Adrenal Gland Disorders: Symptoms, Causes, and Treatment

For some people, feeling stressed and relying on coffee to boost their energy levels are perfectly normal for them. However, when you’re constantly experiencing those things with bloating, weight gain, and lightheadedness upon getting up, you might be experiencing problems with your adrenal glands.

What Are Adrenal Glands?

Your adrenals are those two small glands that sit atop your kidneys. About the size of a walnut, they are primarily responsible for producing and regulating cortisol, a stress hormone.

They also play an essential part in fluid balance, digestion, metabolism, and the production of estrogen and progesterone.

In today’s fast-paced world, your body enters the ‘fight-or-flight’ mode more frequently. This stresses out your adrenals and your body experiences more inflammation, increased damage in your healthy tissues, and sluggish digestion. As a result, you feel completely depleted.

Also Read: Emotional Stress and Your Digestive Health

When nothing is done to help your adrenals recover, a number of disorders develop, especially if you have a family history of autoimmune conditions. If you do have a family history of autoimmune diseases, then check out this article on the treatment of autoimmune diseases by Wahls Protocol.

What Are Adrenal Gland Disorders?

Disorders of the adrenal glands typically involve two things- too much or too little hormone.

The most common adrenal gland disorders are Cushing’s Syndrome and Addison’s Disease, these are both extreme examples of excess cortisol or very low cortisol, and this is primarily what endocrinologists are looking for.

However, what if you don’t have a diagnosable disease, does that mean your adrenals are perfect?

A good way to diagnose sub-optimal adrenal function is with the DUTCH Plus hormone test, which measures the free cortisol levels at 5-6 points throughout the day and night plus a urine test for total cortisol production. Also, check out our article on why Dutch Test is best for diagnosing adrenal disorders: Testing Adrenal Function with the DUTCH Test

The cortisol awakening response is a well-researched marker of adrenal health and the DUTCH Plus test is able to measure this very well, so it is not just the total amount of cortisol that you are producing but the other important factor is the rhythm of free cortisol throughout the day.

Cushing Syndrome

With Cushing Syndrome, the adrenal glands produce more cortisol than what’s needed by the body. This results in high blood pressure, obesity, too much facial hair, and irregular menstrual cycles. It also makes a person more prone to bruising.

Causes

An excess growth or tumor of the pituitary gland primarily causes Cushing Syndrome. Pituitary tumors produce excessive amounts of ACTH, triggering the adrenal glands to produce more cortisol.

Benign adrenal cortical tumors, particularly adrenal adenoma, can also cause the adrenal glands to secrete way too much cortisol. Cancerous growths of the adrenal cortex can also cause the disorder but they’re rare.

Another common cause of Cushing Syndrome is the long-term administration of cortisol-like drugs and glucocorticoid medications that are typically given to manage conditions such as lupus, arthritis, chronic obstructive lung disease, and asthma. 

Signs and Symptoms

Cushing Syndrome isn’t easy to detect since most of its signs and symptoms point toward different syndromes. It’s also important to note that not every person with the disorder will exhibit the same set of symptoms.

The list includes:

• High blood pressure
• Rapid weight gain in the back of the neck, face, abdomen, and chest
• Excessive hair growth
• Diabetes
• Poorly healing wound

Pheochromocytoma

People with pheochromocytoma have tumors in their medulla. It’s the part of the brain where your respiratory and cardiovascular systems link together to form a system that controls vital functions such as your breathing, heart rate, and blood pressure.

Pheochromocytomas cause an overproduction of norepinephrine and epinephrine, the main hormones involved in the fight-or-flight response. Excessive amounts of these hormones induce high blood pressure. Eventually, if left untreated, the disorder can lead to stroke and heart attack.

Causes

The exact cause of the disorder is still unknown. Although it commonly appears in people between the age of 30 and 50, anyone can get it at any age. However, it’s been linked to heredity in about 25% to 35% of cases.

Signs and Symptoms

Not all cases of pheochromocytomas have obvious signs and symptoms since some cases are asymptomatic. It’s the same reason why some people with the disorder are undiagnosed.

For people with obvious signs and symptoms, they may experience:

• Headache
• High blood pressure
• Unexplained weight loss
• Irregular, fast, or pounding heartbeat
• Excessive sweating
• Shaking
• Constipation
• Diarrhea
• Pain in the abdomen or chest
• Nausea and vomiting
• Orthostatic hypotension

Addison’s Disease

Also known as adrenal insufficiency, Addison’s disease happens when the adrenal glands fail to produce enough aldosterone and cortisol. 

Cortisol, as mentioned earlier, is the hormone that helps your system respond to stress. Aldosterone, on the other hand, helps maintain the balance of potassium and sodium in your body. By keeping them in check, the hormone helps control the amount of fluid your kidneys pass as pee.

If Addison’s disease isn’t managed right away, a severe complication known as Adrenal Crisis can happen.

