high blood pressure and other serious health iss...

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While adrenal vein sampling (AVS) is the gold standard for diagnosing subtypes of primary hyperaldosteronism (Conn’s syndr...

While adrenal vein sampling (AVS) is the gold standard for diagnosing subtypes of primary hyperaldosteronism (Conn’s syndrome), it is not always necessary for every patient. The decision to perform AVS depends on individual circumstances, and many patients may not need it at all. This is where consulting with an expert adrenal surgeon and team becomes crucial, as they can help determine whether...

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INTRODUCTION Cortisol, often referred to as the "stress hormone," plays a crucial role in our body's response to stress. ...

INTRODUCTION Cortisol, often referred to as the "stress hormone," plays a crucial role in our body's response to stress. Produced by the adrenal glands, cortisol helps regulate metabolism, blood sugar levels, and the immune response. However, like many things in life, balance is key. When cortisol levels become chronically elevated—a condition known as adrenal hypercortisolism or Cushing's syn...

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Introduction Primary hyperaldosteronism, also known as Conn's syndrome, is a condition characterized by the overproductio...

Introduction Primary hyperaldosteronism, also known as Conn's syndrome, is a condition characterized by the overproduction of the hormone aldosterone by the adrenal glands, leading to high blood pressure and low potassium levels. While traditionally considered a somewhat rare cause of hypertension, recent studies suggest it is much more common than previously thought. Advances in medical resea...

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It is very important to highlight Mild Autonomous Cortisol Secretion (MACS) during Adrenal Awareness Month. Mild Autonomo...

It is very important to highlight Mild Autonomous Cortisol Secretion (MACS) during Adrenal Awareness Month. Mild Autonomous Cortisol Secretion (MACS) is a condition where the body produces excess cortisol, a hormone crucial for various bodily functions. Other names for MACS are subclinical Cushing’s syndrome (SCS) and primary hypercortisolism. YES! They are all names for the same thing. The na...

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What are the most frequent questions we get at the Carling Adrenal center? “Dr. Carling: I’m so worried I am going to h...

What are the most frequent questions we get at the Carling Adrenal center? “Dr. Carling: I’m so worried I am going to have to take steroids after my adrenal surgery. Do I really need to take steroids (prednisone or hydrocortisone) after adrenal surgery? I am so concerned I am going to have adrenal insufficiency. I have read a lot about it online…I have googled adrenal insufficiency and Addis...

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If you or someone you know is facing the prospect of removing adrenal glands, you're in the right place. As the highest vo...

If you or someone you know is facing the prospect of removing adrenal glands, you're in the right place. As the highest volume adrenal surgeon globally, Dr. Carling specializes in a cutting-edge technique known as the Mini Back Scope Adrenalectomy (MBSA). In this post, we'll delve into what adrenal glands are, why their removal may be necessary, and how this groundbreaking procedure offers pati...

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Pheochromocytoma Specialist: Introduction When it comes to the diagnosis and treatment of pheochromocytomas, expertise ma...

Pheochromocytoma Specialist: Introduction When it comes to the diagnosis and treatment of pheochromocytomas, expertise matters and finding a pheochromocytoma specialist is crucial. Pheochromocytomas are rare and complex tumors of the adrenal gland that require careful management. Selecting a highly experienced pheochromocytoma specialist can make a significant difference in the outcomes and ov...

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So, you've just received the news that you need an adrenalectomy. Perhaps you have a cortisol-producing tumor, an aldoster...

So, you've just received the news that you need an adrenalectomy. Perhaps you have a cortisol-producing tumor, an aldosterone-producing tumor, an adrenal carcinoma, or another adrenal disorder that requires surgery to be cured. It's completely normal to feel a mix of emotions and have a thousand questions running through your mind. Don't worry, we're here to guide you through the process. At t...

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Adrenal nodules (aka mass, lesion, tumor) are growths that occur in the adrenal gland forming a lump or bump within the ot...

