What are adrenal glands?
Our bodies are complex creations of interwoven systems that must work together in order for life to continue. When just one function fails or is compromised, our life and livelihood can be thrown into a tailspin.
A lesser-known piece of the much larger puzzle is the adrenal glands. While we are relatively unaware of their existence throughout our daily lives – they act as regulatory entities of an entire system. It’s common to experience stomach aches, a sore throat, or stiff joints, but we don’t usually suffer from an aching adrenal gland. The two quiet, undercover glands do their job without causing much fuss – usually.
The small, triangular-shaped adrenal glands sit atop each kidney and are composed of two parts – the cortex and the medulla. The adrenal cortex makes up the largest part of each adrenal gland and breaks out into three specific zones that produce specific, vital hormones. The cortex also plays an important role in the adrenal glands’ function by creating stress hormones. The entire gland is wrapped in a protective adipose capsule. The glands wrap around the top of each kidney like a glove.
While the adrenal glands are best known for the creation of adrenaline – a hormone that releases in stressful situations, generating the “fight or flight” reflex – it also produces corticosteroid hormones. This hormone group includes glucocorticoids and mineralocorticoids, which are responsible for regulating immune system responses, fighting inflammation, monitoring heart functions, and converting fats, proteins, and carbohydrates into energy.
In addition to these crucial duties, the main mineralocorticoid hormone – aldosterone – balances salt and water within the bloodstream, regulating the body’s blood pressure. Without aldosterone, kidneys lose too much sodium and water, which can then generate a drop in blood pressure or life-threatening dehydration.
The adrenal glands also release sex hormones, androgen, and estrogen. In males, the adrenal glands ensure sex organs form correctly during the childhood development years. In females, the secretion of sex hormones is responsible for body hair growth during puberty.
What are adrenal gland disorders?
Adrenal gland disorders run the gamut from causation and treatment, however, they can severely inhibit an individual from thriving, both physically and mentally. The following adrenal gland disorders include:
- Addison’s disease. This adrenal insufficiency disorder is caused by underproducing adrenal glands and usually triggered by a previously existing autoimmune disorder like HIV, Lupus, and type I diabetes. The failure to produce adequate amounts of hormones, including cortisol and aldosterone, can result in fatigue, nausea, muscle weakness, and eventually lead to an Addisonian crisis or adrenal crisis – a life-threatening situation that requires immediate treatment and hospitalization.
- Cushing’s disease. In direct opposition to Addison’s disease, Cushing’s is caused by the overproduction of hormones within the adrenal glands. They send too much cortisol into the bloodstream, causing obesity, high blood pressure, excessive facial hair, irregular menstrual cycles, and susceptibility to bruising. These symptoms can absolutely deter from high quality of life and require a professional diagnosis, monitoring, and treatment.
- Adrenal incidentaloma. Caused by masses or tumors found on the adrenal glands, the masses could secrete additional hormones and wreak havoc on the body. Surgery is often needed to remove them.
- Pheochromocytomas. Those with this adrenal disorder suffer from tumors that grow in the medulla, leading to the overproduction of epinephrine and norepinephrine. An excess of these hormones causes high blood pressure, which could eventually cause heart attacks or stroke.
- Pituitary tumors. Situated at the base of the brain, the pituitary gland is also responsible for releasing hormones into our bodies. Certain hormones, including adrenocorticotropic, trigger the adrenal glands to pump cortisol into the bloodstream. A lack of communication between the pituitary gland and the adrenal glands because of benign or cancerous tumors can throw the whole system out of whack.
- Adrenal gland suppression. Steroid usage often leads to the suppression of adrenal glands. Since steroids mimic cortisol, the adrenal glands can be notified to release less of this cortisol. When steroid medication is immediately halted, the adrenal glands may not receive the message to take up the creation of cortisol. A hormone imbalance can ensure and proceed for weeks or even months until the adrenal glands balance out again.
What are the symptoms of adrenal disorders?
Adrenal disorders can present themselves in a number of ways. Symptoms may vary depending on the individual and preexisting conditions but often include the following:
- Weight loss
- Muscle weakness
- Darkening of skin
- Craving salty foods
- Mouth sores
- Abdominal pain
While symptoms vary, there are specific dominant signs that something may be wrong with your adrenal glands. Those include:
- Abdominal pain and weight loss. Hormones produced in the adrenal glands control our appetites and the processing of food. When they are overactive or underproduced, this can lead to digestive issues and can hinder your body from gleaning the nutrients it needs from food sources.
- High blood pressure. While this symptom can be a signal of a wide variety of ailments, it is particular to adrenal disorders when paired with low sodium levels, headaches, and facial flushing. Overproduction of hormones can throw off the particular balance of water and salt in the bloodstream, sending blood pressure levels sky-high.
- Fatigue and weakness. These symptoms of Addison’s disease in particular may signal an underlying issue that needs immediate attention. A lack of hormones can cause blood pressure to drop, muscles to weaken, and general fatigue to set in. Many who are eventually diagnosed with Addison’s disease often experience an Addisonian crisis first, which alerts Doctors to the adrenal insufficiency.
Risk factors for adrenal disorders can vary but the majority of cases are caused by underlying autoimmune disorders. Other predetermining factors may include:
- Chronic diseases, including tuberculosis
- Previous infections
- Surgeries that removed portions of adrenal glands
- Autoimmune diseases like Graves’ diseases, Lupus, or HIV
- Certain antifungal medications
How are adrenal disorders diagnosed and treated?
The diagnosis of various adrenal disorders may vary on a case by case basis. However, the initial process usually begins by conversing with your primary care doctor about the symptoms you are experiencing. Keeping a journal of particular symptoms and when they arise may better assist your primary care doctor in diagnosing, monitoring, and treating adrenal disorders.
After discussing symptoms, your doctor may order a blood test to check potassium and sodium levels. They can also conduct imaging, including MRIs or a CT scan that can detect potential tumors, abdominal swelling, or other issues related to adrenal disorders.
Treatment for adrenal disorders in which tumors manifest either on the glands themselves or on the pituitary gland typically involves some sort of surgery. The operation may be minimally invasive depending on the size or severity of the tumors. The pros of this treatment include accurate, total removal of said tumors, and patients may not need additional surgeries. The downside to surgery can be the risk factors involved, including infection and recovery time.
Hormone suppression or replacement therapy offers relief for those suffering from Addison’s disease or Cushing’s disease. For patients with Addison’s disease, your doctor may prescribe daily medication that supplements your adrenal glands’ natural production of hormones. Failure to take this medication can result in an adrenal crisis. Those with Cushing’s disease may take medication that helps suppress the overproduction of hormones. Many have found success in managing their adrenal disorders through hormone-related medication and have gone on to lead happy healthy lives. However, for some, prescription medication can be expensive or may cause other symptoms related to the specific medication to arise.
For adrenal disorders involving tumors, there is a chance for curability. When found early and removed, adrenal cancer can be halted altogether. The same goes for Pituitary tumors. Invasive surgery through the nostrils can remove these growths and restore a healthy function. If left untreated, cancerous tumors can spread to other internal organs and pose life-threatening issues.
UCF Health Services offers patients premium health care at affordable prices. Our team of doctors, nurse practitioners, and other medical professionals collaborate to provide superior health care. For Orlando Endocrinology Services, visit our patient portal and schedule your appointment. Not only does UCF Health offer preventative care, but we also provide the treatment of endocrine disorders, like adrenal disorders. Contact us today to learn more.