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RE: PHEOCHROMOCYTOMA » tealady

Posted by Elroy on April 9, 2005, at 21:24:58

In reply to RE: Segeline (Deprenyl) and phenyalanine » Elroy, posted by tealady on April 8, 2005, at 21:08:52

Tea,

Thanks for the info. Pretty much what I had found so far with my research, but still good to know.

I have still not heard anything back from the Endo who is running the specialized Pheo oriented testing. Most of those tests were done not this last week, but the week before that. This last week I had a follow-up contrasting CT Scan done. The previous contrasting CT Scan that found the adrenal tumor was done last September, maybe early October. The tumor at that time was 2.1 x 1.8 cm. No results back - at least as have been relayed to me!

QUOTE:
These tumors make catecholamines, just like the normal medulla, except in an unregulated fashion. Patients with pheochromocytomas typically have a plethora of symptoms, as might be expected from such a wide-ranging hormonal system. Paroxysmal (sudden outburst) hypertension, tachycardia, headache, episodes of sweating, anxiousness, tremor, and glucose intolerance usually dominate the clinical findings...
END QUOTE

Well, I have fluctuating BP and heart rate, headaches, "anxiousness" (ha-ha... severe anxiety), termors, and my blood sugar has increased to some degree....

I find that Pheos are a lot like tumors that cause Cushing's... there are actually a LOT more symptoms than are generally recognized my doctors since they only read about the top handful of symptoms....

Study from Italy (1999): Data on 284 patients with pheochromocytoma observed between 1978 and 1997 were collected from 18 Italian Centers through a questionnaire reporting epidemiological, clinical, laboratory, radiological and surgical data - Results: Patients were 53.6% females and 46.4% males. 32 tumors were discovered as incidental adrenal masses. The most frequent referred symptoms were palpitations (58.1%), headache (51.9%), sweating (48.8%) and anxiety (35.3%). Their association was present only in 15.5%. Paroxysmal symptoms were reported in 67.1% and hypertensive in 59.7%. Normal blood pressure (systolic and diastolic) was present both in supine and upright position in 21.1%...
END QUOTE

Note the last sentence.

Most docs (endos and otherwise) will tell you - quite confidently - that if you are not experiencing severe BP problems that you do NOT have a Pheo tumor. And yet this study of patients with POSITIVE pheo tumors showed that over 1 in 5 had NORMAL blood pressure levels!

Argghhh....

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>
> Hi Elroy again, good luck with all of this.
> A book I have says this on pheochronocytomas, but I think you probably know all of this
>
> "PHEOCHROMOCYTOMA
> These tumors make catecholamines, just like the normal medulla, except in an unregulated fashion. Patients with pheochromocytomas typically have a plethora of symptoms, as might be expected from such a wide-ranging hormonal system. Paroxysmal (sudden outburst) hypertension, tachycardia, headache, episodes of sweating, anxiousness, tremor, and glucose intolerance usually dominate the clinical findings. The key to the diagnosis of this disorder is a careful history, evidence on physical examination of excessive adrenergic tone, and laboratory detection of increased amounts of urinary catecholamines and their metabolites. When chemical evaluation of the urinary metabolites confirms the presence of a pheochromocytoma, it is often possible to localize the tumor to one or the other adrenal gland and resect the tumor. Rarely, both glands will be affected and necessitate bilateral adrenalectomy. Such patients must subsequently receive glucocorticoid and mineralocorticoid replacement. Interestingly, no therapy is routinely given to replace the adrenal medullary function. It is not clear whether these individuals react less well to external stimuli that might trigger the fight-or-flight response."
>
> also "catecholamines-dopa, dopamine, norepinephrine, and epinephrine-are all made in the adrenal medulla. Norepinephrine is found in many other somatic tissues in amounts that roughly parallel the extent of sympathetic innervation of the tissue. In other words, the norepinephrine in these other tissues is not made there but is derived from the sympathetic nerve endings in them. Epinephrine, the principal product of the adrenal medulla, is made only in the adrenal medulla. "
>
> my understanding is that adrenaline=epinephrine, noradrenaline=norepinphrine,
> (the latter terms being US terms and this text is a US book)
>
> Hope all goes as smoothly and as well as possible with all of this for you. The adrenals still seem to be a bit of a mystery to medicine as far as I can see unfortunately.
>
> tea
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poster:Elroy thread:452259
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