Adrenal nodules (aka mass, lesion, tumor) are growths that occur in the adrenal gland forming a lump or bump within the otherwise smooth, even adrenal. Adrenal nodules are common in older people (occurring in 7-10%), but less common (but often even more important) in younger people. The overall prevalence of adrenal nodules in the general population has been estimated to be as high as 10% based...

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Adrenalectomy is a surgical procedure that involves the removal of one or both adrenal glands, which are responsible for p...

Adrenalectomy is a surgical procedure that involves the removal of one or both adrenal glands, which are responsible for producing hormones that regulate various bodily functions. Adrenalectomy may be performed for a number of reasons, including the presence of tumors or other abnormalities in the adrenal gland. Recovery from adrenalectomy can be challenging, but with proper care, individuals c...

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Conn's syndrome, also known as primary hyperaldosteronism, is a hormonal disorder that affects the adrenal glands. It is c...

Conn's syndrome, also known as primary hyperaldosteronism, is a hormonal disorder that affects the adrenal glands. It is caused by the overproduction of aldosterone, a hormone that regulates salt and water balance in the body. This overproduction can lead to high blood pressure, low potassium levels, and other health problems. Find out why Conn’s syndrome is a silent killer. Further, Conn’s s...

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The Best Surgery and Treatment Options for Cushing's Disease We perform more bilateral total adrenal operations (BLA) for...

The Best Surgery and Treatment Options for Cushing's Disease We perform more bilateral total adrenal operations (BLA) for “failed” Cushing’s Disease than any institution in the United States. What is “failed” Cushing’s Disease? What is bilateral total adrenal surgery (BLA)? Cortisol production by the adrenal glands is under the control of the pituitary (a small endocrine gland located i...

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April is Adrenal Disease Awareness Month, and the Carling Adrenal Center is bringing you expert content on adrenal disea...

April is Adrenal Disease Awareness Month, and the Carling Adrenal Center is bringing you expert content on adrenal diseases all month long. In this article, we will discuss how pheochromocytoma is diagnosed. How is pheochromocytoma diagnosed? First things first, the diagnosis of pheochromocytoma hinges on the treating physician entertaining the diagnosis in the first place. We can't diagnos...

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April is Adrenal disease awareness month. We surely need an adrenal awareness month because there is a significant lack ...

April is Adrenal disease awareness month. We surely need an adrenal awareness month because there is a significant lack of understanding about adrenal disease, type of adrenal tumors, and their treatment. INTRODUCTION Various adrenal tumor types are common. (A tumor simply means a mass. Tumors can be either benign or malignant; cancer). In fact, the vast majority of adrenal tumor types are ...

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Why are adrenal tumors more common in women than in men? In considering a newly diagnosed adrenal tumor, you want to know...

Why are adrenal tumors more common in women than in men? In considering a newly diagnosed adrenal tumor, you want to know how to treat it and move on with your life. If the tumor is producing too much hormone or has reached a certain size, the adrenal tumor needs to be surgically removed for definitive treatment. Depending on which adrenal hormone is being overproduced, we will know how best t...

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Adrenal tumors cause weight gain Weight gain is a common concern for many patients with hormone problems, including those...

Adrenal tumors cause weight gain Weight gain is a common concern for many patients with hormone problems, including those with adrenal tumors. Adrenal tumors frequently cause weight gain and obesity.  Changes in the body’s fat tissue at a cellular level is caused by the cortisol over-production from the adrenal tumor. The cortisol slows down metabolism and increases appetite. So, not only are...

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January is Adrenal Cancer Awareness month. Many individuals and even healthcare providers and doctors know very little abo...

January is Adrenal Cancer Awareness month. Many individuals and even healthcare providers and doctors know very little about symptoms of metastatic adrenal cancer, and what the most common symptoms are. Unfortunately, adrenal cancer is often aggressive, and is often not diagnosed in time for effective treatment. If adrenal cancer already has spread outside the adrenal gland (most commonly liver...

