Adrenocortical Health Dictionary

Natural steroid hormones or synthetic analogues, usually taken for suppressing inflammation (and immunity) and therefore having cortisone-like functions, or taken as analogues to adrenocortical androgen...or even testosterone, in order to impress the other gym members, make varsity by your junior year or to join the WWF and get newbie-mangled for two years by The Hangman or even the Hulkster Himself. Then, if your gonads don’t fall off and your back holds up you get promoted to Good Guy, have your chance to Take A Name and finally wear your chosen costume...a spandex violet nurse’s uniform.... corticosteroids

A disorder caused by the increased secretion of growth hormone by an ADENOMA of the anterior PITUITARY GLAND. It results in excessive growth of both the skeletal and the soft tissues. If it occurs in adolescence before the bony epiphyses have fused, the result is gigantism; if it occurs in adult life the skeletal overgrowth is con?ned to the hands, feet, cranial sinuses and jaw. Most of the features are due to overgrowth of the cartilage of the nose and ear and of the soft tissues which increase the thickness of the skin and lips. Viscera such as the thyroid and liver are also affected. The overgrowth of the soft tissues is gradual.

The local effects of the tumour commonly cause headache and, less frequently, impairment of vision, particularly of the temporal ?eld of vision, as a result of pressure on the nerves to the eye. The tumour may damage the other pituitary cells giving rise to gonadal, thyroid or adrenocortical insu?ciency. The disease often becomes obvious in persons over about 45 years of age; they may also complain of excessive sweating, joint pains and lethargy. The diagnosis is con?rmed by measuring the level of growth hormone in the serum and by an X-ray of the skull which usually shows enlargement of the pituitary fossa.

Treatment The most e?ective treatment is surgically to remove the pituitary adenoma. This can usually be done through the nose and the sphenoid sinus, but large adenomas may need a full CRANIOTOMY. Surgery cures about 80 per cent of patients with a microadenoma and 40 per cent of those with a large lesion; the rate of recurrence is 5–10 per cent. For recurrences, or for patients un?t for surgery or who refuse it, a combination of irradiation and drugs may be helpful. Deep X-ray therapy to the pituitary fossa is less e?ective than surgery but may also be helpful, and recently more sophisticated X-ray techniques, such as gamma knife irradiation, have shown promise. Drugs – such as BROMOCRIPTINE, capergoline and quiangoline, which are dopamine agonists – lower growth-hormone levels in acromegaly and are particularly useful as an adjunct to radiotherapy. Drugs which inhibit growth-hormone release by competing for its receptors, octeotride and lanreotride, also have a place in treatment.

See www.niddk.nih.gov/health/endo/pubs/ acro/acro.htm

www.umm.edu/endocrin/acromegaly.htm... acromegaly

The cause of Addison’s disease (also called chronic adrenal insu?ciency and hypocortisolism) is a de?ciency of the adrenocortical hormones CORTISOL, ALDOSTERONE and androgens (see ANDROGEN) due to destruction of the adrenal cortex (see ADRENAL GLANDS). It occurs in about 1 in 25,000 of the population. In the past, destruction of the adrenal cortex was due to TUBERCULOSIS (TB), but nowadays fewer than 20 per cent of patients have TB while 70 per cent suffer from autoimmune damage. Rare causes of Addison’s disease include metastases (see METASTASIS) from CARCINOMA, usually of the bronchus; granulomata (see GRANULOMA); and HAEMOCHROMATOSIS. It can also occur as a result of surgery for cancer of the PITUITARY GLAND destroying the cells which produce ACTH (ADRENOCORTICOTROPHIC HORMONE)

– the hormone which provokes the adrenal cortex into action.

Symptoms The clinical symptoms appear slowly and depend upon the severity of the underlying disease process. The patient usually complains of appetite and weight loss, nausea, weakness and fatigue. The skin becomes pigmented due to the increased production of ACTH. Faintness, especially on standing, is due to postural HYPOTENSION secondary to aldosterone de?ciency. Women lose their axillary hair and both sexes are liable to develop mental symptoms such as DEPRESSION. Acute episodes – Addisonian crises – may occur, brought on by infection, injury or other stressful events; they are caused by a fall in aldosterone levels, leading to abnormal loss of sodium and water via the kidneys, dehydration, low blood pressure and confusion. Patients may develop increased tanning of the skin from extra pigmentation, with black or blue discoloration of the skin, lips, mouth, rectum and vagina occurring. ANOREXIA, nausea and vomiting are common and the sufferer may feel cold.

Diagnosis This depends on demonstrating impaired serum levels of cortisol and inability of these levels to rise after an injection of ACTH.

