Adrenal Gland Conditions

Adrenal gland function

The adrenal glands are a pair of hormone- producing glands located on top of the kidneys. Each gland is about 1.5” x 3”, and contains a cortex and a medulla. The cortex produces hormones that are vital to life, such as sex hormones and cortisol which regulates metabolism and our response to stress, and aldosterone which controls blood pressure, and adrenal androgens (DHEA). The medulla produces hormones that are not essential to life, but which are important to body function, such as adrenaline(epinephrine) which controls our response to stress, norepinephrine, and dopamine.

These hormones are responsible for many important body functions, impact growth and development, and control stress and kidney function, and include:

  • Regulation and maintenance of certain metabolic functions like blood sugar levels, fat and protein metabolism, immunity and inflammation
  • Regulation and maintenance of the balance between salt and water which impacts kidney and cardiovascular function
  • Regulating the ‘fight or flight ‘response to stress, and the hormones that control the stress response. Maintaining pregnancy
  • Initiating and controlling sexual maturation in childhood and puberty
  • Producing sex hormones precursors to estrogen and testosterone
  • Regulation and maintenance of hormones to control stress response

Additionally, there is a precisely regulated relationship between adrenal hormones and hormones secreted by the hypothalamus and the pituitary gland. Together these 3 structures comprise the Hypothalmic- pituitary- adrenal axis (HPA axis) which is crucial to various physical functions.

Disorders of these glands cause them to produce more than (hyper) or not enough (hypo) hormones, that can result in a host of complications including diabetes, high blood pressure, fatigue and depression. Two major disorders are Addison’s disease and Cushing’s syndrome.

Causes of Adrenal Gland Disorders

  • Genetics
  • Tumors- most adrenal gland tumors are noncancerous and generally do not cause symptoms or require treatment. However, adrenal tumors can cause Cushing’s disease, excess levels of aldosterone and too much adrenaline. Cancerous tumors of the adrenal gland are slow- growing and often discovered years after they began. By that time they have metastasized or spread to other organs.
  • Infections
  • Certain medications
  • Problems with the pituitary glands which help regulate the adrenals.

Cushing’s Syndrome

Cushing’s syndrome is a rare debilitating illness that is due to excessive production of cortisol over long periods of time. It is commonly caused by a tumor of the pituitary ( pituitary adenoma) or adrenal glands, and ectopic tumors (tumors in other organs). In 70% of patients the cause is a pituitary adenoma. It commonly affects adults between ages 20- 50.

Symptoms of elevated cortisol include fatty tissue deposits and weight gain in the trunk and upper back, in the face ( moon face) , and a hump between the shoulders, thin skin that bruises easily, muscle weakness and atrophy, menstrual disorders, erectile dysfunction, hypertension, Diabetes, susceptibility to infection, hyperglycemia and osteoporosis, and excessive hair growth. The hump at the back of the neck and the moon face are characteristic of Cushing’s disease.

Surgery is the only treatment that offers a cure when Cushing’s syndrome is caused by an pituitary adenoma. The surgeons at BASS Medical Group are experienced in Transsphenoidal surgery, that removes a pituitary tumor.

Addison’s disease (adrenal insufficiency)

Addison’s disease is a rare, debilitating illness that occurs when the adrenal glands are unable to produce adequate adrenal hormones for normal function. The most common cause is an autoimmune disease where the immune system attacks the adrenal glands.

Symptoms include weakness, low blood pressure, extreme fatigue, hyperpigmentation of the skin, nausea, diarrhea, vomiting, abdominal pain, muscle and joint pain, loss of body hair, irritability and depression. Low blood pressure, shock, vomiting and abdominal pain are signs of an adrenal crisis which is life-threatening.

Diagnosis

In addition to the signs and symptoms of Addison’s disease, lab tests to evaluate blood cortisol levels. Other tests are often needed to confirm the diagnosis. Cushing’s syndrome signs and symptoms are diagnostic and are confirmed by lab tests. Imaging studies are used to diagnose pituitary and adrenal tumors.

Treatment

In Addison’s, standard hormone replacement therapy with hydrocortisone is used to treat cortisol deficiency.

The general surgeons at BASS Medical Group are board-certified and experienced in disorders of the adrenal glands, and Fellows of the American College of Surgeons. They are dedicated to your health and well being. Choosing the right surgeon to perform your surgery is one of the most important decisions a patient can make. Our offices are conveniently located in San Francisco, and the East Bay, California, to serve our patients. Call BASS Medical Group to schedule a consultation and learn about your concerns, get answers to your questions and receive professional, quality care.