Adrenalectomy (ADX for short!) has its pros and cons. ADX would reduce the excess adrenal androgens and all those issues. However, it also has some drawbacks. For example, loss of production of other adrenal hormones (such as catacholamines). In addition, if genetic therapy was ever developed, your adrenal’s wouldn’t be there to participate!

I believe that Addison’s is exactly like SWCAH- you don’t make cortisol or aldosterone (someone may want to double check my facts and correct me if I’m wrong!). So if you have SVCAH or LOCAH, ADX may be creating more serious lifethreating problems like M.R. pointed out.

However, regardless if you have CAH or Addison’s, you’re still going to have to take glucocorticoids and still have an higher risk of increased blood sugars and, thus, increased insulin levels. Lots of people with PCOS just have the increased insulin=increased androgens; CAHer’s have a double whammy from excess androgens coming from the adrenals and due to increased insulin levels (tho one would think if enough cortisol was given to increase insulin levels that much, that the person would be oversuppressed and, therefore, not producing that many excess androgens!)

Anyhow, isn’t Dr. Merke looking at blood sugars and insulin levels with her NIH study? And if you want info now on how glucocorticoids affect insulin levels, one could look at cushing’s disease (high cortisol) as well as addison’s to see how people with other cortisol issues are insulin levels affected. (I do know of one study that said women with cushing’s have higher rates of PCOS) It will be interesting once they get all these issues/factors figured out and make an easy to understand pathway for everyone to look at!

Martha