Adrenal Gland Disease

Adrenal Gland Disease

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Addison’s disease, also known as adrenal insufficiency, is a rare disorder that occurs when your body does not produce certain hormones. In Addison’s disease, your adrenal glands, which are located just above your kidneys, produce too little cortisol and often, too little aldosterone. Addison’s disease affects all age groups and both genders and can be life-threatening. Treatment consists of replacing the hormones that are missing. Your adrenal glands are two small organs that sit above each kidney. The adrenal glands make a variety of hormones that you need to stay alive and healthy. Hormones are chemicals that travel through your bloodstream and control how different parts of your bodywork. The hormones which are produced by adrenal glands are cortisol, aldosterone, adrenaline, and noradrenaline. They also make the hormones your body uses to make sex hormones (estrogen and testosterone). Adrenal Gland Disease

Common types of adrenal disorders

There are various conditions related to your adrenal glands. Some of the most common include:

  1. Addison’s disease is also called adrenal insufficiency. In this disorder, your body may not produce enough cortisol or aldosterone.
  2. Cushing syndrome. In this case, your cortisol levels are too high. The term may be applied when large doses of steroids are given to treat certain medical conditions.
  3. Congenital adrenal hyperplasia. The term refers to a genetic condition in which your adrenal glands are unable to make cortisol well. As a result, ACTH is elevated. Depending on the disorder, high levels of male hormones can occur.
  4. Suppression of the adrenal glands. This is a type of adrenal insufficiency associated with external sources of cortisol or related synthetic hormones such as prednisone or dexamethasone.
  5. Hyperaldosteronism. If you have this condition, your body produces too much aldosterone, which can lead to high blood pressure and potassium deficiency.
  6. Virtualization. This condition occurs when your body produces too much male sex hormone and only appears in girls or boys before puberty.

There are also adrenal gland conditions related to growth (tumors). These include:

  1. Tumors of the adrenal glands. Tumors can disrupt hormone production but are usually noncancerous.
  2. Adrenocortical carcinoma. This rare condition refers to cancer forming in the outer layer of the adrenal gland.
  3. Pheochromocytoma. If you have this condition, your glands make too much epinephrine and norepinephrine, which can raise blood pressure or increase your heart rate.
  4. Pituitary tumor. Abnormal growth in the pituitary gland can cause adrenal gland conditions by disrupting the number of hormones produced by the adrenal glands. ACTH-producing tumors cause Cushing’s disease. If the tumors are large enough, they can put pressure on normal pituitary cells and cause ACTH deficiency and secondary adrenal insufficiency. Adrenal Gland Disease

What are the symptoms of Adrenal Gland Disease?

Adrenal disorders can present themselves in many ways. Symptoms can vary depending on the individual and pre-existing conditions, but often include the following:

  1. Weight loss
  2. Muscular weakness
  3. Fatigue
  4. Darkening of the skin
  5. Headache
  6. Nausea
  7. vomit
  8. Diarrhea
  9. Craving salty foods
  10. Mouth sores
  11. Stomach pain
  12. Constipation

Although symptoms vary, there are particularly dominant signs that something may be wrong with your adrenal glands. These include:

  1. Abdominal pain and weight loss. Hormones produced in the adrenal glands control our appetite and food processing. When they are overactive or underproduced, they can cause digestive problems and prevent your body from getting the nutrients it needs from food sources.
  2. High blood pressure. Although this symptom can be indicative of a variety of illnesses, it is especially true of adrenal disorders when combined with low sodium levels, headaches, and facial flushing. Overproduction of hormones can throw off the special balance of water and salt in the bloodstream, causing blood pressure levels to skyrocket.
  3. Fatigue and weakness. These symptoms of Addison’s disease may specifically indicate an underlying problem that needs immediate attention. A lack of hormones can cause low blood pressure, muscle weakness, and general fatigue. Many people who eventually develop Addison’s disease often experience an Addisonian crisis, which alerts doctors to adrenal insufficiency.

Risk Factors of Adrenal Gland Disease

Risk factors for adrenal disorders can vary, but most cases are caused by underlying autoimmune disorders. Other predisposing factors may include:

  1. Chronic diseases, including tuberculosis
  2. Previous infection
  3. Surgery that removes parts of the adrenal gland.
  4. Autoimmune diseases such as Graves’ disease, lupus, or HIV
  5. Some antifungal medications

Acute adrenal insufficiency (Addisonian crisis)

Addisonian crisis can lead to life-threatening shock. Get emergency medical treatment if you experience the following signs and symptoms:

  1. Severe weakness.
  2. get confused
  3. Pain in your back or legs
  4. Severe abdominal pain, vomiting, and diarrhea lead to dehydration.
  5. Loss of consciousness or delirium

In the Addisonian crisis you will also have:

  1. Low blood pressure
  2. High potassium (hyperkalemia) and low sodium (hyponatremia)

Causes

The cause of adrenal gland dysfunction depends on the type of disorder you have. Reasons may include:

  1. Medicines such as steroids
  2. A problem with another gland like the pituitary gland. The pituitary gland releases hormones that affect the way the adrenal glands work.
  3. Changes (mutations) in genes. These changes can cause the adrenal glands to produce too much or too little of one or more hormones.
  4. Infections

In often cases, the cause of the problem is not clear.

Diagnosis of adrenal gland disease

A doctor may perform a variety of tests to check for an adrenal disorder. Tests may include:

  1. Urine tests
  2. Blood tests
  3. X-ray
  4. CT scan
  5. MRI scan

Tests will differ depending on a person’s symptoms and health history.

Treatment

All treatments for Addison’s disease include medication. You will be given hormone replacement therapy to correct the levels of steroid hormones that your body is not producing.
Fludrocortisone acetate to replace aldosterone.
You will need plenty of salt (sodium) in your diet, especially during heavy exercise, when the weather is hot or if you have a stomach upset, such as diarrhea.

If your body is under stress, such as from surgery, infection, or a minor illness, your doctor may also recommend a temporary increase in the dose of your medication. If you are sick with vomiting and cannot take oral medications, you may need corticosteroid injections.

Other treatment recommendations include:

  1. Carry a medical alert card and bracelet with you at all times. A steroid emergency card and medical alert identification will tell emergency medical personnel what type of care you need. Also, plan a written action.
  2. Keep extra medications on hand. Missing even a day’s medication can be dangerous, so carry a small supply of medication with you at work and whenever you travel.
  3. Carry a glucocorticoid injection kit with you. The kit contains a needle, syringe, and form of injectable corticosteroids for emergency use.
  4. Stay in touch with your doctor. Keep in touch with your doctor to make sure that the dose of replacement hormones is adequate, but not excessive. If you continue to have problems with your medication, you may need an adjustment in the dose or timing of the medication.
  5. Get an annual checkup. See your doctor or endocrinologist at least once a year. Your doctor may recommend annual screenings for many autoimmune diseases.

Treatment for an Addisonian crisis, which is a medical emergency, usually involves intravenous injections of:

  1. Corticosteroids
  2. Saline solution
  3. Sugar (dextrose)
  4. Possible future treatments

Researchers are working to develop delayed-release corticosteroids, which work like the ones in the human body. They are also working on pumps implanted under the skin that can deliver more precise doses of steroids. Future treatments may eventually include the use of adrenocortical stem cells in combination with immunomodulatory treatments – immune responses or changes in the immune system – as well as gene therapy.

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