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Adrenal cancer, or adrenocortical carcinoma, typically occurs in adults with the average age of diagnosing being 44. Only ...

Adrenal cancer, or adrenocortical carcinoma, typically occurs in adults with the average age of diagnosing being 44. Only 30% of adrenal cancers are confined to the adrenal glands at the time of diagnosis, and that’s mainly because they are typically not diagnosed early on. If they are caught early on, they are potentially curable through surgery. When the adrenal cancer has spread to other par...

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Meet Sara, the Carling Adrenal Center's Lead Intake Coordinator If you've had adrenal surgery at the Carling Adrenal Cent...

Meet Sara, the Carling Adrenal Center's Lead Intake Coordinator If you've had adrenal surgery at the Carling Adrenal Center, chances are Sara was your guide through the process. From initial intake conversations through post-op follow-up, Sara is a valuable member of the team who our patients know and adore. Get to know her better through the Q&A below! 1) Tell us about your background and ...

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Adrenocortical carcinoma (ACC), or adrenal gland cancer, is a rare cancer that doesn’t have nearly enough awareness. Since...

Adrenocortical carcinoma (ACC), or adrenal gland cancer, is a rare cancer that doesn’t have nearly enough awareness. Since January is Adrenal Cancer Awareness Month, we’ll be taking this time to educate patients about adrenal gland cancer symptoms. Adrenal cancer is known for being diagnosed at a late stage, which can make it quite aggressive and dangerous. This makes knowing your body and adr...

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This blog post will touch on the sensitive but very important topic: Sex, sexual dysfunction, and adrenal tumors. Sexual d...

This blog post will touch on the sensitive but very important topic: Sex, sexual dysfunction, and adrenal tumors. Sexual dysfunction and loss of sexual desire and interest in sex is common in patients with adrenal tumors, due to overproduction of adrenal hormones (cortisol, aldosterone, and adrenaline-type hormones, catecholamines). Thus, adrenal tumor disease can seriously affect the sexual fu...

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Laparoscopic Adrenalectomy Is Not Recommended Laparoscopic adrenalectomy is not recommended for adrenal gland removal, si...

Laparoscopic Adrenalectomy Is Not Recommended Laparoscopic adrenalectomy is not recommended for adrenal gland removal, since newer, more modern techniques of adrenal surgery are much faster, better, and safer. Despite this, many patients are only offered laparoscopic adrenalectomy. The reason for this is that their surgeon is inexperienced. The surgeon only performs adrenal surgery rarely and ...

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There is a surgical adage that speed is the last thing a surgeon should attain. The philosophy behind the adage is that wi...

There is a surgical adage that speed is the last thing a surgeon should attain. The philosophy behind the adage is that with dedication to one’s patients and repetition, the surgeon gains the knowledge, confidence, and experience necessary to provide safe efficiency yielding ideal patient outcomes. It is also said that mastery is achieved after doing something thousands of times.  Achieving 1s...

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If you've had adrenal surgery at the the Carling Adrenal Surgery, chances are you remember Angie. Angie helps patients get...

If you've had adrenal surgery at the the Carling Adrenal Surgery, chances are you remember Angie. Angie helps patients get scheduled for their adrenal operation and often brightens the days of the patients she interacts with. Angie works closely with Dr. Tobias Carling on scheduling and is an integral part of the Carling Adrenal Center team. Meet Angie, Scheduling Manager at the Carling Adre...

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Children should not have to deal with adrenal tumors, but unfortunately, sometimes they and their parents do. Although adr...

Children should not have to deal with adrenal tumors, but unfortunately, sometimes they and their parents do. Although adrenal tumors in children are quite uncommon, they do occur. Fortunately, most of them are benign, and can be cured with adrenal surgery (adrenal gland removal), including using the best operation: Mini Back Scope Adrenalectomy (MBSA). Adrenal tumors in children: What you nee...

