Adrenal Glands
What are the adrenal glands?
The adrenal glands are small (4–6 cm in length), paired, endocrine organs located above the kidneys. They produce and secrete hormones into the bloodstream that play a significant role in regulating metabolism, blood pressure, the immune system, and the body's response to stress.
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Main hormones that are released by adrenal glands are cortisol, aldosterone, adrenaline, noradrenaline and others.
Cortisol is body’s main hormone that participates in regulating the stress response. It also controls metabolism, suppresses inflammation, regulates blood pressure, the sleep-wake cycle and energy level, and increases blood sugar level.
Aldosterone regulates blood pressure, balances sodium and potassium level in the blood.
Adrenaline and noradrenaline, also known as epinephrine and norepinephrine, regulate the dilation/constriction of blood vessels, increase blood pressure, heart rate, and blood sugar levels.
What are the diseases of adrenal gland?
Adrenal gland diseases can occur with either reduced or excessive hormone production.
Primary Hyperaldosteronism – in this condition, the adrenal glands secrete excessive amounts of aldosterone into the blood, leading to an increase in blood pressure and, in some cases, low potassium levels. Primary hyperaldosteronism can be caused by increased activity of one or both adrenal glands.
Cushing's syndrome – refers to an excess level of cortisol in the blood. It can be caused by hyperactivity of pituitary (Cushing’s disease) or adrenal gland. The most common cause is the prolonged use of steroid medications.
Pheochromocytoma – is a tumor of the adrenal gland that secretes excessive amounts of adrenaline (epinephrine) and noradrenaline (norepinephrine) into the blood.
Adrenal gland tumors – can be benign or malignant, functionally active or inactive, and their evaluation is based on radiological and laboratory investigations.
Adrenal insufficiency – is a rare condition in which the adrenal glands secrete insufficient amounts of cortisol and aldosterone. The underlying causes may include autoimmune diseases (where the immune system attacks its own organs and tissues), diseases of the pituitary gland or hypothalamus, infections, and other factors.
What are the symptoms associated with adrenal diseases?
Excess cortisol: Pink/purple stretch marks on the skin, increased abdominal circumference, elevated blood pressure, increased blood sugar levels, general weakness, muscle weakness, irregular menstrual cycle, decreased bone density.
Excess aldosterone: Arterial hypertension, low potassium levels in the blood. Additionally, muscle pain, spasms, and in some cases, muscle paralysis may occur.
Excess epinephrine and norepinephrine: Episodic symptoms, during which increased blood pressure, headache, sweating, shortness of breath, and anxiety are observed.
Adrenal insufficiency: General weakness, low energy, low blood pressure, decreased appetite, weight loss, vomiting, diarrhea, muscle pain, irregular menstrual cycle, in some cases, skin hyperpigmentation and other.
How are adrenal diseases diagnosed and treated?
The diagnosis of adrenal gland diseases is carried out by an endocrinologist. Laboratory tests are used to assess hormone levels in the blood and/or urine, and radiological examinations, including computed tomography (CT) and magnetic resonance imaging (MRI), are employed. After the diagnosis of the disease, treatment options are determined: either medication or surgical intervention.