Adrenal gland disorders (or diseases) are conditions that interfere with the normal functioning of the adrenal glands. Your body produces too much or too little of one or more hormones when you have an

adrenal gland The adrenal glands (also known as suprarenal glands) are endocrine glands that produce a variety of hormones including adrenaline and the steroids aldosterone and cortisol. They are found above the kidneys. Each gland has an outer adrenal corte ...

dysfunction. The type of issue you have and the degree to which it affects your body's hormone levels determine the symptoms. The

produces hormones that affects growth, development and stress, and also helps to regulate kidney function. There are two parts of the

adrenal glands The adrenal glands (also known as suprarenal glands) are endocrine glands that produce a variety of hormones including adrenaline and the steroids aldosterone and cortisol. They are found above the kidneys. Each gland has an outer cortex which ...

, the

adrenal cortex The adrenal cortex is the outer region and also the largest part of the adrenal gland. It is divided into three separate zones: zona glomerulosa, zona fasciculata and zona reticularis. Each zone is responsible for producing specific hormones. I ...

and the

adrenal medulla The adrenal medulla () is the inner part of the adrenal gland. It is located at the center of the gland, being surrounded by the adrenal cortex. It is the innermost part of the adrenal gland, consisting of chromaffin cells that secrete catecho ...

. The

produces

mineralocorticoid Mineralocorticoids are a class of corticosteroids, which in turn are a class of steroid hormones. Mineralocorticoids are produced in the adrenal cortex and influence salt and water balances (electrolyte balance and fluid balance). The primary ...

s, which regulate salt and water balance within the body,

glucocorticoid Glucocorticoids (or, less commonly, glucocorticosteroids) are a class of corticosteroids, which are a class of steroid hormones. Glucocorticoids are corticosteroids that bind to the glucocorticoid receptor that is present in almost every vertebra ...

s (including

cortisol Cortisol is a steroid hormone in the glucocorticoid class of hormones and a stress hormone. When used as medication, it is known as hydrocortisone. Cortisol is produced in many animals, mainly by the ''zona fasciculata'' of the adrenal corte ...

) which have a wide number of roles within the body, and

androgens An androgen (from Greek ''andr-'', the stem of the word meaning ) is any natural or synthetic steroid hormone that regulates the development and maintenance of male characteristics in vertebrates by binding to androgen receptors. This includes ...

, hormones with testosterone-like function.Adrenal Glands
Johns Hopkins Medicine Health Library. The

produces

epinephrine Adrenaline, also known as epinephrine, is a hormone and medication which is involved in regulating visceral functions (e.g., respiration). It appears as a white microcrystalline granule. Adrenaline is normally produced by the adrenal glands a ...

(adrenaline) and

norepinephrine Norepinephrine (NE), also called noradrenaline (NA) or noradrenalin, is an organic compound, organic chemical in the catecholamine family that functions in the brain and human body, body as a hormone, neurotransmitter and neuromodulator. The ...

(noradrenaline).

Tumors of the adrenal gland

Adrenal adenoma

Adrenal adenomas are benign tumors that start in the cortex of the

. They fall into one of two categories: functional or non-secreting.

Adenoma An adenoma is a benign tumor of epithelium, epithelial tissue with glandular origin, glandular characteristics, or both. Adenomas can grow from many glandular organ (anatomy), organs, including the adrenal glands, pituitary gland, thyroid, prosta ...

s that are nonfunctional or have modest levels of hormone secretion may not show any symptoms at all and may remain asymptomatic. But adenomas with high levels of hormones frequently show up with primary hyperaldosteronism, Cushing syndrome, or hyperandrogenism symptoms.

Adrenocortical carcinoma

Adrenocortical carcinoma, (ACC), is cancer that develops in the

' cortex, or outer layer. Adrenocortical carcinoma usually occurs randomly, independent of a genetic predisposition. The majority of patients' primary complaints at first are indications and manifestations of excess hormones. Due to local tumor growth, some patients have vague symptoms such as flank or

abdominal pain Abdominal pain, also known as a stomach ache, is a symptom associated with both non-serious and serious medical issues. Since the abdomen contains most of the body's vital organs, it can be an indicator of a wide variety of diseases. Given th ...

, fullness in the abdomen, or early satiety.

