[Continued from above] . . first line of defense and response to physical and emotional stresses. The adrenal glands are shaped like the French Emperor Napoleon's hat and, just as Napoleon's three-cornered hat sat on his head, so each gland is perched on each of the kidneys. These glands are about one to two inches in length; they weigh only a fraction of an ounce each yet are among the most productive of all of the body's glands, secreting more than three dozen hormones. The adrenal cortex takes instruction from the pituitary glands and have important effects on physical characteristics, development and growth. The adrenal gland has two parts. The cortex, or outer, yellow layer, takes its instructions from the pituitary hormone ACTH. The hormones secreted here are called steroids and have three main types: those which control the balance of sodium and potassium in the body; those which raise the level of sugar in the blood; and sex hormones. The inner, reddish brown layer of the adrenal gland (the adrenal medulla) makes two types of hormones; this part of the adrenal gland takes its instruction from the nervous system, producing chemicals which react to fear and anger and are sometimes called fight or flight hormones.
Catecholamines are produced in chromaffin cells in the medulla of the adrenal gland, from tyrosine , a non-essential amino acid derived from food or produced from phenylalanine in the liver. The enzyme tyrosine hydroxylase converts tyrosine to L-DOPA in the first step of catecholamine synthesis. L-DOPA is then converted to dopamine before it can be turned into noradrenaline. In the cytosol , noradrenaline is converted to epinephrine by the enzyme phenylethanolamine N-methyltransferase (PNMT) and stored in granules. Glucocorticoids produced in the adrenal cortex stimulate the synthesis of catecholamines by increasing the levels of tyrosine hydroxylase and PNMT.  
Adrenalectomies are performed by general or endocrine surgeons. Surgeons work closely with their medical colleagues (endocrinologists) who are often the doctors who are responsible for both the initial diagnosis and investigation of endocrine disorders. Endocrinologists may also be involved in long-term follow-up care after the adrenalectomy. Endocrine surgeons also work with nuclear medicine physicians, radiologists, pathologists, geneticists, and anesthetists to provide the best possible patient care.