Adrenal gland death

Well, I just read over the article on removing the adrenal glands, and while it mentions that removing these little beauties is bad for your health, it is not specific as to exactly what happens. So, what, besides not getting your adrenaline when you need it, are the specific ill effects of such a procedure? How could one die from the absence of these glands?


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[[Well, I just read over the article on removing the adrenal glands, and while it mentions that removing these little beauties is bad for your health, it is not specific as to exactly what happens. So, what, besides not getting your adrenaline when you need it, are the specific ill effects of such a procedure? How could one die from the absence of these glands?]]

Don’t know exactly what the death would look like, but people can’t survive without the many hormones and chemicals produced or released by these glands. Adrenaline is only one of them.
Jill

Well, let’s break it down, then.

The adrenal glands secrete corticosteroids, right? So, what do corticosteroids do? As I understand it, they’re needed for regulating the convertion of carbohydrates into their many, varied, and exciting forms and to help regulate the sodium-potasium pump.

Alright, let’s think about what kind of effects not being able to interconvert your carbohydrates and regulate your sodium and potasium levels will have on the body.

So, converting carbohydrates, what is that good for? Well, you need glucose for direct energy production, so you need to change other carbohydrates into glucose in order to use them. You’ve only got about a twenty-four hour supply of glucose, so if you can’t convert other carbohydrates you’re going to run out very fast. In this respect, someone without adrenal glands would be forced to eat a very planned, regular diet much like a diabetic would (ignoring insulin, for the sake of explaination).

If you can’t convert carbohydrates and don’t have a very well managed diet, you would end up with an unusually high amount of complex carbos in the blood, and not enough usable glucose in the cells. Sound familiar? Yup. If I don’t miss my guess, it would be very similar to diabetic shock and (eventual) coma. You would see severe and abrupt weight loss, a general slowing down and weakness, loss of coordination, and eventual death.

And if that’s not enough fun for you, we’ve still got the effects of the sodium-potasium pump. You need that thingamajig to regulate the amounts of dissolved ions in your tissue. Now, fluids always tend towards an equal concentration of dissolved ions throughout the solution. The cell membrane (that thing that keeps all the goo in) is permiable to both of these ions. In the absense of a pump, sodium will leak into the cell and potasium will leak out, though potasium leaks much more slowly (I may have those two reversed, but I think that’s right).

Both ions are positive, so you end up with a slightly negative charge outside the cell and a slightly positive charge inside the cell (since more of the sodium leaks out). This is the case in all cells, but it is especially important for neurons. It’s that electrical potential (ie. potential energy stored up because the negative and positive charges “want” to balance out) that allows your nerves to fire. Normally, a sufficient amount of stimulation will cause the nueron to fire, and those charges will balance out all the way down the axon (the outbound portion of the neuron) and stimulate whatever it is that particular axon connects to (a mucle, another nueron, a gland, etc). If the potential isn’t high enough, the axon can’t fire. Think of a rubber band: if you don’t pull it back far enough, you can’t snap it forward.

So, what would happen if your pump isn’t working right? I don’t know a heck of a lot about the nervous system, but I would imagine that you’d see lots of twitching, possible insanity, and a slow decay of awareness and motor ability. It’s actually somewhat similar to getting tenure, now that I think of it.

It should also be noted that removing the adrenal glands won’t stop you from getting stressed. It will only eliminate some of the things your body does to deal with that stress. In the long run, it would have the opposite effect than that intended, even if you didn’t die.

-Bob
We’re all gonna die, baby. I’m just trying to make it a little more interesting.

This topic actually belongs in the forum COMMENTS ABOUT MAILBAG QUESTIONS since the item on adrenelin was a Mailbag item answered by SDStaff Jill rather than by Cecil.

I believe the original answer, and the subsequent follow-ups, overlooked what may have been an interesting truth to the question. In response to the question of whether removing the adrenal can help with nervousness, the answer is “yes”. Sometimes.

One condition not alluded to is pheochromocytoma, an interesting problem seen mostly in the first years of medical school (it’s fairly rare but fun to talk about). In this disease there is a tumor of the endocrine cells, usually located in the adrenal glands, causing periodic release of large amounts of adrenal hormones which, without getting into the science too deeply, causes the classical symptom complex of refractory intermittent hypertension, a feeling of nervousness, and palpitations. In addition one may have weight loss, nausea, vague nonspecific abdominal or thoracic pain, swaeting, severe headaches, or increased irritability. Basically, “fight-or-flight” without any stimulus, nor feedback mechanism. Treatment is to remove the offending tumor, sometimes the entire adrenal, which alleviates the symptoms. Once removed, symtoms will vanish, though removal is made more difficult by a short period where the feedback mechanisms have inhibited the other adrenal, making one essentially in full adrenergic blockade post-operatively.

Just thought it should be included for full coverage of the topic.

I don’t know anything about adrenal glands (at least not much) but I can correct a few details in the above description of neuron potentials. In the resting state, it’s the potassium (K+) channels that are leakier. The resting potential is negative on the inside and positive on the outside. There are factors other than Na+ and K+ concentration working on this (especially negatively charged molecules inside the cell) but the Na+/K+ pump is very important, not in the transmission of the AP but to restore the resting potential afterward (to pull back the rubber band, as you put it). So inactivity of the sodium-potassium pump would indeed make you twitchy rather than lethargic, but I don’t know about any other effects. By the way, it’s possible to live with only one adrenal gland – the other takes over, but I don’t know how well.