Treatment consists in replacement of the de?cient hormones. HYDROCORTISONE tablets are commonly used; some patients also require the salt-retaining hormone, ?udrocortisone. Treatment enables them to lead a completely normal life and to enjoy a normal life expectancy. Before surgery, or if the patient is pregnant and unable to take tablets, injectable hydrocortisone may be needed. Rarely, treated patients may have a crisis, perhaps because they have not been taking their medication or have been vomiting it. Emergency resuscitation is needed with ?uids, salt and sugar. Because of this, all patients should carry a card detailing their condition and necessary management. Treatment of any complicating infections such as tuberculosis is essential. Sometimes DIABETES MELLITUS coexists with Addison’s disease and must be treated.

Secondary adrenal insu?ciency may occur in panhypopituitarism (see PITUITARY GLAND), in patients treated with CORTICOSTEROIDS or after such patients have stopped treatment.... addison’s disease

Having low adrenocortical function.... hypocortical

An inflammatory response to mild skin irritation, with a well-defined, raised redness, lasting for perhaps an hour and then disappearing. The cause is usually atopic allergies in an IgE-excess person, although mild, subclinical adrenocortical deficiency can be another factor.... wheal

a hormonal disorder resulting from abnormal steroid production by the adrenal cortex, due to a genetic fault. It may cause masculinization in girls, precocious puberty in boys, and adrenocortical failure (see Addison’s disease) in both sexes. Treatment is by lifelong steroid replacement.... adrenogenital syndrome

Hydrocortisone has the chemical formula, 17hydroxycorticosterone. It is closely allied to CORTISONE both in its structure (cortisone is an oxidation product of hydrocortisone) and in its action. Available in tablet, topical or injection form, hydrocortisone is used in adrenocortical insu?ciency, for the suppression of local and systemic in?ammatory and allergic disorders, and in the treatment of shock. Its mineralocorticoid effects – control of salt and water balance – mean that the drug should not be used long term except as replacement therapy in the treatment of ADDISON’S DISEASE or following adrenalectomy when hydrocortisone should be given with the mineral corticoid

?udrocortisone (see ADRENAL GLANDS; CORTICOSTEROIDS).... hydrocortisone

ACROMEGALY or gigantism is the result of the overactivity of, or tumour formation of cells in, the adenohypophysis which produces GROWTH HORMONE (see also PITUITARY GLAND). If this overactivity occurs after growth has ceased, acromegaly arises, in which there is gross overgrowth of the ears, nose, jaws, and hands and feet. DWARFISM may be due to lack of growth hormone.

DIABETES INSIPIDUS, a condition characterised by the passing of a large volume of URINE every day, is due to lack of the antidiuretic hormone (see VASOPRESSIN). Enhanced production of the ADRENOCORTICOTROPHIC HORMONE (ACTH) leads to CUSHING’S SYNDROME. Excessive production of PROLACTIN by micro or macro adenomas (benign tumours) leads to hyperprolactinaemia and consequent AMENORRHOEA and GALACTORRHOEA. Some adenomas do not produce any hormone but cause effects by damaging the pituitary cells and inhibiting their hormone production.

The most sensitive cells to extrinsic pressure are the gonadotrophin-producing cells and the growth-hormone producing cells, so that if the tumour occurs in childhood, growth hormone will be suppressed and growth will slow. Gonadotrophin hormone suppression will prevent the development of puberty and, if the tumour occurs after puberty, will result in amenorrhoea in the female and lack of LIBIDO in both sexes. The thyroid-stimulating hormone cells are the next to suffer and the pressure effects on these cells will result in hypothyroidism (see under THYROID GLAND, DISEASES OF).

Fortunately the ACTH-producing cells are the most resistant to extrinsic pressure and this is teleologically sound as ACTH is the one pituitary hormone that is essential to life. However, these cells can suffer damage from intracellular tumours, and adrenocortical insu?ciency is not uncommon.

Information about these disorders may be obtained from the Pituitary Foundation.... pituitary-linked disorders

Salvia lavendulaefolia

FAMILY: Lamiaceae (Labiatae)

SYNONYMS: Lavender-leaved sage.

GENERAL DESCRIPTION: An evergreen shrub, similar to the garden sage but with narrower leaves and small purple flowers. The whole plant is aromatic with a scent reminiscent of spike lavender.

DISTRIBUTION: Native to the mountains in Spain, it also grows in south west France and Yugoslavia. The oil is mainly produced in Spain.

OTHER SPECIES: A very similar oil is distilled in Turkey from a Greek variety, S. triloba, which is used for pharmaceutical purposes. See also entries on clary sage and common sage for other types of sage.

HERBAL/FOLK TRADITION: In Spain it is regarded as something of a ‘cure-all’. Believed to promote longevity and protect against all types of infection (such as plague). Used to treat rheumatism, digestive complaints, menstrual problems, infertility and nervous weakness.

ACTIONS: Antidepressant, anti-inflammatory, antimicrobial, antiseptic, antispasmodic, astringent, carminative, deodorant, depurative, digestive, emmenagogue, expectorant, febrifuge, hypotensive, nervine, regulator (of seborrhoea), stimulant (hepatobiliary, adrenocortical glands, circulation), stomachic, tonic (nerve and general).

