Adrenal Disorders
The adrenal glands, situated directly on top of each kidney, play a crucial role in regulating many physiological functions through the production of hormones. For instance, the glands contribute to stress management as well as the maintenance of metabolism, immune system response, and blood pressure. Disorders affecting these glands can lead to significant health implications.
This article will delve into four notable adrenal disorders— Cushing’s syndrome, adrenal insufficiency, primary aldosteronism, and pheochromocytoma— while also exploring the intriguing connection between adrenal nodules and hypertension in young individuals.
Cushing’s Syndrome
Cushing’s syndrome results from prolonged exposure to elevated levels of cortisol. The adrenal glands secrete cortisol, which is often referred to as the “stress hormone.” Common causes of Cushing’s syndrome include adrenal tumors, excessive use of corticosteroid medications, and overproduction of adrenocorticotropic hormone (ACTH). Early onset symptoms include weight gain, formation of a fatty lump between the shoulders, plump face, muscle weakness, and slow wound healing. Diagnosis of Cushing’s involves cortisol level assessments, imaging studies, and sometimes a dexamethasone suppression test to measure the adrenal gland’s response to ACTH. Treatment options include surgery or medication to tackle the root cause of the excessive cortisol production.
Adrenal Insufficiency
Adrenal insufficiency (also known as Addison’s Disease) is a state in which the adrenal glands do not generate sufficient hormones, particularly cortisol and aldosterone.
Adrenal insufficiency is often triggered by an autoimmune attack or infections that damage your adrenal glands. Individuals with the disease usually suffer from symptoms like fatigue, weight loss, low blood pressure, and electrolyte imbalance. Diagnosis often involves blood tests and stimulation tests. Treatment typically requires hormone replacement therapy.
Primary Aldosteronism
Primary aldosteronism results from the overproduction of aldosterone, a hormone that regulates electrolyte balance. It is often caused by adrenal gland tumours. Symptoms can include high blood pressure with low potassium, constant fatigue, and general weakness. Diagnosis typically involves aldosterone-renin ratio testing and imaging studies such as CT or MRI to check for the presence of tumours in your adrenal gland. Treatment options may include medication intended to block the effects of aldosterone or surgery, depending on the cause.
Pheochromocytoma
Pheochromocytomas are rare tumours that produce excessive amounts of adrenaline and noradrenaline. Excess of these adrenal hormones can lead to severe hypertension, headaches, and palpitations. Diagnosis involves blood and urine tests, as well as imaging studies. Treatment options for pheochromocytoma include alpha-blockers (e.g., phenoxybenzamine), beta-blockers (e.g., propranolol), surgical removal (adrenalectomy), preoperative medical management, follow-up monitoring, and, in rare cases, chemotherapy or radiation therapy.
Adrenal Nodules and Early-Onset Hypertension
Adrenal nodules are noncancerous growths on the adrenal glands. While most are benign and asymptomatic, some may produce excess hormones, leading to conditions such as primary aldosteronism. In young individuals, the presence of adrenal nodules may contribute to early-onset hypertension. Diagnostic methods include imaging studies, hormone level assessments, and sometimes adrenal vein sampling. Treatment may involve medication or surgery to control hormone production and blood pressure.
Adrenal disorders represent a diverse spectrum of conditions, often requiring a holistic approach for accurate diagnosis and effective treatment. Recent advancements in diagnostic imaging have helped many endocrinologists in Singapore to quickly identify the causes of adrenal disorders and create a personalised treatment plan to address the condition.
Suppose you or your loved ones are suffering from any symptoms of adrenal disorders. In that case, you can schedule an appointment with our Senior Consultant Endocrinologist, Dr Vikram from Harmony Thyroid, Endocrinology, and Diabetes Centre.
References:
- Cobb A, Aeddula NR. Primary Hyperaldosteronism. PubMed. Published 2021. https://www.ncbi.nlm.nih.gov/books/NBK539779/
- Huecker MR, Dominique E. Adrenal Insufficiency. PubMed. Published 2020. https://www.ncbi.nlm.nih.gov/books/NBK441832/
- Munir S, Waseem M. Addison disease. National Library of Medicine. Published 2020. https://www.ncbi.nlm.nih.gov/books/NBK441994/