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  This week, here at the Carling Adrenal Center, we are highlighting the pheochromocytoma and paraganglioma awareness wee...

  This week, here at the Carling Adrenal Center, we are highlighting the pheochromocytoma and paraganglioma awareness week. We see multiple pheochromocytoma and paraganglioma patients every week, and in fact we performed surgery on 4 such patients in just the last 2 days. Most large university hospitals hardly see that many pheochromocytoma and paraganglioma patients in a whole year. Pheochrom...

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Meet Meredith LaRue, APRN, FNP-BC, MSN, RN If you've been an adrenal surgery patient at the Hospital for Endocrine Surger...

Meet Meredith LaRue, APRN, FNP-BC, MSN, RN If you've been an adrenal surgery patient at the Hospital for Endocrine Surgery, you probably remember Meredith! She works closely with Dr. Carling on a daily basis and is essential in making sure our patients receive the best care possible. Now, we invite you to get to know this vital member of our Carling Adrenal Center team. 1) Tell us about your ...

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An adrenal metastasis is a cancer which has spread from some other organ (another primary site) to one or both adrenal gla...

An adrenal metastasis is a cancer which has spread from some other organ (another primary site) to one or both adrenal glands. When appropriate, adrenal surgery in this scenario can save and prolong life. Since primary adrenal cancer is rare, an adrenal metastasis is the most common malignant lesion of the adrenal gland.  Nearly any cancer can spread to the adrenal glands via blood vessels, bu...

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This blog post will touch on the sensitive but very important topic: obesity, weight gain, adrenal tumors, and surgery. M...

This blog post will touch on the sensitive but very important topic: obesity, weight gain, adrenal tumors, and surgery. Multiple times per week, I have patients ask me: Can I have an adrenal operation (Mini Back Scope Adrenalectomy; MBSA) despite my size? Do I need to lose weight before the operation? My body mass index (BMI) is more than 50, do I need to have bariatric surgery before my ...

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Subclinical Cushing’s syndrome is highly under-diagnosed and under-treated. Unfortunately, despite subclinical Cushing’s s...

Subclinical Cushing’s syndrome is highly under-diagnosed and under-treated. Unfortunately, despite subclinical Cushing’s syndrome being relatively common, causing significant problems for patients, referral for cure by an expert surgeon is oftentimes never done or delayed.  The diagnosis itself is rarely made in a timely manner (if at all). This leaves most subclinical Cushing’s syndrome patien...

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April is Adrenal Disease Awareness Month. Adrenal disease and adrenal tumors occur in both genders and all age groups. Thi...

April is Adrenal Disease Awareness Month. Adrenal disease and adrenal tumors occur in both genders and all age groups. This means that occasionally adrenal tumors occur during pregnancy. Top 5 Things to Know About Adrenal Tumors and Pregnancy It is very important for women to know about the symptoms of adrenal tumors, as they can occur and be diagnosed during pregnancy. In fact, sometimes the...

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April is adrenal disease awareness month, and today we would like to highlight a very silent but potentially lethal diseas...

April is adrenal disease awareness month, and today we would like to highlight a very silent but potentially lethal disease – Conn’ syndrome or primary hyperaldosteronism. Hypertension, or high blood pressure, has been called a silent killer because often there are no associated symptoms.  Individuals with high blood pressure can go undiagnosed for years if they do not have something tipping t...

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The best surgeons in the world all work together at the Hospital for Endocrine Surgery The Hospital for Endocrine Surgery...

The best surgeons in the world all work together at the Hospital for Endocrine Surgery The Hospital for Endocrine Surgery is the world’s top hospital for all types of endocrine surgery, including both open and robotic thyroid and parathyroid surgery for patients with thyroid disease, thyroid cancer as well as parathyroid tumors and primary hyperparathyroidism, respectively. The Hospital is als...

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Robotic adrenal surgery is not recommended. No significant or high-volume adrenal surgeon uses a robot. If your surgeon r...

