Adrenal Disorders

What are Adrenal Glands?

The Adrenal GlandsThe adrenal glands are small glands that sit atop the kidneys on each side of the body. They secrete hormones that are involved in controlling blood pressure, sodium and potassium levels, the normal stress response of “flight or fight” and metabolism in general. Like other endocrine glands, one can have too much or too little of these hormones that may cause clinical problems.

Adrenal Insufficiency

There are a number of situations that can cause the adrenal gland to secrete too little amounts of adrenal hormones. These patients may have symptoms of fatigue, weakness, nausea, weight loss and salt craving. A detailed history and physical and specific blood and sometimes saliva tests at a specific time of day are required to make this diagnosis. Additionally specific dynamic testing using the pituitary hormone that normally stimulates the adrenal gland (ACTH) is often required to secure the diagnosis. Treatment with adrenal hormones usually restores the patient’s sense of well-being.

Endocrine Hypertension

Overactivity of the adrenal glands often results in high blood pressure (hypertension). Too much cortisol results in Cushing’s Syndrome that may lead to hypertension, weight gain (“trunk” obesity), easy bruising, diabetes, and purplish or red skin coloring on the face or abdomen. Hyperaldosteronism results from too much aldosterone that can cause hypertension and low potassium. Pheochromocytoma is usually a tumor of the adrenal gland or tissue similar to the adrenal gland elsewhere in the body that can cause hypertension, headache, spells of increased heart rate, dizziness, or sweats and changes in skin color. All of these syndromes are diagnosed by a detailed history of these symptoms (and others) and a physical exam. Screening blood and urine tests and imaging studies (ultrasound, MRI, CT scan) will likely be needed. Often additional dynamic testing will be performed to see if these excess hormones can be suppressed with agents given by mouth or IV in the office. Sometimes two or three procedures may be required, including adrenal vein sampling, usually done in the radiology department of the local hospitals. Treatment may be medication or include surgery if a tumor is identified.

Adrenal Incidentalomas

Sometimes patients are referred to an endocrinologist when an adrenal tumor is identified by a CT scan or MRI taken for another reason such as chest pain or abdominal pain. These are called adrenal incidentalomas. They are very rarely malignant, but have to be evaluated for the syndromes listed above, since removal often improves the patient’s health. In this case, we will work closely with the surgeon involved. Most of the time these adrenal tumors are non-functional and can simply be observed.

Enzyme Abnormalities

There are rare errors of metabolism that may affect the adrenal glands. These are usually inherited, but may not show up until adulthood. There may be enzyme abnormalities so that the normal metabolism of the adrenal hormones is affected. These patients may present with a number of symptoms. Abnormalities of blood pressure, and electrolyte disturbances, as well as problems of sexual maturation in both boys and girls and even excessive hair growth in females are the most common symptoms of these uncommon diseases.

Contact Stonesifer Endocrine Care & Clinical Research

Schedule your appointment with Dr. Stonesifer by calling 253-927-4777. We serve all patients with adrenal disorders in Seattle, Federal Way, Tacoma and surrounding areas.