Adrenal incidentaloma

An adrenal incidentaloma is a mass lesion larger than 1 cm in diameter that was unintentionally found through radiologic examination. In patients who do not yet have a confirmed cancer diagnosis, adrenal incidentaloma is infrequently caused by malignancy.

Pheochromocytoma

Pheochromocytoma originates from

chromaffin cells Chromaffin cells, also called pheochromocytes (or phaeochromocytes), are neuroendocrine cells found mostly in the medulla of the adrenal glands in mammals. These cells serve a variety of functions such as serving as a response to stress, monito ...

and is a kind of

neuroendocrine tumor Neuroendocrine tumors (NETs) are neoplasms that arise from cells of the endocrine (hormonal) and nervous systems. They most commonly occur in the intestine, where they are often called carcinoid tumors, but they are also found in the pancreas, lu ...

. Pheochromocytomas are generally benign. 10% to 15% of pheochromocytomas have the potential to be cancerous.

Hereditary disorders associated with adrenal tumors

Von Hippel–Lindau disease

Von Hippel–Lindau disease is a rare genetic multi-system disorder where certain body parts develop non-cancerous tumors. Pheochromocytomas are a particular kind of tumor that are linked to von Hippel-Lindau syndrome. VHL gene mutations result in von Hippel-Lindau syndrome.

Multiple endocrine neoplasia

Multiple endocrine neoplasia results in tumors or overgrowth on one or more endocrine glands. Multiple endocrine neoplasia is classified into three main forms: type 1, type 2, and type 4. Multiple endocrine neoplasia can be brought on by mutations in the MEN1, RET, and

CDKN1B Cyclin-dependent kinase inhibitor 1B (p27Kip1) is an enzyme inhibitor that in humans is encoded by the CDKN1B gene. It encodes a protein which belongs to the CIP/KIP, ''Cip/Kip'' family of cyclin dependent kinase (Cdk) inhibitor proteins. The enc ...

genes.

Disorders of hormone over/under-production

Addison's disease

Addison's disease Addison's disease, also known as primary adrenal insufficiency, is a rare long-term endocrine disorder characterized by inadequate production of the steroid hormones cortisol and aldosterone by the two outer layers of the cells of the adr ...

, or primary

adrenal insufficiency Adrenal insufficiency is a condition in which the adrenal glands do not produce adequate amounts of steroid hormones. The adrenal glands—also referred to as the adrenal cortex—normally secrete glucocorticoids (primarily cortisol), mineraloco ...

, is an uncommon chronic illness characterized by insufficient production of

and

aldosterone Aldosterone is the main mineralocorticoid steroid hormone produced by the zona glomerulosa of the adrenal cortex in the adrenal gland. It is essential for sodium conservation in the kidney, salivary glands, sweat glands, and colon. It plays ...

by the

. Chronic primary adrenal insufficiency is typically characterized by an extended period of

malaise In medicine, malaise is a feeling of general discomfort, uneasiness or lack of wellbeing and often the first sign of an infection or other disease. It is considered a vague termdescribing the state of simply not feeling well. The word has exist ...

fatigue Fatigue is a state of tiredness (which is not sleepiness), exhaustion or loss of energy. It is a signs and symptoms, symptom of any of various diseases; it is not a disease in itself. Fatigue (in the medical sense) is sometimes associated wit ...

, anorexia,

weight loss Weight loss, in the context of medicine, health, or physical fitness, refers to a reduction of the total body mass, by a mean loss of fluid, body fat (adipose tissue), or lean mass (namely bone mineral deposits, muscle, tendon, and other conn ...

, joint and back pain, and skin darkening.

Mineralocorticoid Mineralocorticoids are a class of corticosteroids, which in turn are a class of steroid hormones. Mineralocorticoids are produced in the adrenal cortex and influence salt and water balances (electrolyte balance and fluid balance). The primary ...

and

hormone deficiency must be physiologically replaced in order to treat primary

Adrenal crisis

Adrenal crisis is a serious, life-threatening complication of

Hypotension Hypotension, also known as low blood pressure, is a cardiovascular condition characterized by abnormally reduced blood pressure. Blood pressure is the force of blood pushing against the walls of the arteries as the heart pumps out blood and is ...

, or

hypovolemic shock Hypovolemic shock is a form of Shock (circulatory), shock caused by severe hypovolemia (insufficient blood volume or extracellular fluid in the body). It can be caused by severe dehydration or blood loss. Hypovolemic shock is a medical emergency ...

