Adrenal Gland Disorders

What are adrenal gland disorders?

Adrenal gland disorders occur when your adrenal glands make too much or too little hormone. Your adrenal glands, just above each kidney, are small and triangular. They make hormones that help keep your metabolism, blood pressure, immune system and stress response in balance. These hormones are:

• Cortisol.
• Adrenaline.
• Aldosterone.

Types of adrenal gland disorders

The most common adrenal gland disorders are:

• Addison’s disease (adrenal insufficiency). People with this condition don’t produce enough cortisol and/or aldosterone.
• Adrenal gland suppression. This is a type of adrenal insufficiency that relates to outside sources of cortisol. It often affects people who take synthetic hormones like prednisone or dexamethasone.
• Cushing syndrome. People with this condition have high levels of cortisol in their bodies.
• Congenital adrenal hyperplasia (CAH). People with CAH lack enzymes that the adrenal glands need to make enough hormones.
• Hyperaldosteronism. If you have this condition, your body produces too much aldosterone.
• Virilization. This condition happens when your body produces too much of the male sex hormones and is only apparent in females or boys before puberty.

There are also adrenal gland disorders that relate to growths (tumors). These include:

• Adrenal gland tumors. Tumors can disrupt hormone output but are usually benign (noncancerous). An adrenal adenoma is the most common adrenal gland tumor.
• Adrenocortical carcinoma. This rare adrenal gland disorder happens when cancer forms in your adrenal gland’s outer layer.
• Pheochromocytoma. If you have this condition, your glands make too much epinephrine and norepinephrine which can raise your blood pressure or make your heart race.
• Pituitary adenomas. Benign tumors on your pituitary gland can cause adrenal gland disorders because they can affect hormone production in your adrenal glands.

How common are adrenal gland disorders?

Adrenal gland disorders can happen to anyone. Within the individual conditions, some (like Cushing syndrome) occur more often in people assigned female at birth (AFAB).

What are the symptoms of adrenal gland disorders?

Adrenal gland disorder symptoms vary depending on which hormones play a role. Some symptoms are similar to those of other conditions. So, it’s important to visit a healthcare provider for proper diagnosis and treatment.

Symptoms of high cortisone levels include:

• Upper body obesity, while arms and legs stay thinner.
• Fatigue.
• High blood pressure.
• Diabetes.
• Skin that bruises easily.
• Wide discolored streaks on abdominal skin.
• Confusion.

Symptoms of high aldosterone levels include:

• High blood pressure.
• Low potassium (hypokalemia).
• Weakness.
• Muscle spasms.
• Muscle pain.

High levels of male sex hormones are only apparent in people AFAB or in young children assigned male at birth (AMAB) before puberty. This hormonal imbalance can cause symptoms like:

• Facial hair.
• Balding.
• Acne.
• Having a deeper voice.
• Becoming more muscular.
• Developing a greater sex drive.

These symptoms indicate virilization — when a prepubescent child AMAB or person AFAB develops masculine traits.

What causes adrenal gland disorders?

Adrenal gland disorders can happen for a few different reasons, like when:

• Your adrenal glands make too much — or too little — hormone.
• You have a condition affecting another gland, like your pituitary gland.
• Outside sources — like medications or chemicals in your environment — raise or lower your hormone levels.
• You have a genetic mutation (change in your DNA) that raises or lowers your hormone levels.

Healthcare providers don’t always know why some people get adrenal gland disorders and others don’t.

What are the complications of adrenal gland disorders?

The adrenal glands and the hormones they control are important to many of your body’s functions. Untreated disorders can have serious complications. Some of them may be life-threatening.

How are adrenal gland disorders diagnosed?

Your healthcare provider will likely start by asking questions about your symptoms and doing a physical exam. Then they’ll order tests to determine the levels of hormones in your saliva, blood and urine.

If your provider suspects tumors, they might recommend:

• CT (computed tomography) scans.
• MRI (magnetic resonance imaging).
• Nuclear medicine imaging.

Your regular healthcare provider may refer you to an endocrinologist, a specialist in hormones and diseases of the endocrine system. There are also pediatric endocrinologists who treat babies and children.

How are adrenal gland disorders treated?

How to treat adrenal gland disorders depends on the specific condition. Some disorders require medications to increase your hormone levels. Your provider might suggest surgery or radiation therapy for conditions that involve tumors.

Can adrenal gland disorders be prevented?

Since researchers don’t know why certain adrenal gland disorders happen, there’s currently no way to prevent them from happening.

How can I lower my risk?

If you’re thinking about taking male hormones to build muscle mass, reconsider your strategy. It can cause adrenal gland disorders and result in damage to other glands.

What can I expect if I have an adrenal gland disorder?

Your outlook varies depending on the condition you have. But early diagnosis and treatment can get you back on track and help you manage your condition successfully. Talk to your healthcare provider about what to expect in your situation.

When should I see my healthcare provider?

You should contact your healthcare provider whenever you have symptoms that concern you, with or without a diagnosis of an adrenal disorder. Some of these might include:

• Unexplained weight loss.
• Gaining weight primarily in your upper body.
• Feeling so tired that you can’t get through your daily tasks.
• Being in any type of pain that’s severe or that doesn’t stop.
• Experiencing changes in hair growth.
• Experiencing skin changes, like bruising easily or developing stretch marks.

When should I go to the ER?

If you have adrenal insufficiency, you could experience an adrenal crisis. This life-threatening condition happens due to a severe lack of cortisol.

Call 911 or go to your local emergency room if you develop:

• Severe pain in your lower body that comes on quickly.
• Bouts of vomiting and diarrhea.
• Weakness.
• Confusion and loss of consciousness (fainting).
• Low blood sugar (hypoglycemia).
• Low blood pressure.

If you have adrenal insufficiency, ask your provider for an injectable glucocorticoid that you can carry with you. An injectable glucocorticoid is an injectable medication that reduces pain and inflammation. Make sure that you know how to inject yourself, and that your family and friends also know how and when to inject you.

Other potentially life-threatening symptoms can occur with adrenal gland disorders. These include having too much potassium (hyperkalemia) or not enough sodium (hyponatremia) in your blood.

If you experience severe symptoms like the ones mentioned here, don’t wait for a regular appointment. Seek emergency care right away.

What questions should I ask my doctor?

Hearing that you have an adrenal gland disorder can feel uncertain — even scary. Here are some questions you might want to ask your healthcare provider:

• What type of adrenal gland disorder do I have?
• Is it curable? Or will I need to find ways to manage it?
• Will I need medication? If so, what kind?
• Do I have any tumors causing my symptoms?
• What are my treatment options?

A note from Cleveland Clinic

You probably don’t think about your adrenal glands much unless they stop working like they used to. When you develop new and unfamiliar symptoms, it can feel frustrating and isolating. You’re not alone. Ask your healthcare provider for additional resources or support groups that can guide you along your journey. Becoming an active part of your healthcare team can help you successfully manage your condition and improve your quality of life.