How Adrenal Gland Disorders Are Diagnosed
Testing for adrenal gland disorders is usually done by an endocrinologist. You will probably have your blood, urine, and/or saliva checked for levels of the hormones secreted by the adrenal gland. The doctor may also order one or more imaging tests of your adrenals such as an CT scan, MRI, or nuclear scan. If your health care provider believes your adrenal gland problem is due to a malfunction in another gland , such as a pituitary tumor, you might also need testing done on your pituitary gland.
The severe form of congenital adrenal hyperplasia is most commonly identified during newborn screening.
Excess Of Adrenaline Or Noradrenaline: Pheochromocytoma
Pheochromocytoma is a tumor that results in excess production of adrenaline or noradrenaline by the adrenal medulla that often happens in bursts. Occasionally, neural crest tissue, which has similar tissue to the adrenal medulla, may be the cause of overproduction of these hormones. This known as a paraganglioma.
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. Some people are genetically predisposed to developing this type of tumor.
Anatomy Of The Adrenal Glands
An adrenal gland is made of two main parts:
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The adrenal cortex is the outer region and also the largest part of an adrenal gland. It is divided into three separate zones: zona glomerulosa, zona fasciculata and zona reticularis. Each zone is responsible for producing specific hormones.
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The adrenal medulla is located inside the adrenal cortex in the center of an adrenal gland. It produces stress hormones, including adrenaline.
The adrenal cortex and adrenal medulla are enveloped in an adipose capsule that forms a protective layer around an adrenal gland.
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Adrenal Gland Disorder Outlook
With the right therapies and medical care, many people with adrenal gland disorders can live long, healthy livesthough in some cases you may need to take medication for life. Talk with your doctor about the outlook for your specific condition and what steps you can take to achieve the best positive outcome.
Module : The Endocrine System
- Describe the location and structure of the adrenal glands
- Identify the hormones produced by the adrenal cortex and adrenal medulla, and summarize their target cells and effects
The adrenal glands are wedges of glandular and neuroendocrine tissue adhering to the top of the kidneys by a fibrous capsule . The adrenal glands have a rich blood supply and experience one of the highest rates of blood flow in the body. They are served by several arteries branching off the aorta, including the suprarenal and renal arteries. Blood flows to each adrenal gland at the adrenal cortex and then drains into the adrenal medulla. Adrenal hormones are released into the circulation via the left and right suprarenal veins.
Figure 1. Both adrenal glands sit atop the kidneys and are composed of an outer cortex and an inner medulla, all surrounded by a connective tissue capsule. The cortex can be subdivided into additional zones, all of which produce different types of hormones. LM × 204.
The adrenal gland consists of an outer cortex of glandular tissue and an inner medulla of nervous tissue. The cortex itself is divided into three zones: the zona glomerulosa, the zona fasciculata, and the zona reticularis. Each region secretes its own set of hormones.
Adrenal hormones also have several nonstress-related functions, including the increase of blood sodium and glucose levels, which will be described in detail below.
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What Do My Adrenal Glands Do
Each adrenal gland is composed of two distinct parts: the outer part called the adrenal cortex and the inner adrenal medulla. The adrenal glands secrete different hormones which act as ‘chemical messengers’. These hormones travel in the bloodstream and act on various body tissues to enable them to function correctly. All adrenocortical hormones are steroid compounds made from cholesterol.
Lower Back Adrenal Glands And Chronic Pain
Year after year lower back pain is the leading contributor to missed work. Chances are good you will experience it at least once in your life. You may even know somebody who has lost a job or been severely debilitated. Many of the common forms of treatment are surgery, physical therapy, painkillers, and chiropractic spinal adjustments.
But what these procedures are missing, is one of the most common causes of lower back pain
Adrenal gland stress.
The adrenal glands sit on top of the kidneys and are about the size of a walnut. They are responsible for many different hormones in the body, especially adrenaline. But they are also involved in blood sugar regulation, sex hormone production and the balancing of electrolytes such as potassium and sodium.
Under acute stress the adrenal glands increase their production of hormones as they are working harder to respond to the stress situation. This is beneficial, however, when the stress never ends the adrenals get tired and cant perform their functions.
