Adrenal glands are responsible for many of the body’s different functions and processes. The glands produce various hormones in the body and these hormones trigger reactions in the body in all of the other systems.

Causes

If the adrenal glands are not operating properly, the cause could be outside the gland. The hypothalamus, a part of the brain, or pituitary glands can sometimes fail to produce hormones that control the adrenal glands. Problems inside the adrenal gland can be caused by disease or infection in or around the gland. Major problems occur when the adrenal glands produce too many or too few hormones.

Types of Adrenal Gland Disorders

There are five primary adrenal gland disorders: Cushing’s Syndrome, Hyperaldosteronism, Congenital Adrenal Hyperplasia (CAH), Pheochromocytoma/Paraganglioma, and Addison’s Disease. Each is different and each will be discussed including symptoms, diagnosis, prognosis and treatment.

Symptoms

There are a few different adrenal gland disorders and each one has different symptoms. These signs are all outlined below.

Cushing’s Syndrome

• Upper body obesity (round face and neck); thinning arms and legs
• Skin problems such as acne
• High blood pressure
• Muscle weakness, bone weakness
• Irritability, depression, moodiness
• High blood sugar
• Increased facial hair growth (women only)
• Menstrual irregularities (women only)
• Loss of fertility (men only)
• Decreased or absent sex drive (men only)

Hyperaldosteronism

• Moderate to high blood pressure
• Muscle cramping
• Low potassium
• Excessive urination
• Headache
• General weakness

Congenital Adrenal Hyperplasia (CAH)

• Shorter than average height
• Early signs of puberty (in children)
• Acne
• Irregular menstrual periods (women only)
• Excess facial hair (women only)
• Dehydration
• Low blood pressure
• Low blood sugar
• Difficulty keeping enough salt in the body
• Possible trouble getting pregnant (women only)
• Benign testicular tumors (men only)
• Infertility (men only)

Pheochromocytoma/Paraganglioma

• High blood pressure
• High blood sugar
• Rapid heart ache
• Abdominal pain
• Anxiety
• Shaking of the hands
• Headache
• Weight loss
• Sweating
• Constipation
• Pale skin
• Blurry vision
• Psychiatric disturbances

Addison’s Disease

• Weight loss
• Craving for salt
• Nausea/vomiting
• Dizziness
• Weakness
• Depression
• Low blood pressure
• Extreme fatigue
• Patches of dark skin

Diagnosis

There are three different tests currently used to diagnose Cushing’s Syndrome. One test looks for elevated cortisol levels in saliva, another test looks for elevated cortisol levels in urine, and the third test determines if a synthetic steroid suppresses cortisol produced in the body.

To diagnose Addison’s Disease, your doctor may administer a blood test to measure cortisol and adrenocorticotropic hormone (ACTH) levels. The doctor measures blood levels after ACTH is given and determines if adrenal insufficiency (lack of cortisol) is present in the body.

Diagnosing Congenital Adrenal Hyperplasia (CAH) requires a screening blood test of infants. If the screening shows that the infant may have CAH, the doctor will order another blood test to confirm. Pituitary Tumors are another illness that can be found during Adrenal Treatment. The first step in diagnosing these is a physical examination. Your doctor may also conduct a vision test to see if a pituitary tumor has had an effect on your sight. Further tests will need to be done if the results of the vision tests lead to suspicion of pituitary tumors.

If you notice signs of adrenal problems and have suspected Pheochromocytoma/Paraganglioma, your doctor will administer blood or urine testing to measure levels of catecholamines. Catecholamines are hormones that increase heart rate, blood pressure, breathing rate, and energy available in the body.

Hyperaldosteronism is another illness that could be suspected. If it is, your doctor will order blood or urine tests to check for high levels of aldosterone or low levels of potassium. Your doctor may also order a tomography scan to determine if the adrenal gland have a noncancerous tumor or signs of other abnormal growths.

Treatment

Treatment for Cushing’s syndrome depends on the cause of the illness. If medication is causing the excess cortisol, your doctor can change your dosage or try different medication. If your body making too much cortisol causes Cushing’s syndrome, treatments could include medication, surgery, radiation, or a combination.

Congenital Adrenal Hyperplasia (CAH) cannot be cured, but it can be treated and controlled by medication to replace the hormones that your body is not making.

Pituitary tumors have a widely used treatment in transsphenoidal adenomectomy, which uses a microscope and small instruments to remove the tumor through a nostril or an opening below the upper lip. Radiation is another treatment option.

Pheochromocytoma/Paraganglioma is usually treated by the removal of the tumor through surgery. More often than not, removing the tumor improves the patient’s blood pressure control.

Replacing the cortisol or aldosterone that the body is lacking can treat Addison’s disease. Patients with Addison’s disease take medication every day to replace these hormones.

Hyperaldosteronism is treated with medications that block the effect of aldosterone, which causes excessive growth of normal cells in adrenal glands. The affected gland can also be removed using minimally invasive surgery.

Prognosis

Most patients with adrenal gland illnesses or deficiencies can be treated very effectively with specialists. All of the different types of adrenal diseases can be treated if not cured. Adrenal doctors and surgeons at Baptist Health can provide more information.