ADRENAL GLANDS AND FUNCTIONS

This month let’s look into adrenal glands and their functions. From salivation to perspiration, your body relies on glands to carry out many vital functions. Your endocrine system contains eight main glands to keep it running smoothly:

• Hypothalamus
• Pineal body
• Pituitary
• Thyroid
• Thymus
• Pancreas
• Ovary or testis
• Adrenal

These glands secrete hormones that control energy levels, metabolism, sexual function, growth and development, pain response, stress, and mood.

At Palmetto Endocrinology we provide expert care for patients suffering from endocrine-related disorders and diseases. Here, we take a deeper dive into the potential problems with adrenal glands to give you a better understanding of the symptoms, causes, and treatments available when things go wrong.

About adrenal glands

Each of your two kidneys is topped by a small, triangular-shaped adrenal gland — they’re also known as suprarenal glands. Only about 3 inches long, they’re powerful hormone producers. The adrenal glands generate:

• Cortisol, which affects blood pressure, metabolism, immunity, bones and nerves, and the heart
• Aldosterone, which affects fluid retention
• Androgens, which converts into sex hormones
• Adrenaline, which regulates blood pressure, metabolism, and heart function

If these glands overproduce or underproduce, you may experience significant health issues, including one of the following four adrenal diseases.

Adrenal incidentaloma

As its name suggests, adrenal incidentalomas are incidental or unexpected tumors. We typically find them accidentally during an imaging test, as they don’t usually cause warning signs. When they are symptomatic, you may notice:

• Muscle weakness
• Weight loss or gain
• Mood or sleep problems
• Acne
• Easily bruised skin

About 85% of adrenal incidentalomas are considered nonfunctioning, meaning they need no treatment. However, if the tumor is producing excess hormones — a functioning adrenal incidentaloma — we may need to surgically remove it.

Addison’s disease

Out of every 100,000 people, only four have Addison’s disease, a condition marked by underactive adrenal glands. Adrenal insufficiency results in potentially life-threatening low levels of cortisol and aldosterone.

Primary Adrenal Insufficiency is often attributed to an autoimmune disorder, Addison's Disease.  But it can also be secondary to tuberculosis or infection. Secondary Adrenal Insufficiency may be due to a lack of a certain hormone produced by the pituitary gland, called adrenocorticotropin (ACTH). Without ACTH, your cortisol level plummets.

The symptoms of Addison’s disease are like those of other adrenal problems but may also include:

• Craving salty foods
• Lightheadedness
• Constipation or diarrhea
• Skin darkening
• Joint and muscle pain

We treat Addison’s disease by replacing the hormones you’re lacking.

What does adrenal crisis mean?

Adrenal crisis is a medical emergency. It’s the most serious complication of adrenal insufficiency and happens due to a severe lack of cortisol. An adrenal crisis can be life-threatening. Symptoms of adrenal crisis include:

• Severe pain in your lower body that comes on quickly.
• Bouts of vomiting and diarrhea.
• Weakness.
• Confusion and loss of consciousness.
• Low blood glucose,
• Low blood pressure.

If you have adrenal insufficiency, you should always have an injectable form of glucocorticoid medicine with you and you should wear some type of medical alert jewelry with that information. Make sure your family and friends know how to give the injection in the case of an emergency.

Cushing’s disease

High levels of the hormone cortisol can lead to Cushing’s disease. This can occur due to a malfunction that causes your adrenal glands to overproduce this hormone, or it may be the result of steroid treatments that are often used to combat conditions such as: inflammatory bowel disease (IBD), rheumatoid arthritis, severe asthma, or lupus. Those with Cushing’s disease experience:

• Fatigue
• High blood pressure and blood sugar
• Increased abdominal fat
• Thin skin and weak bones
• Easy bruising and poor wound healing
• Mood disorders
• Rounded face
• Frequent thirst and urination

Cushing’s disease can often be countered by drugs that reduce your cortisol level, but sometimes radiation therapy or surgery may be necessary.

Primary Hyperaldosteronism (Conn’s Syndrome or Primary Aldosteronism)

Primary hyperaldosteronism occurs when the adrenal gland produces too much of the steroid hormone aldosterone, which helps to control blood pressure. Primary hyperaldosteronism usually results in high blood pressure and potassium deficiency. It is more common in women than in men, and it typically occurs in people aged 30 to 50 years.

Treatment for primary hyperaldosteronism is determined based on the underlying cause of the disease. Most of the cases are caused by the swelling and enlargement of the adrenal glands leading to the overproduction of aldosterone. If only one adrenal gland is affected, surgery can cure the hypertension. If both adrenal glands produce too much aldosterone, then medication is the treatment of choice. Rare cases are caused by a genetic disorder called familial hyperaldosteronism.

Other hormone imbalances and symptoms can occur with adrenal disorders. These include having too much potassium (hyperkalemia) or not enough sodium (hyponatremia) in your blood.

If you suspect you have an adrenal gland condition, don’t wait — schedule an appointment with us today. Request an appointment online, or call us at Palmetto Endocrinology.

Author

Joseph Mathews, MD, FACP, FACE, ECNU, CCD Joseph W. Mathews M.D., a board certified Endocrinologist and Medical Director of Palmetto Endocrinology, was born and raised in South Carolina. He earned his Bachelor of Science in Biology from the College of Charleston, Cum Laude. He then achieved his M.D. at the Medical University of South Carolina where he also completed his residency in Internal Medicine and a Fellowship in Endocrinology, Diabetes, and Metabolism. Dr. Mathews is also a Fellow of both the American College of Endocrinology and the American College of Physicians, holds an Endocrine Certification in Neck Ultrasound (ECNU) and is a Certified Clinical Densitometrist (CCD). He has extensive experience performing ultrasound guided fine needle aspiration biopsies. His practice includes a range of specializations including prescribing and fitting patients with insulin pumps. Dr. Mathews' practice has drawn patients from out of state to benefit from his expertise in thyroid disorders, diabetes, cortisol problems and their Endocrine disorders.