Adrenal Medulla

What is the adrenal medulla?

The medulla is the inner part of your adrenal gland. It releases hormones that regulate your autonomic nervous system. This system controls involuntary functions you usually wouldn’t think about, like your heart rate.

What are the parts of the adrenal gland?

The medulla is the smaller part of the gland. The adrenal cortex is the outer section and takes up the bulk of the gland’s tissue.

Where are the adrenal glands?

You have two adrenal glands, one on top of each kidney. Your kidneys lie just below your ribcage.

What is the adrenal medulla function?

The adrenal medulla secretes catecholamines, hormones that help your body respond to stress. Catecholamines include adrenaline and noradrenaline, also known as epinephrine and norepinephrine.

Within moments, your body releases adrenal medulla hormones to boost organ functioning. This is also known as the fight-or-flight response.

Other signs of the fight-or-flight response include:

• Delayed pain if injured.
• Increase in strength or speed.
• Heightened awareness of your surroundings.

What is the role of adrenaline?

Your medulla secretes adrenaline in response to low blood sugar levels or exercise. It helps your body react to stress by:

• Delivering extra oxygen to muscles.
• Increasing blood pressure and heart output.
• Widening small arteries.

What is the role of noradrenaline?

This hormone helps your body respond to stress by:

• Increasing blood sugar levels.
• Narrowing blood vessels.
• Raising your blood pressure.

Norepinephrine (noradrenaline) also:

• Contributes to your brain’s ability to store memories.
• Helps you wake up.
• Increases attention and focus.
• Supports emotional health.

What is the anatomy of the adrenal medulla?

Features of your medulla’s anatomy include:

• Blood supply: A significant blood supply is necessary to regulate adrenal medulla hormones. Adrenal arteries branch from blood vessels such as the inferior phrenic artery, renal artery and abdominal aorta.
• Nerve supply: The greater splanchnic nerve helps your medulla communicate with the rest of your body. This nerve is part of your autonomic nervous system.
• Chromaffin cells: These cells contain tiny granules. When splanchnic nerve cells trigger a stress response, chromaffin cells release their granules. This sends adrenaline and noradrenaline into your bloodstream.

What conditions and disorders affect the adrenal medulla?

Conditions affecting the medulla are rare but can be life-threatening. These disorders typically include medullary or adrenal tumors, most of which are benign (noncancerous). Some tumors run in families.

Adrenal medullary tumors include:

• Ganglioneuroma, a tumor occurring in adults and children that develops in autonomic nervous system cells.
• Neuroblastoma, a cancer in nerve tissue that often affects children. Neuroblastomas can also develop in your abdomen, chest or spinal cord.
• Paraganglioma, a tumor made of tissue (chromaffin) that's found in your adrenal glands. It forms in the peripheral nervous system and affects your limbs, head, neck and abdomen.
• Pheochromocytoma, tumor affecting the release of epinephrine and norepinephrine. This condition causes dangerous blood pressure spikes (hypertensive crisis).

What are the symptoms of adrenal medullary tumors?

Medullary tumors grow slowly, so you might not notice symptoms at first. They're often discovered in imaging studies taken for other reasons (adrenal incidentaloma).

Medulla tumor symptoms can affect your:

• Blood pressure.
• Digestive system.
• Nervous system.
• Respiratory system.
• Urinary system.

What are the signs of a hypertensive crisis?

A hypertensive crisis can occur when your body can’t regulate medullary hormones in response to mild stress. Simple activities, such as bending forward or eating certain foods, can cause symptoms that include:

• Chest pain.
• Excessive sweating (hyperhidrosis).
• Headaches.
• Loss of consciousness (syncope).
• Nausea and vomiting.
• Seizures, episodes of abnormal electrical activity in the brain.
• Shortness of breath (dyspnea).

Are there other disorders affecting the adrenal medulla to be aware of?

When there are abnormally high levels of hormones, you may experience mental health issues, such as:

• Addiction.
• Anxiety.
• Attention deficit hyperactivity disorder (ADHD).
• Depression.
• Panic disorder.
• Post-traumatic stress disorder (PTSD).

What treatments might I need for diseases affecting my adrenal medulla?

The treatments you may need depend on your diagnosis and symptom severity.

Care may include:

• Hypertensive crisis therapy: Emergency treatment is necessary to lower your blood pressure. You may receive vasodilators, medications that work quickly to widen narrow blood vessels.
• Tumor and cancer treatments: Tumors often require surgery. The surgeon may need to remove one or both of your adrenal glands. Radiation and chemotherapy may be necessary for cancerous tumors.

How can I take care of my adrenal medulla?

Taking good care of yourself optimizes gland functioning, including your adrenal medulla. This includes:

• Living an active lifestyle with regular physical activity.
• Eating a diet that’s rich in nutrients.
• Consuming plenty of water.
• Managing stress with deep breathing exercises or meditation.
• Receiving preventive care, including regular physical exams.

A note from Cleveland Clinic

Hormones produced by your adrenal medulla regulate your body’s response to stress. They cause temporary spikes in organ activity that help you avoid dangerous situations. Having abnormally high levels of these hormones can cause health issues, some of which are life-threatening. If you are concerned about having an adrenal medullary tumor, hypertensive crisis or excess hormones, an endocrinologist can help you get answers.