EXTRACTION: Essential oil by steam distillation from the leaves.

CHARACTERISTICS: A pale yellow mobile liquid with a fresh-herbaceous, camphoraceous, slightly pinelike odour. It blends well with rosemary, lavandin, lavender, pine, citronella, eucalyptus, juniper, clary sage and cedarwood.

PRINCIPAL CONSTITUENTS: Camphor (up to 34 per cent), cineol (up to 35 per cent), limonene (up to 41 per cent), camphene (up to 20 per cent), pinene (up to 20 per cent) and other minor constituents.

SAFETY DATA: Relatively non-toxic, non-irritant, non-sensitizing. Avoid during pregnancy; use in moderation.

AROMATHERAPY/HOME: USE

Skin care: Acne, cuts, dandruff, dermatitis, eczema, excessive sweating, hair loss, gingivitis, gum infections, sores.

Circulation muscles and joints: Arthritis, debility, fluid retention, muscular aches and pains, poor circulation, rheumatism. Respiratory system: Asthma, coughs, laryngitis.

Digestive system: Jaundice, liver congestion.

Genito-urinary system: Amenorrhoea, dysmenorrhoea, sterility.

Immune system: Colds, fevers, ’flu.

Nervous system: Headaches, nervous exhaustion and stress-related conditions.

OTHER USES: Extensively used as a fragrance component in soaps, cosmetics, toiletries and perfumes, especially ‘industrial’ type fragrances. Extensively employed in foods (especially meat products), as well as alcoholic and soft drinks.... sage, spanish

Pelargonium graveolens

FAMILY: Geraniaceae

SYNONYMS: Rose geranium, pelargonium.

GENERAL DESCRIPTION: A perennial hairy shrub up to 1 metre high with pointed leaves, serrated at the edges and small pink flowers. The whole plant is aromatic.

DISTRIBUTION: Native to South Africa; widely cultivated in Russia, Egypt, Congo, Japan, Central America and Europe (Spain, Italy and France). With regard to essential oil production, there are three main regions: Reunion (Bourbon), Egypt and Russia (also China).

OTHER SPECIES: There are over 700 varieties of cultivated geranium and pelargonium, many of which are grown for ornamental purposes. There are several oil-producing species such as P. odorantissimum and P. radens, but P. graveolens is the main one commercially cultivated for its oil. Geranium Bourbon (P. Roseum) has a superior fragrance to other species, having a rich rosy-fruity scent due to the higher levels of linalook and iso-methone content. See also Botanical Classification section.

HERBAL/FOLK TRADITION: The British plant herb robert (Geranium robertianum) and the American cranesbill (G. maculatum) are the most widely used types in herbal medicine today, having been used since antiquity. They have many properties in common with the rose geranium, being used for conditions such as dysentery, haemorrhoids, inflammations, metrorrhagia and menorrhagia (excessive blood loss during menstruation). The root and herb of cranesbill is specifically indicated in the British Herbal Pharmacopoeia for diarrhoea and peptic ulcer.

ACTIONS: Antidepressant, antihaemorrhagic, anti-inflammatory, antiseptic, astringent, cicatrisant, deodorant, diuretic, fungicidal, haemostatic, stimulant (adrenal cortex), styptic, tonic, vermifuge, vulnerary.

EXTRACTION: Essential oil by steam distillation from the leaves, stalks and flowers. An absolute and concrete are also produced in Morocco.

CHARACTERISTICS: The Bourbon oil is a greenish-olive liquid with a green, rosy-sweet, minty scent. The Bourbon oil is generally preferred in perfumery work; it blends well with lavender, patchouli, clove, rose, sandalwood, jasmine, juniper, neroli, bergamot and other citrus oils.

PRINCIPAL CONSTITUENTS: Citronellol, geraniol, linalol, isomenthone, menthane, phellandrene, sabinene, limonene, among others. Constituents vary according to type and source.

SAFETY DATA: Non-toxic, non-irritant, generally non-sensitizing; possible contact dermatitis in hypersensitive individuals, especially with the Bourbon type.

AROMATHERAPY/HOME: USE

Skin Care: Acne, bruises, broken capillaries, burns, congested skin, cuts, dermatitis, eczema, haemorrhoids, lice, oily complexion, mature skin, mosquito repellent, ringworm, ulcers, wounds.

Circulation Muscles And Joints: Cellulitis, engorgement of breasts, oedema, poor circulation.

Respiratory System: Sore throat, tonsillitis.

Genito-Urinary And Endocrine Systems: Adrenocortical glands and menopausal problems, PMT.

Nervous System: Nervous tension, neuralgia and stress-related conditions.

OTHER USES: Used as a fragrance component in all kinds of cosmetic products: soaps, creams, perfumes, etc. Extensively employed as a flavouring agent in most major food categories, alcoholic and soft drinks.... geranium