Once they get tired it takes more and more stimulants like caffeine to get you going, which further deplete the adrenals leading to exhaustion. Once they are exhausted, and often before, the adrenals will give you warning signs they are not working correctly.
Here are some of the more common:
- Bright lights bother your eyes
- Tired/sore feet at the end of the day
- Shin splints
- You get dizzy when you stand up
- High blood pressure
- Fatigue
- Lower back, pelvis and ankle pain
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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. Its common to experience stomach aches, a sore throat, or stiff joints, but we dont 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.
In addition to these crucial duties, the main mineralocorticoid hormone aldosterone balances salt and water within the bloodstream, regulating the bodys blood pressure. Without aldosterone, kidneys lose too much sodium and water, which can then generate a drop in blood pressure or life-threatening dehydration.
What’s Special About University Of Michigan’s Treatment For Adrenal Disease
Surgeons in the Division of Endocrine surgery at University of Michigan are experts in providing care for patients with adrenal disorders. Our surgeons offer treatment for both common conditions and the most advanced types of adrenal disease, including adrenal cancer. We are often referred patients with highly complex issues requiring state of the art surgical care not available elsewhere.
The care we provide, both in and out of the operating room, is based on years of research and personal experience. We are constantly evaluating new techniques and therapies to care for patients with adrenal disorders and to provide the best and most up-to-date care possible.
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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.
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.
Medical Definition Of Adrenal Failure
- Medical Editor: Melissa Conrad Stöppler, MD
Reviewed on 3/29/2021
Adrenal failure: A condition in which the adrenal glands do not produce enough of the adrenal hormones that control important functions such as blood pressure.
The adrenal glands sit on top of the kidneys. The adrenal is made up of an outer layer and an inner portion . The adrenal glands produce hormones that help control the heart rate, blood pressure, the way the body uses food, and other vital functions. The adrenal cortex secretes steroid hormones and mineralocortoids that regulate the levels of minerals such as sodium and potassium in the blood.
The adrenal medulla makes adrenaline and noradrenaline . Adrenaline is secreted in response to low blood levels of glucose as well as exercise and stress it causes the breakdown of the storage product glycogen to the sugar glucose in the liver, facilitates the release of fatty acids from adipose tissue, causes dilation of the small arteries within muscle and increases the output of the heart. Noradrenaline is a neurohormone, a neurotransmitter, for of most of the so-called sympathetic nervous system.
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Role In Hormonal Regulation
The body controls the levels of corticosteroids according to need. The levels tend to be much higher early in the morning than later in the day. When the body is stressed from illness or otherwise, the levels of corticosteroids increase dramatically.
Image 4: The hypothalamic-pituitary-adrenal axis integrates and mediates the stress response.
2. The Renin-angiotensin-aldosterone system – Hormone system within the body that is essential for the regulation of blood pressure and fluid balance. Comprised of the three hormones renin, angiotensin II and aldosterone. The RAAS is regulated mostly by the kidneys and rate of renal blood flow). The RAAS causes the adrenal glands to produce more or less aldosterone.
Image 5: RAAS
Adrenal Insufficiency And Addisons Disease
When the adrenal glands do not make enough cortisol, it is known as adrenal insufficiency. There are three types of adrenal insufficiency:
- Primary adrenal insufficiency, or Addisons disease. This condition develops when the adrenal gland itself does not function well and cannot make enough cortisol.
- Secondary adrenal insufficiency. This occurs when the pituitary gland does not make enough of a hormone called adrenocorticotropin . Without ACTH, the adrenals do not receive a signal to make cortisol.
- Tertiary adrenal insufficiency. This occurs when the brain cannot produce enough corticotropin-releasing hormone . Without CRH, the pituitary gland cannot make ACTH. This means that the adrenals cannot make enough cortisol.
There are many potential causes of adrenal insufficiency, including:
- autoimmune disease, which is the most common cause of Addisons disease, according to the
- darkening of the skin, especially on scars, lips, skin folds, and joints
- depression
Adrenal insufficiency requires treatment. Without enough cortisol, a person may experience an adrenal crisis. Signs and symptoms of an adrenal crisis include:
- severe vomiting and diarrhea
- low blood pressure
- a sharp pain in the abdomen, lower back, or legs
If a person shows any signs of an adrenal crisis, they should seek immediate medical help. Without treatment, an adrenal crisis can be fatal.