Cause

Around 75% of Addison’s disease cases are linked to an autoimmune attack. This happens when the body’s own immune system attacks its healthy tissues for an unclear reason. 

Symptoms

The symptoms of Addison’s disease don’t manifest right away. Usually, they appear slowly over a period of time.

The most common symptoms include:

• Hyperpigmentation
• Worsening fatigue
• Nausea and vomiting
• Abdominal pain
• Diarrhea
• Muscle or joint pain
• Unintentional weight loss
• Loss of appetite
• Low blood sugar
• Changes in behavior

Hypoaldosteronism

In hypoaldosteronism, there’s not enough aldosterone in the body or ineffective action of the hormone. As a result, low levels of sodium in the body and high concentrations of serum potassium happen. The condition is also accompanied by low extracellular volume.

Cause

Hypoaldosteronism can happen because of a tumor or growth in the adrenal gland. It can also develop in response to certain illnesses like diabetes, primary adrenal insufficiency, and kidney disease.

Taking non-steroidal anti-inflammatories can contribute to the condition too. Taking medications for heart failure and heparin can be factors as well.

Signs and Symptoms

The presentation of the disorder can vary depending on the severity. Those with mild cases may present no symptoms. 

However, the most common symptoms include:

• Vision changes
• Difficulty breathing
• Headache
• Dizziness
• Muscle weakness and spasms
• Numbness or tingling
• Frequent urination
• Extreme thirst

Adrenal Gland Disorders: How Are They Diagnosed?

Diagnosing adrenal gland disorders require different methods. Tests and procedures will depend on your specific disorder.

Cushing’s Syndrome

This particular adrenal gland disorder is usually diagnosed with one of the following tests:

• Elevated cortisol levels (saliva)
• Test for dexamethasone
• Elevated cortisol levels (urine)

Pheochromocytoma

If this condition is suspected, you will be advised to take submit to a urine or blood test to check for the following:

• Metanephrines
• Catecholamines

Addison’s Disease

Usually, cases of Addison’s disease are diagnosed with a blood test that checks the levels of adrenocorticotropic hormone and cortisol in the body.

The ACTH stimulation test may also be required. This procedure requires the administration of synthetic ACTH through an IV line. After an hour, the levels of ACTH before and after administration are measured and compared.

Hypoaldosteronism

Blood and urine tests are typically ordered to diagnose hypoaldosteronism. In some cases, a computed tomography scan may be required to check for any abnormal growths and tumors.

How Are Adrenal Disorders Treated?

Treating adrenal gland disorders may require a variety of medical and surgical treatments.

Usually, medications are prescribed when there’s excessive production of hormones. When there’s not enough production, like in the case of hypoaldosteronism and Addison’s disease, hormone replacement may be done to correct aldosterone or cortisol deficiency.

If the cause of the disorder is an abnormal growth in the adrenal glands, surgery is done. In some cases, the removal of one or both glands may be necessary. This is typically the case with pheochromocytoma.

What Are The Complications of Adrenal Gland Disorders?

Cushing Syndrome

Without proper treatment, Cushing syndrome may lead to osteoporosis. It’s a condition in which bone loss results in bone fractures.

High blood pressure and type 2 diabetes are common complications too. There may also be a loss of muscle strength and mass and the occurrence of frequent infections that are hard to explain.

Pheochromocytoma

Without prompt treatment, pheochromocytomas can result in a number of life-threatening conditions. The list includes:

• Bleeding in the brain
• Cardiomyopathy
• Stroke
• Kidney failure
• Myocarditis
• Heart attack

Hypoaldosteronism

The complications that come with this adrenal gland disorder will depend on the severity of the hyperkalemia as well as the underlying adrenal and renal conditions. It may include:

• Hyponatremia
• Metabolic acidosis
• Hypovolemia
• Hyperkalemia
• Hypotension

Addison’s Disease

Adrenal crisis is the most severe complication of Addison’s disease. And if it’s not managed properly and quickly, it can lead to death.

Some of the symptoms of adrenal crisis include:

• Weakness
• Vomiting and diarrhea
• Loss of consciousness
• Confusion
• Sudden and severe pain

How Are Adrenal Gland Disorders Prevented

Most adrenal gland disorders have unknown causes which makes them hard to prevent.

In the case of hypoaldosteronism, lowering potassium intake and salt consumption to about 4 grams/day can help. It’s also good to avoid medications that affect the RAAS or Renin Angiotensin Aldosterone System. This includes avoiding potassium-sparing diuretics, ACE inhibitors, angiotensinogen receptor blockers, and beta-adrenergic receptor blockers.

In Summary

Your adrenal glands are the small glands located on the top of each kidney. Tumors, hereditary factors, auto-immune issues, and certain medications may cause them to produce too little or excessive amounts of certain hormones. This leads to several health issues.