The adrenal glands are two triangle-shaped organs about five centimeters long that sit on top of the kidneys. They are made up of two distinct parts. Their outer region (cortex) makes hormones that are vital to life. These hormones are involved in control of metabolism, sexual functioning, and the regulation of salts and water in the body. The inner region (medulla) produces nonessential hormones. It secretes epinephrine (adrenaline) which helps the body react to stress.
Disorders and Diseases of the Adrenal Glands
There are multiple reasons why the adrenal glands might not work as they should. The problem could be with the adrenal gland itself, or the root cause may be due to a defect in another gland.
These are the most common disorders and diseases of the adrenal glands:
Cushing’s syndrome is caused by overproduction of the hormone cortisol. Patients with this syndrome usually have central obesity with a rounded facial appearance (moon face) but thin arms and legs. Also they may experience weakness, backache, headache, hypertension and acne. Blood tests are available to confirm the cause. In the majority cases, the cause is a pituitary tumor. In 15% of cases, an adrenal tumor is responsible. An adrenal tumor causing Cushing’s syndrome should be surgically removed.
Pheochromocytoma is a tumor of the adrenal gland that results in excess production of adrenaline or noradrenaline. Pheochromocytomas may cause persistent or sporadic high blood pressure that may be difficult to control with regular medications. Other symptoms include headaches, sweating, tremors, anxiety and rapid heartbeat.
Conn’s syndrome is a condition in which a benign tumor of the adrenal secretes a hormone that raises the blood pressure and lowers level of potassium in the blood.
Addison’s disease is a rare autoimmune disease that develops when your adrenal glands don’t produce enough cortisol or aldosterone. This is a self-destructive disease, in which your own immune system may attack your adrenal tissues.
Congenital adrenal hyperplasia (CAH): People who have this inherited hormonal disorder have difficulties producing adrenal hormones. This disorder can affect the development of sex organs in men.
Adrenocortical cancer is a rare but aggressive tumor that tends to spread to other organs and cause adverse changes within the body because of the excess hormones it produces. It requires surgical removal for cure. These tumors are usually large and may or may not be symptomatic.
Adrenal incidentaloma is the term used to describe adrenal masses that are found incidentally on Ultrasound, CT scan or MRI performed for other reasons. These may be benign or malignant tumors or may be the result of cancer that has spread from another area of the body. Depending on the size and the results of blood tests, these lesions should be closely watched or removed.
The diagnosis of adrenal gland disorders is made with special blood and imaging tests.
The blood tests measure your levels of:
- adrenal hormones
- pituitary hormones
- glucose
- potassium
- sodium
The imaging studies include the Ultrasound, MRI or CT scan.
If you’re diagnosed with an adrenal gland disorder, you can be treated either medically or surgically. Surgery is a treatment option for certain adrenal disorders. Your doctor may recommend surgery if:
- you have malignant tumors that can be removed
- you have tumors on your adrenal or pituitary glands
- hormone suppressants fail.
Removal of the adrenal gland with the tumor can be done laparoscopically. At one time an adrenalectomy was considered a major surgical procedure requiring a lengthy hospital stay and a prolonged recovery period. Now, the patient usually remains overnight in the hospital and may resume normal activities in 1 or 2 weeks.