, is the main symptom of adrenal crisis, other indications and symptoms include

weakness Weakness is a symptom of many different medical conditions. The causes are many and can be divided into conditions that have true or perceived muscle weakness. True muscle weakness is a primary symptom of a variety of skeletal muscle diseases, ...

, anorexia,

nausea Nausea is a diffuse sensation of unease and discomfort, sometimes perceived as an urge to vomit. It can be a debilitating symptom if prolonged and has been described as placing discomfort on the chest, abdomen, or back of the throat. Over 30 d ...

, vomiting, fever,

, abnormal

electrolyte An electrolyte is a substance that conducts electricity through the movement of ions, but not through the movement of electrons. This includes most soluble Salt (chemistry), salts, acids, and Base (chemistry), bases, dissolved in a polar solven ...

confusion In psychology, confusion is the quality or emotional state of being bewildered or unclear. The term "acute mental confusion"

, and coma. Laboratory testing may detect lymphocytosis, eosinophilia,

hyponatremia Hyponatremia or hyponatraemia is a low concentration of sodium in the Serum (blood), blood. It is generally defined as a sodium concentration of less than 135 mmol/L (135 mEq/L), with severe hyponatremia being below 120 mEq/L. Symp ...

hyperkalemia Hyperkalemia is an elevated level of potassium (K+) in the blood. Normal potassium levels are between 3.5 and 5.0 mmol/L (3.5 and 5.0 mEq/L) with levels above 5.5mmol/L defined as hyperkalemia. Typically hyperkalemia does not cause symptoms. Oc ...

hypoglycemia Hypoglycemia (American English), also spelled hypoglycaemia or hypoglycæmia (British English), sometimes called low blood sugar, is a fall in blood sugar to levels below normal, typically below 70 mg/dL (3.9 mmol/L). Whipple's tria ...

, and on occasion,

hypercalcemia Hypercalcemia, also spelled hypercalcaemia, is a high calcium (Ca2+) level in the blood serum. The normal range for total calcium is 2.1–2.6 mmol/L (8.8–10.7 mg/dL, 4.3–5.2 mEq/L), with levels greater than 2.6 mmol/L def ...

Adrenal insufficiency

Adrenal insufficiency Adrenal insufficiency is a condition in which the adrenal glands do not produce adequate amounts of steroid hormones. The adrenal glands—also referred to as the adrenal cortex—normally secrete glucocorticoids (primarily cortisol), mineraloco ...

is the clinical sign of insufficient

production or action, with or without concurrent insufficiency in

mineralocorticoids Mineralocorticoids are a class of corticosteroids, which in turn are a class of steroid hormones. Mineralocorticoids are produced in the adrenal cortex and influence salt and water balances (electrolyte balance and fluid balance). The primary mi ...

and adrenal

. Adrenocorticotropic hormone deficiency or exogenous

opioid Opioids are a class of Drug, drugs that derive from, or mimic, natural substances found in the Papaver somniferum, opium poppy plant. Opioids work on opioid receptors in the brain and other organs to produce a variety of morphine-like effects, ...

medication suppression of

adrenocorticotropic hormone Adrenocorticotropic hormone (ACTH; also adrenocorticotropin, corticotropin) is a polypeptide tropic hormone produced by and secreted by the anterior pituitary gland. It is also used as a medication and diagnostic agent. ACTH is an important ...

can cause

, as can primary adrenal disorders. Unintentional

, anorexia, postural hypotension, extreme exhaustion, muscle and

, and hyponatraemia are characteristic clinical features.

Congenital adrenal hyperplasia

Congenital adrenal hyperplasia Congenital adrenal hyperplasia (CAH) is a group of Genetic disorder#Autosomal recessive, autosomal recessive disorders characterized by impaired cortisol synthesis. It results from the deficiency of one of the five enzymes required for the Biosy ...

is a group of autosomal recessive disorders characterized by impaired

synthesis. It results from the deficiency of one of the five

enzymes An enzyme () is a protein that acts as a biological catalyst by accelerating chemical reactions. The molecules upon which enzymes may act are called substrates, and the enzyme converts the substrates into different molecules known as pro ...

required for the

synthesis Synthesis or synthesize may refer to: Science Chemistry and biochemistry *Chemical synthesis, the execution of chemical reactions to form a more complex molecule from chemical precursors **Organic synthesis, the chemical synthesis of organi ...