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Adrenal Gland Disorder Treatment
Treatment for an adrenal gland disorder will vary depending on which disorder you have and how severe it is. Your treatment may include medication, surgery, or both. Specific treatments used for adrenal disorders include:
- Medication to stop the excess production of hormones
- Hormone replacement medication
- Surgery to remove tumors in the adrenal gland
- Surgery to completely remove one or both of the adrenal glands
- Minimally invasive surgery to remove tumors in the pituitary gland
- For cancer, surgery, radiation, or chemotherapy
What Hormones Do The Adrenal Glands Make
The adrenal glands mainly make the hormones adrenaline, noradrenaline, cortisol and aldosterone.
Adrenaline and noradrenaline are involved in the bodys stress response. They make the heart beat faster, send more blood to muscles and cause other changes in the body that prepare it for fight or flight.
Cortisol does many things, including influencing metabolism , changing blood sugar levels and slowing down the immune system.
Aldosterone plays a part in controlling blood pressure.
The adrenal glands also make weak sex hormones that travel to the testes or ovaries where they are converted into testosterone or oestrogen.
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Hormones Of The Adrenal Glands
The role of the adrenal glands in your body is to release certain hormones directly into the bloodstream. Many of these hormones have to do with how the body responds to stress, and some are vital to existence. Both parts of the adrenal glands the adrenal cortex and the adrenal medulla perform distinct and separate functions.
Each zone of the adrenal cortex secretes a specific hormone. The key hormones produced by the adrenal cortex include:
About The Adrenal Glands
The adrenals are small glands that sit above each of the kidneys. The kidneys are located deep inside the upper part of the abdomen.
Each adrenal gland has 2 parts. The outer part, the cortex, is where most tumors develop. The cortex makes certain hormones for the body. These hormones all have a similar chemical structure and are called steroids:
- Cortisol causes changes in metabolism to help the body to handle stress.
- Aldosterone helps the kidneys regulate the amount of salt in the blood and helps regulate blood pressure.
- Adrenal androgens can be converted to more common forms of the sex hormones estrogen and testosterone in other parts of the body. The amount of these hormones that result from conversion of adrenal androgens is small compared to what is made in other parts of the body. The testicles produce most of the androgens in men. The ovaries produce most of the estrogens in women.
The inner part of the adrenal gland, the medulla, is really an extension of the nervous system. Nervous system hormones such as norepinephrine and epinephrine are made in the medulla. Tumors and cancers that start in the adrenal medulla include pheochromocytomas and neuroblastomas.
Tumors and cancers of the adrenal cortex are covered here, but tumors of the adrenal medulla are not. Neuroblastomas are covered separately elsewhere.
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Drink Your Daily Dose Of Fluids
One primary function of the kidneys is to process and eliminate waste from the body. One way to help this along is to make sure youredrinking enough water throughout the day. Plus, drinking enough water can help regulate blood sugar and reduce your risk of diabetes, two issues that can greatly impact the health of your kidneys.
We recommend you drink half your body weight in ounces every day. On days when youre super active or when you get a good workout, its a good idea to drink a little bit more than you otherwise would.
Hormones Of The Zona Glomerulosa
The most superficial region of the adrenal cortex is the zona glomerulosa, which produces a group of hormones collectively referred to as mineralocorticoids because of their effect on body minerals, especially sodium and potassium. These hormones are essential for fluid and electrolyte balance.
Aldosterone is the major mineralocorticoid. It is important in the regulation of the concentration of sodium and potassium ions in urine, sweat, and saliva. For example, it is released in response to elevated blood K+, low blood Na+, low blood pressure, or low blood volume. In response, aldosterone increases the excretion of K+ and the retention of Na+, which in turn increases blood volume and blood pressure. Its secretion is prompted when CRH from the hypothalamus triggers ACTH release from the anterior pituitary.
Aldosterone is also a key component of the renin-angiotensin-aldosterone system in which specialized cells of the kidneys secrete the enzyme renin in response to low blood volume or low blood pressure. Renin then catalyzes the conversion of the blood protein angiotensinogen, produced by the liver, to the hormone angiotensin I. Angiotensin I is converted in the lungs to angiotensin II by angiotensin-converting enzyme . Angiotensin II has three major functions:
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