Robotic adrenal surgery is not recommended. No significant or high-volume adrenal surgeon uses a robot. If your surgeon recommends a robotic adrenalectomy, seek out a better alternative. Typically, surgeons recommend robotic adrenal surgery due to inexperience, or they usually use the robot for prostate surgery which is a completely different type of surgery. If your surgeon recommends robotic...

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It's Healthcare Employee Appreciation Week!  Employee Spotlight: Lead Adrenal Surgery Tech Chrisnailil Delgado To celebr...

It's Healthcare Employee Appreciation Week!  Employee Spotlight: Lead Adrenal Surgery Tech Chrisnailil Delgado To celebrate we're spotlighting our lead adrenal surgery technician, Chrisnailil Delgado! Chrisnailil works closely with Dr. Tobias Carling every day and is an integral part of the Carling Adrenal Center team. Check out the Q&A below to learn a bit more about Chrisnailil. Tell ...

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February is National Cancer Prevention Month. To prevent adrenal cancer, knowing about adrenal incidentalomas is very imp...

February is National Cancer Prevention Month. To prevent adrenal cancer, knowing about adrenal incidentalomas is very important. Preventing a disease like cancer is obviously advantageous over treating it when it already has developed, or even worse, spread (metastasis). There are many great ways we can prevent cancer, such as modifying lifestyle choices, e.g., not smoking prevents lung cance...

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If you're reading this post, you or someone you love likely have some type of adrenal disease and your research for adrena...

If you're reading this post, you or someone you love likely have some type of adrenal disease and your research for adrenal tumor treatment or adrenal surgery has led you here. So, what is the Best Hospital for Adrenal Surgery? The best hospital for adrenal surgery, adrenalectomy and adrenal gland removal is the Hospital for Endocrine Surgery. You may be familiar with the US News and World R...

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January is Adrenal Cancer Awareness month. Many individuals and even healthcare providers and doctors know very little abo...

January is Adrenal Cancer Awareness month. Many individuals and even healthcare providers and doctors know very little about adrenal cancer, and what the typical symptoms are. Adrenocortical carcinoma (ACC), or adrenal cancer, is fortunately a rare cancer, but is notorious for being diagnosed at a late stage, quite aggressive, and deadly. The only opportunity for cure is through surgery to rem...

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So, you have a pheochromocytoma, now what? You know you need life-saving surgery but are not quite sure what that entails....

So, you have a pheochromocytoma, now what? You know you need life-saving surgery but are not quite sure what that entails. The best adrenal operation for roughly 95% of pheochromocytomas (and thus, likely your pheochromocytoma) is the posterior retroperitoneal adrenalectomy, or more simply put, the Mini-Back Scope Adrenalectomy (MBSA). Your surgeon has options when considering the best adrenal...

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January is Adrenal Cancer Awareness month. Many individuals and even healthcare providers and doctors know very little abo...

January is Adrenal Cancer Awareness month. Many individuals and even healthcare providers and doctors know very little about adrenal cancer, and how to diagnose it. Unfortunately, adrenal cancer is often aggressive, and is not diagnosed in time for effective treatment. If adrenal cancer already has spread outside the adrenal gland, the cancer is often lethal. If you ever had an adrenal mass fou...

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High blood pressure is a silent killer. High blood pressure is also known as hypertension. It is one of the most common di...

High blood pressure is a silent killer. High blood pressure is also known as hypertension. It is one of the most common diseases in the world and most people believe you cannot be cured of high blood pressure. They believe that the only option is to treat it with blood pressure medications. Doctors and patients try one pill after another to get the blood pressure down. Although that works for s...

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Cushing’s syndrome means that you have signs and symptoms that are due to too much cortisol. Cortisol is a very toxic horm...

