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A rare tumour releasing stress hormones — blood pressure in attacks is the leading sign.
Also known as: pheochromocytoma · catecholamine tumor · paraganglioma
Open in the tool — with search and all the links →This compilation is for information and replaces neither medical diagnosis nor treatment. If you have symptoms, see a doctor.
A rare tumour of the adrenal medulla releasing adrenaline/noradrenaline in bursts. Classic triad: headache, palpitations, heavy sweating — with blood-pressure spikes and heat. Rare, but important to rule out when the thyroid is normal. Treatment is surgical removal of the affected adrenal gland; afterwards the heat and sweating attacks usually settle completely.
The suspicion is confirmed via metanephrines in blood or urine before searching and treating.
CT or MRI show which adrenal gland is affected.
Before surgery, blood pressure is safely controlled with medication (alpha-blockade) for some weeks — an important safety step.
The affected adrenal gland is removed (adrenalectomy) — this removes the cause, and the attacks usually disappear afterwards.
With the remaining adrenal gland the body usually copes well — unlike removal of both sides, no permanent hormone replacement is generally needed.
As a pheochromocytoma rarely returns, long-term check-ups are worthwhile.
Before surgery the alpha receptors are blocked first, over ten to fourteen days, and only then is a beta blocker added if needed. That order is the most important point: a beta blocker given first can drive the blood pressure dangerously high. During that time plenty of salt and fluid are given deliberately, because the blood volume must refill. After surgery the blood pressure normalises in about two thirds.
About two to eight people per million are affected each year; in about one in a thousand people with high blood pressure it is the cause. The attacks last minutes to an hour, with headache, palpitations and sweating — those three together are the pattern. Metanephrines are measured in blood or in twenty-four-hour urine; certain medicines and caffeinated drinks are stopped beforehand, otherwise the value is wrong. In about one in three there is a hereditary cause.
Typically in attacks, not constant — unlike the continuous thyroid picture.
The key confirmatory test — measures catecholamine breakdown products.
They lower the blood fats and act on the excitability of the heart muscle. Oily sea fish twice a week is the best-supported route; very high doses from capsules are not a harmless more.
Keeps the rhythm steady and lowers blood pressure. Water tablets drive it down, certain blood pressure drugs and a weak kidney drive it up — which is why it is checked under treatment.
A lack favours extra beats and at the same time keeps a potassium deficiency going. Anyone replacing only the potassium sees no success while the magnesium is missing.
Less salt lowers blood pressure measurably, and most of it is not in the salt cellar but in bread, cheese, cured meat and ready meals. With very low blood pressure the opposite applies.
The most important point here concerns not the treatment but the measurement: the test measures breakdown products of adrenaline and noradrenaline, and a whole range of everyday things raises them — caffeine, nicotine, paracetamol, decongestant nose drops, physical exertion and some antidepressants. A falsely high value sets off a whole chain of searching.
Tyrosine is the building block from which adrenaline and noradrenaline arise. As a supplement it is sold for alertness — here it is the one substance that fits neither the measurement nor the matter. Bananas and vanilla before the collected urine likewise belong to the things that shift the value.
Effects on inflammation and triglycerides established; cardiovascular prevention is mixed. Watch quality and freshness.
Effective when deficient; effects on sleep and stress plausible but moderate. Too much causes loose stool.
The tumour floods the body with catecholamines — hence bursts of heat, sweating, palpitations.
Before catecholamines are measured coffee, bananas, nuts, chocolate and vanilla are usually left out for a few days — they can distort the result. That is the only point where diet counts here.