Dietary taboos for adrenal tumors

High-sodium and high-sugar heavily processed foods that increase metabolic burden, highly stimulating foods that stimulate abnormal hormone fluctuations, and miscellaneous supplements with unknown ingredients that may interfere with endocrine or medicinal effects.

It’s interesting to say that more than half of the patients in the outpatient clinic who came to ask about dietary taboos were frightened by the “popular science” in patient groups or short videos. Last month, I met a 42-year-old patient with a non-functioning adrenal tumor. The tumor itself was only 0.8cm in size and he had no symptoms of hormonal abnormalities. He heard from the patient that he should "absolutely avoid seafood and hairy food" and he did not eat meat, eggs or milk for three months. During the follow-up examination, his albumin was as low as 30g/L. He even felt dizzy even when he stood, which caused problems for his body. In fact, for patients with non-functioning adenomas, as long as they have no underlying diseases, there is no need to engage in extreme dietary restrictions. A normal and healthy diet is enough. At most, they should avoid heavily processed foods such as fried skewers, milk tea, and pickles, which are harmful to the health of ordinary people if they eat too much.

If you happen to have a functional adenoma, the taboos will be much more targeted. For example, in patients with aldosteronoma, the tumor itself will secrete excessive amounts of aldosterone, causing the body to retain sodium and excrete potassium. Eating too much salt will directly aggravate the symptoms of high blood pressure and hypokalemia. Believe it or not, there was an old retired patient whose blood pressure was under stable control. But because he ate pickles and porridge for a week, his blood pressure soared to 180/110. His legs were too weak to get out of bed. When he was sent to the hospital, his blood potassium was found to be only 2.8mmol/L. He took potassium supplements for three days before he recovered. For this type of patients, we generally recommend that the amount of salt consumed per day should not exceed the amount of a beer bottle cap. Soy sauce, oyster sauce, prepared dishes and other invisible salt-rich foods should be avoided if possible. If you are a patient with pheochromocytoma, you will over-secret catecholamines, causing palpitation, headaches, and soaring blood pressure. You should try to avoid things like strong coffee, energy drinks, and super spicy hot pot that can stimulate sympathetic nerve excitement. There was a 28-year-old young man who originally asked for a light diet to stabilize hormones three days before the operation. He took advantage of his accompanying mother to go out to buy food and secretly ordered a thickened iced American style with spicy braised sauce. As a result, he was so flustered that night that he could not measure his blood pressure. The scheduled operation was postponed for a week, which was not worth the loss.

Having said this, someone must ask, are the types of "controversial foods" that have caused a lot of quarrels on the Internet really untouchable? Take soy products for example. Traditional Chinese medicine schools do believe that soy isoflavones are phytoestrogens and may interfere with endocrine stimulation and stimulate tumor growth. Patients are advised to avoid them completely. ； However, judging from the research results of modern evidence-based medicine, the daily intake of soy isoflavones in the diet is extremely low. Drinking two cups of soy milk and eating a piece of tofu a day cannot reach the threshold that affects hormone levels. Instead, it can supplement high-quality plant protein, which is good for the body. Our current clinical advice is that as long as you do not have estrogen-sensitive complications such as uterine fibroids or breast hyperplasia, there is no need to deliberately avoid soy products. There are also seafood that are said to be "fat foods". As long as you don't have high uric acid and are not allergic to seafood, steamed fish and shrimp can be eaten normally. What you need to avoid is spicy crayfish and braised prawns that are heavy in oil, salt and spicy. You don't have to overwhelm a whole boat with one pole.

There are also a few pitfalls that we have seen clinically and stepped on, but we really want to remind everyone to avoid them. Don't believe the "adrenal maintenance tea" and "tumor-eliminating Chinese medicine pills" sold online. There was a patient who took an herbal supplement that was said to be able to "remove tumors" for half a year. The 1cm tumor did not disappear, but his liver function was abnormal. After checking, he found that the supplement contained unknown hepatotoxic ingredients, which interfered with normal hormone metabolism. If you are a patient who has just undergone adrenal surgery, don’t pile on ginseng, velvet antler, royal jelly and other large supplements. The body’s hormone levels are still in the adjustment stage after surgery, and large supplements can easily disrupt the endocrine rhythm. Start with light porridge, lean pork, and fresh vegetables and slowly add them.

I usually talk about diet to patients, and I never make a long list of taboos. I just tell them three principles: you can eat it if you don’t feel uncomfortable after eating it, eat as little as possible of heavy oil, salt, and flavor, and never eat supplements with unknown ingredients. That’s enough. There is really no need to make eating like a prison. Many patients have small tumors and mild symptoms. They are frightened by the taboo lists on the Internet and dare not eat anything. Instead, malnutrition weakens their immunity. After all, diet is only a part of auxiliary control. Regular review and monitoring of changes in tumor size and hormone levels, and more personalized precautions to communicate with your attending doctor are much more useful than following an online list of taboos.