Cushing’s syndrome means that you have signs and symptoms that are due to too much cortisol. Cortisol is a very toxic hormone in excess levels. Adrenal Cushing’s syndrome means that the disease originates from the adrenal glands. This is in contrast to Cushing’s disease, where patients have a pituitary tumor producing ACTH that stimulates the adrenal glands to produce too much cortisol. Adrena...

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Weight gain is a common concern for many patients with hormone problems, including those with adrenal tumors. Weight Gain...

Weight gain is a common concern for many patients with hormone problems, including those with adrenal tumors. Weight Gain and Adrenal Tumors Benign (non-cancerous) adrenal tumors can cause hormone over-production leading to weight gain. The hormone being over-produced depends on which cell in the adrenal gland it arose from. Specifically, with regard to weight gain and adrenal tumor-type, the...

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If you are like me, for every family trip, or big purchase, or need around the house, I perform research.  I cross referen...

If you are like me, for every family trip, or big purchase, or need around the house, I perform research.  I cross reference this website with that website. I read the expert and consumer reviews, and sometimes, get three or more quotes to figure out who will provide me the best quality for the best value.  I talk with trusted friends and get their advice.  Why would your health, and more speci...

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This is the second part of “Top 10 Things to Know About Adrenal Vein Sampling for Primary Hyperaldosteronism”. View the fi...

This is the second part of “Top 10 Things to Know About Adrenal Vein Sampling for Primary Hyperaldosteronism”. View the first part of the post  in this series about adrenal vein sampling here. Primary hyperaldosteronism, or Conn’s syndrome, is due to overproduction of the very toxic hormone, aldosterone, from the adrenal glands. The disease can be due to a single tumor on one of the adrenal gl...

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Primary hyperaldosteronism, or Conn’s syndrome, is due to overproduction of the very toxic hormone, aldosterone, from the ...

Primary hyperaldosteronism, or Conn’s syndrome, is due to overproduction of the very toxic hormone, aldosterone, from the adrenal glands. The disease can be due to a single tumor on one of the adrenal glands (left or right) or too much aldosterone from both adrenal glands. Read more about primary hyperaldosteronism, or Conn’s syndrome, here. Adrenal vein sampling is an X-ray study to figure o...

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When faced with adrenal gland surgery, a few questions come to mind as to what you should know and expect before and after...

When faced with adrenal gland surgery, a few questions come to mind as to what you should know and expect before and after your operation. How should I prepare for adrenal gland surgery? How quickly can I return to work and my normal activities after adrenal gland surgery? What can I expect at home after adrenal gland surgery? How should I prepare for adrenal gland surgery? By now, you...

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When you have been told by your doctor that you need to see a surgeon for adrenal gland removal, several questions, and ev...

When you have been told by your doctor that you need to see a surgeon for adrenal gland removal, several questions, and even worries, may come to mind. Top 4 Worries for Adrenal Gland Removal: Why do I need adrenal gland removal? Is it cancer? Is my surgeon experienced in adrenal gland removal? How will my surgeon perform my adrenal gland removal? Is there a team in-place to care for me ...

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The symptoms of adrenal pheochromocytoma (“pheo” for short) can be variable, and often missed by doctors for years and dec...

The symptoms of adrenal pheochromocytoma (“pheo” for short) can be variable, and often missed by doctors for years and decades. Some people with pheos have all of these symptoms, but most have only one or a few symptoms. The top 5 symptoms of pheochromocytoma are: High blood pressure (hypertension) Headache Racing heartbeat (tachycardia) Sweating Anxiety All symptoms of a pheochrom...

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Sometimes it is possible, and preferable, to remove the adrenal tumor without removing the entire gland. This is called pa...

Sometimes it is possible, and preferable, to remove the adrenal tumor without removing the entire gland. This is called partial adrenal surgery. Removing only part of the adrenal gland is a much more advanced operation and should be reserved only for the most expert adrenal surgeons. The goal is to leave some normal adrenal tissue behind so that the patient can avoid adrenal insufficiency (not ...

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