of cortisol in the

. Most of these disorders involve excessive or deficient production of

hormone A hormone (from the Ancient Greek, Greek participle , "setting in motion") is a class of cell signaling, signaling molecules in multicellular organisms that are sent to distant organs or tissues by complex biological processes to regulate physio ...

s such as

s, or

sex steroid Sex hormones, also known as sex steroids, gonadocorticoids and gonadal steroids, are steroid hormones that interact with vertebrate steroid hormone receptors. The sex hormones include the androgens, estrogens, and progestogens. Their effects a ...

s, and can alter development of

primary Primary or primaries may refer to: Arts, entertainment, and media Music Groups and labels * Primary (band), from Australia * Primary (musician), hip hop musician and record producer from South Korea * Primary Music, Israeli record label Work ...

secondary sex characteristic A secondary sex characteristic is a physical characteristic of an organism that is related to or derived from its sex, but not directly part of its reproductive system. In humans, these characteristics typically start to appear during pubert ...

s in some affected

infant In common terminology, a baby is the very young offspring of adult human beings, while infant (from the Latin word ''infans'', meaning 'baby' or 'child') is a formal or specialised synonym. The terms may also be used to refer to juveniles of ...

s, children, or adults.

Cushing's disease

Cushing's disease Cushing's disease is one cause of Cushing's syndrome characterised by increased secretion of adrenocorticotropic hormone (ACTH) from the anterior pituitary (secondary hypercortisolism). This is most often as a result of a pituitary adenoma (spec ...

is an illness where an excess of

(ACTH) is released by the

pituitary gland The pituitary gland or hypophysis is an endocrine gland in vertebrates. In humans, the pituitary gland is located at the base of the human brain, brain, protruding off the bottom of the hypothalamus. The pituitary gland and the hypothalamus contr ...

. Cushing syndrome can be brought on by Cushing disease.

Hyperaldosteronism

Hyperaldosteronism is caused by the

's overproduction of the hormone

. The excess production of the

, specifically the

zona glomerulosa The ''zona glomerulosa'' (sometimes, glomerular zone) of the adrenal gland is the most superficial layer of the adrenal cortex, lying directly beneath the renal capsule. Its cells are ovoid and arranged in clusters or arches (''glomus'' is Latin ...

, is the cause of primary hyperaldosteronism. Excessive renin-angiotensin-aldosterone system activation results in secondary hyperaldosteronism.

Hypoaldosteronism

Hypoaldosteronism is a clinical condition marked by either an

deficiency or impaired tissue-level action of the hormone.

Angiotensin Angiotensin is a peptide hormone that causes vasoconstriction and an increase in blood pressure. It is part of the renin–angiotensin system, which regulates blood pressure. Angiotensin also stimulates the release of aldosterone from the adr ...

I to Angiotensin II conversion, adrenal aldosterone synthesis and secretion, abnormal target tissue response to

, and renal renin production and secretion are all potential causes of the disorder.

Notable people with adrenal gland disorders

* John F. Kennedy, the 35th president of the United States was diagnosed with

. * Some have suggested

Jane Austen Jane Austen ( ; 16 December 1775 – 18 July 1817) was an English novelist known primarily for #List of works, her six novels, which implicitly interpret, critique, and comment on the English landed gentry at the end of the 18th century ...

was an ''

avant la lettre Many words in the English vocabulary are of French language, French origin, most coming from the Anglo-Norman language, Anglo-Norman spoken by the upper classes in England for several hundred years after the Norman conquest of England, Norman ...

'' case of

Addison's Disease Addison's disease, also known as primary adrenal insufficiency, is a rare long-term endocrine disorder characterized by inadequate production of the steroid hormones cortisol and aldosterone by the two outer layers of the cells of the adr ...

, but others have disputed this. * Scientist

Eugene Merle Shoemaker Eugene Merle Shoemaker (April 28, 1928 – July 18, 1997) was an American geologist. He co-discovered Comet Shoemaker–Levy 9 with his wife Carolyn S. Shoemaker and David H. Levy. This comet hit Jupiter in July 1994: the impact was televise ...

, co-discoverer of the Comet Shoemaker-Levy 9 had

References

External links

Cleveland Clinic

Mount Sinai
{{Adrenal gland disorder