The adrenal glands are a vital part of the endocrine system and are responsible for producing many essential hormones. Diseases that develop in these glands can disrupt hormonal balance and lead to serious health problems. In this article, we will examine in detail the functions of the adrenal glands, common diseases, diagnostic methods, and treatment options.
What Are the Adrenal Glands?
The adrenal glands are small, triangular-shaped organs located on top of each kidney. They perform many important functions, including regulating the body’s stress response, maintaining blood pressure, controlling metabolism, and producing sex hormones.
Structure of the Adrenal Glands
The adrenal glands are composed of two main parts:
-
- Adrenal cortex: Produces cortisol, aldosterone, and androgens.
- Adrenal medulla: Produces adrenaline (epinephrine) and noradrenaline (norepinephrine).
Key Hormones Secreted by the Adrenal Glands
| Hormone | Source | Function |
|---|---|---|
| Cortisol | Adrenal cortex | Stress response, glucose metabolism, immune regulation |
| Aldosterone | Adrenal cortex | Salt-water balance, blood pressure regulation |
| Androgens | Adrenal cortex | Male hormones, muscle and bone development |
| Adrenaline | Adrenal medulla | Heart rate, blood pressure, energy production |
| Noradrenaline | Adrenal medulla | Blood vessel constriction, increased blood pressure |
Common Adrenal Gland Disorders
When the adrenal glands produce too much or too little of a hormone, various diseases may occur. These conditions often present with systemic effects and hormonal imbalances.
Major Adrenal Disorders
| Disease Name | Hormonal Imbalance | Key Symptoms |
|---|---|---|
| Cushing’s Syndrome | Excess cortisol | Weight gain, round face, muscle wasting |
| Addison’s Disease | Cortisol and aldosterone deficiency | Fatigue, weight loss, low blood pressure |
| Pheochromocytoma | Excess adrenaline | Palpitations, high blood pressure, sweating |
| Hyperaldosteronism | Excess aldosterone | High blood pressure, muscle cramps |
| Congenital Adrenal Hyperplasia | Enzyme deficiency | Early puberty, electrolyte imbalance |
| Adrenal Adenomas/Carcinomas | Hormonal imbalance | Symptoms vary depending on tumor type |
1. Cushing’s Syndrome
What is it?
A hormonal disorder characterized by excessive cortisol secretion, often due to cortisol-producing adenomas or overproduction of ACTH from the pituitary gland.
Symptoms:
-
- Fat accumulation in the abdomen and face (“moon face”)
- Purple stretch marks and skin thinning
- Muscle wasting and weakness
- High blood pressure
- Osteoporosis
- Irregular menstruation
Diagnosis:
-
- 24-hour urinary free cortisol test
- Dexamethasone suppression test
- CT or MRI to detect adrenal tumors
Treatment:
-
- Surgical removal of cortisol-producing adenomas
- Medications (ketoconazole, metyrapone)
- Rarely, radiotherapy
2. Addison’s Disease
What is it?
A condition in which the adrenal cortex fails to produce enough cortisol and aldosterone. Most commonly caused by autoimmune destruction.
Symptoms:
-
- Severe fatigue
- Weight loss
- Low blood pressure
- Skin hyperpigmentation
- Salt craving
- Nausea, vomiting
Diagnosis:
-
- Low serum cortisol levels
- ACTH stimulation test
- Electrolyte abnormalities (low sodium, high potassium)
Treatment:
-
- Lifelong cortisol (hydrocortisone) and aldosterone (fludrocortisone) replacement
- Dose adjustment during stress
- Carry injectable cortisol for emergencies
3. Pheochromocytoma
What is it?
A usually benign tumor of the adrenal medulla that secretes adrenaline and noradrenaline.
Symptoms:
-
- Sudden attacks of high blood pressure
- Severe headaches
- Excessive sweating
- Palpitations
- Anxiety or panic-like symptoms
Diagnosis:
-
- 24-hour urinary metanephrines and catecholamines
- MRI or CT to locate the tumor
Treatment:
-
- Surgical removal of the tumor
- Preoperative alpha and beta blocker therapy
- Chemotherapy for malignant cases
4. Hyperaldosteronism (Conn’s Syndrome)
What is it?
Overproduction of aldosterone by the adrenal gland, leading to sodium retention and potassium loss.
Symptoms:
-
- Resistant high blood pressure
- Muscle cramps
- Frequent urination
- Headaches
Diagnosis:
-
- High aldosterone, low renin levels
- Hypokalemia
- Adrenal CT to detect tumors
Treatment:
-
- Surgery if adenoma is present
- Medications such as spironolactone (aldosterone antagonist)
5. Congenital Adrenal Hyperplasia (CAH)
What is it?
A disorder caused by enzyme deficiencies in adrenal hormone production. The most common form involves 21-hydroxylase deficiency.
Symptoms:
-
- Early puberty
- Ambiguous genitalia in females
- Electrolyte imbalances
- Low blood pressure
Diagnosis:
-
- Elevated 17-OH progesterone levels
- Genetic testing
Treatment:
-
- Lifelong glucocorticoid and mineralocorticoid replacement
- Surgical correction if necessary
Diagnostic Methods for Adrenal Disorders
| Diagnostic Method | Description |
|---|---|
| Hormone Tests | Measures cortisol, aldosterone, ACTH, metanephrine levels |
| Urine Analysis | 24-hour urinary hormone levels |
| CT / MRI Imaging | Identifies adrenal tumors |
| Adrenal Venous Sampling | Hormone levels measured from each adrenal gland separately |
| Genetic Testing | Useful in congenital disorders |
Nutrition and Lifestyle Recommendations in Adrenal Disorders
Nutrition:
-
- Addison’s disease: Prefer salt-rich diet
- Cushing’s syndrome: Restrict calories and sodium, supplement with calcium
- Hyperaldosteronism: Low sodium, potassium-rich diet
Lifestyle:
-
- Avoid stress
- Maintain regular sleep and exercise routine
- Adhere to medication schedules
- Carry medical ID or emergency cortisol injection
Adrenal gland disorders are among the most complex and critical endocrine conditions. They often develop slowly and subtly. Symptoms like high blood pressure, sudden weight changes, fatigue, and skin changes may be adrenal-related and should not be ignored.
Early diagnosis and appropriate treatment can significantly improve quality of life. Many adrenal disorders can be successfully managed through medication or surgical intervention.
Disclaimer: All content on this site is for informational purposes only and is based on scientific sources valid at the time of publication. Please consult your doctor or a certified healthcare provider for any symptoms, diagnosis, or treatment.