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Adrenal Gland Disorders

The adrenal glands are responsible for various important processes in the body. Ideally, they produce hormones that trigger chemical activity inside.


What are adrenal glands?

Adrenal glands are inch-high triangular-shaped bodies located just above the kidneys. The adrenal glands secrete various hormones (adrenaline, etc) that affect blood pressure, heartbeat and sweating from its internal part (adrenal medulla) while the outer part (adrenal cortex) secrete hormones to control level of carbohydrates, proteins and fats apart from male hormones and mineralocorticoids.


What can go wrong with adrenal glands?
 

There are several reasons for malfunctioning of adrenal glands. The lack of other necessary hormones that trigger the adrenal gland, such as from the hypothalamus or the pituitary glands, results in adrenal glands not functioning properly.
Adrenal glands also malfunction in case a disorder or disease affects the glands. Mostly, problems occur when adrenal glands malfunction and produce excessive or very less hormones.


These are a few disorder that are a result of the adrenal glands malfunctioning:

Cushing's syndrome: Cushing's syndrome is caused by excess cortisol in the body being produced in the adrenal glands. It can also be caused by excessive or prolonged use of steroids.

Various factors can result in overproduction of cortisol in the body, most common of these being a tumor in the pituitary gland. The tumor results in excessive production of ACTH, an important hormone which acts as a switch for helping start production of hormones by the adrenal glands.
Less often, adrenal tumors and tumors in another part of the body also result in affecting cortisol production by adrenal glands and result in Cushing’s Syndrome.

Adrenal cancer: This is also caused by overproduction of hormones. Adrenal gland cancers are very. When they occur, however, these tumors may secrete excess amounts of cortisol or other adrenal products.

Pheochromocytoma: Although mostly benign, pheochromocytoma is a rare tumor of the medulla that secretes excessive amounts of the hormones epinephrine and norepinephrine, resulting in high blood pressure.. 

Hyperaldosteronism: Hyperaldosteronism, is caused by overproduction of aldosterone, a hormone that controls sodium and potassium levels in the blood. The overproduction of aldosterone leads to hypertension.

The condition results from a benign tumor of the adrenal gland and occurs more frequently in women than men. It leads to potassium loss and increased sodium re-absorption by the kidneys.


How are adrenal gland disorders treated?

Cushing's syndrome: Treatment for Cushing's syndrome depends on the cause of cortisol overproduction (e.g., an adrenal or pituitary tumor) and treating it.

If the disorder is a result of long-term use of glucocorticoid hormones (e.g., prednisone) for another disorder, the doctor may reduce or discontinue the dosage. If it is linked to an underlying benign or malignant adrenal tumor, the growth will be removed surgically.

Pituitary adenoma: Transsphenoidal adenomectomy is the most commonly used to remove a benign, corticotrophin-secreting pituitary tumor. This procedure is minimally invasive. While the technique is extremely delicate, cure rates can be as high as 80 percent if performed by an experienced surgeon.
Your doctor, however, may also prescribe radiation, especially if you are not an adenomectomy candidate.

Adrenal benign and cancerous tumors: Benign or cancerous adrenal tumors are removed through surgical excision of the entire gland. If the growth is small, your doctor will perform a minimally-invasive laparoscopy.

The doctor may also advise chemotherapy as a follow-up procedure.

Pheochromocytoma: Once the high blood pressure is stabilized with medicines, the abnormal adrenal gland may be removed either through a laparoscopic or "open" surgical technique. 

Hyperaldosteronism: Treatment for Conn's syndrome resulting from a solitary tumor centers on removing the growth by laparoscopic surgery. If bilateral hyperplasia is the cause of, then specific medications are first used to block the effect of aldosterone.


How successful is the treatment for adrenal gland disorders?
 

Cushing's syndrome: If you have Cushing's syndrome, your prognosis is relative to the underlying cause of cortisol overproduction. Treatment usually leads to significant improvement, even cure for a significant number of sufferers.

Adrenal cancer: Surgery for adrenal cancer may be followed by chemotherapy. As this treatment removes the source of many important hormones, hormonal supplements may be prescribed. 

Pheochromocytoma: The severe high blood pressure associated with pheochromocytoma can lead to heart attack or stroke. After treatment, the outlook is good for most patients. 

Hyperaldosteronism: With early diagnosis and treatment, prognosis for primary hyperaldosteronism is good. 


Frequently asked questions: 

Is Cushing's syndrome inherited? 

Most cases are not inherited. In rare instances, however, individuals may have a hereditary predisposition to an endocrine tumor that could cause Cushing's syndrome. 

Can Cushing's syndrome be prevented? 

No. There is no known prevention for Cushing's syndrome. 

What is the pituitary gland and how does it work?

Located at the base of the head, the pituitary gland is a vital part of the endocrine system. Although small sized, it is called ‘master gland’ because it regulates the activity of other endocrine glands.

It secretes corticotrophin, which stimulates the adrenal glands to activate other hormones, which initiate multiple chemical activities.

What are incidentally discovered adrenal masses and how are they treated? 

Incidentally discovered adrenal masses show up accidentally on one to two percent of all CT scans and MRIs. They are managed based on their origin. For instance, cystic (or fluid-filled) growths are observed until increased size suggests removal; solid or dense lesions larger than five centimeters are removed immediately. 

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