The adrenal glands are triangular-shaped structures that sit on top of each kidney.
What Are Adrenals?
Your adrenals are a pair of 2 glands, each located right above each kidney. Your adrenal glands produce several hormones that are responsible for many of your essential bodily functions. Some of these functions include helping regulate your immune system, stress hormones, metabolism and blood pressure. The adrenal glands are made up of two parts: the adrenal cortex and the adrenal medulla. The cortex and medulla are each responsible for producing their own hormones. There are specific conditions associated with too little or too much production of adrenal hormones.
Your adrenal cortex makes up the majority of your adrenal gland and is the outermost part of your adrenals. Your adrenal cortex is made up of 3 zones that each produce different hormones; these zones include the zona glomerulosa, zona fasciculata and zona reticularis. The zona glomerulosa secretes aldosterone, the zona fasciculata secretes cortisol and the zona reticularis secretes both androgens (DHEA and androstenedione, both made from cholesterol) and a small amount of glucocorticoids.
Aldosterone is a steroid, released by the zona glomerulosa, that is responsible for regulating the salt and water in your body, having an effect on your blood pressure.
Cortisol is a hormone, specifically known as your stress hormone. Your cortisol plays a large role in regulating your blood sugar, blood pressure, circadian rhythm, energy, metabolism and inflammation. In normal adrenal function, cortisol should be highest in the morning and should reduce as the day goes on. Cortisol is usually test first thing in the morning (before 9 am), however, a more salivary test may be ordered that assesses your cortisol throughout the day.
DHEA is a hormone that is a precursor to your other hormones, like testosterone and estrogen.
The adrenal medulla, the innermost part of the adrenal gland, secretes primarily epinephrine and norepinephrine. Epinephrine and norepinephrine are your stress hormones and neurotransmitters that are often released when you are in “fight or flight.” These chemicals cause your blood pressure and heart rate to increase and your blood sugar to go up. Epinephrine has a greater effect on your heart, and norepinephrine affects your blood vessels, causing them to constrict which is why your blood pressure goes up.
What are conditions associated with adrenal dysfunction?:
Conn’s Syndrome is when there is excess Aldosterone production. It can be caused by primary hyperthyroidism, a pheochromocytoma (a tumor in the adrenal medulla) or an aldosteronoma (a benign tumor that occurs on the adrenal cortex). It can cause electrolyte imbalance, more specifically sodium retention and potassium loss which in turn can lead to hypertension, renal hypertension and metabolic alkalosis. Symptoms of Conn Syndrome include:
- Muscle cramps
- Visual Disturbance
Addison’s Disease, also known as adrenal insufficiency, is when your adrenal glands don’t produce enough hormones, specifically cortisol. There are several causes of Addison’s Disease, including injury to the adrenal glands, infections, cancer, or surgical removal of the adrenal glands. Some symptoms of Addisons Disease include:
- Unintentional weight loss
- Craving for salt
- Nausea or vomiting
- Dizziness or lightheadedness
- Abdominal pain
- Low libido
Lab Tests may show:
- Low morning cortisol
- Elevated ACTH
- Low sodium
- Elevated potassium
Cushings Syndrome or Hypercortisolism:
You’ve probably heard of cushings syndrome and cushings disease, but while the symptoms may present similarly, these two conditions are not entirely the same. Cushings Disease along with several other causes can contribute to Cushings Syndrome. Cushings Syndrome is best defined as an excess amount of cortisol. Some causes of Cushings Syndrome include:
- Intake of corticosteroids, like prednisone for example. These medications are often used to treat conditions like rheumatoid arthritis, asthma, eczema lupus or other autoimmune conditions. This is an exogenous cause of cushings syndrome and should in many cases subside after discontinuation of corticosteroids.
- ACTH-secreting tumor
- Adrenal adenoma
- Cushings Disease can cause Cushings Syndrome. In this disease, a tumor, often benign, produces an excess amount of ACTH, which causes the adrenal glands to make more cortisol. ACTH, also known as Adrenocorticotropic Hormone, is a hormone by the pituitary gland that stimulates the production of cortisol. Often times ACTH will tested, along with cortisol, if your Doctor suspects you have an adrenal dysfunction. Cushings disease.
Some symptoms of hypercortisolism include:
- Easy bruising
- Slow healing
- Striae or stretch marks on the skin
- Weight gain
- Buffalo hump (fat deposit between the shoulders)
- Moon faces (round face)
- Amenorrhea or Dysmenorrhea
- Low libido
- Erectile Dysfunction
- Depression or Anxiety