Adrenal glands – characteristics, structure, functions and diseases [EXPLAINED]

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The adrenal glands, as the name suggests, are the organs that are located above the kidneys. The most important role of the adrenal glands is to produce hormones that enable the body to function properly. How are the adrenal glands built? What diseases are caused by adrenal dysfunction?

What are the adrenal glands?

The adrenal glands are paired endocrine glands and are characterized by a small size. The name of the adrenal glands indicates their location in the human internal system. The adrenal glands are primarily responsible for the production of hormones that are essential for the proper functioning of the body. If the adrenal glands are not working properly, hormones are deficient, which can lead to serious health problems and in some cases even death.

If you want to know more about the functioning of the endocrine system, read on: Endocrine system

Adrenal glands – location and structure

The adrenal glands, as their name already indicates, are located on the upper pole of the kidneys. The posterior surface of the adrenal glands is adjacent to the lumbar region of the diaphragm. Right adrenal gland in addition, it adheres to the inferior vena cava, peritoneum and liver. On the other hand left adrenal glands adjacent to the peritoneal net pouch, stomach, pancreas and splenic artery.

The adrenal glands are small glands, the weight of one adrenal gland ranges from 10 to 18 grams. The adrenal glands are made up of cortical and core parts that differ both in structure and basic functions. In addition, the left and right adrenal glands are also different. The right adrenal gland resembles a pyramid, while the left crescent.

The cortex of the adrenal glands constitutes the main mass of this gland, it is estimated that the cortex is about 80-90% of the entire adrenal gland. The adrenal cortex consists of three layers: glomerular, banded and reticular. The adrenal gland instead, it is made up of epithelial lumps and trabeculae which together constitute a network. In the meshes of this network there are sinus capillaries and venous vessels. The adrenal glands are strongly innervated. Behind innervation of the adrenal glands the adrenal plexus corresponds to the fibers of the vagus, diaphragmatic and visceral nerves.

How are the kidneys built and how do they function in the human body? Check: What do the kidneys do and what do kidney diseases manifest?

Adrenal glands and their role in the body

The adrenal glands are glands the proper functioning of which is extremely important for human health and life. The main task of the adrenal glands is the production of hormones that guide many processes in the body. The cortical part of the adrenal gland produces different hormones than the core part

Hormones secreted by the cortical part of the adrenal glands:

1. mineralokortykoidy – are hormones that are synthesized in the glomerular layer of the adrenal cortex. Among these hormones, aldosterone, an organic chemical compound from the group of steroids, has the strongest effect. Aldosterone is involved in the regulation of the body’s water and mineral balance, which means that it maintains the proper level of mineral salts and water in the body. This hormone influences the functioning of the renal tubules by increasing the absorption of sodium salts and limiting their excretion in the urine. Aldosterone also works by reducing the amount of blood that passes through the kidneys, thereby reducing the amount of urine passed out. Aldosterone also participates in transport processes in the kidneys. Additionally, this hormone, along with renin and angiotensin, regulates blood pressure;
2. glucocorticoids – are hormones that are synthesized in the reticular and banded layers. The most important and powerful hormone in the glucocorticoid group is cortisol, also known as the stress hormone. A characteristic feature of cortisol is the so-called the circadian rhythm of secretion, therefore its highest concentration is observed in the morning, and the lowest around midnight. Cortisol has anti-inflammatory properties, which is why it is a common ingredient in potent drugs to counteract inflammation. This hormone also affects the level of glucose in the blood, and more precisely causes an increase in glucose, e.g. in stressful moments.

The role of cortisol is also to release amino acids, accelerate gluconeogenesis and salt retention in the body. Cortisol is also involved in the breakdown of fatty acids and reduces the use of glucose by skeletal muscles during intense exercise;

1. sex hormones – androgens are produced in small amounts in the banded and reticular layers. These hormones accelerate the growth of the body and the formation of secondary male sexual characteristics.

Hormones secreted by the medulla of the adrenal glands it’s catecholamines. These hormones are compounds that circulate in the blood associated with plasma proteins. The highest concentrations are achieved by adrenaline, noradrenaline and dopamine:

1. adrenalina – is also called epinephrine, it is referred to as the fear, fight and flight hormone. The task of adrenaline is to influence the body’s reaction in a situation of stress or emerging danger. The effects of adrenaline can be recognized from the accelerated heartbeat, increased blood pressure or dilated pupils. Adrenaline inhibits the peristaltic effect of the intestines and regulates blood glucose levels. Adrenaline is administered to patients in cases of anaphylactic shock or resuscitation;
2. norepinephrine – shows adrenaline-like effects. Norepinephrine is produced in the adrenal medulla as well as in the nucleus of the brainstem. The task of norepinephrine is to influence the circulatory system, in particular to increase systolic and diastolic blood pressure. This hormone acts on the intestinal sympathetic nerves, which in turn lowers the tonic tone in the intestines. During sleep, the secretion of norepinephrine is negligible, while waking up and getting up increases it;
3. dopamine – dopamine is produced in small amounts in the adrenal medulla. Dopamine is synthesized mainly in neurons. This hormone greatly influences emotions. Dopamine also regulates the concentration of other hormones, especially prolactin. The action of dopamine increases blood pressure and the strength of muscle contraction. This property of dopamine is used in the treatment of traumatic, septic and cardiogenic shocks. 

In order to regulate the work of the adrenal glands, try the infusion prepared on the basis of the herbal adaptogenic mixture, which you can buy at a favorable price on Medonet Market. Herbs in its composition improve well-being, add energy and reduce stress.

Who is an endocrinologist and what diseases does he treat? Read: Endocrinologist – what does he do?

The adrenal glands in diagnosis

The proper functioning of the adrenal glands is extremely important for human health. What symptoms are the reason to start diagnostics for diseases of the adrenal glands? When the adrenal glands are not working properly, there is a change in the level of hormones in the blood – it may be an increase or a decrease. When this happens, symptoms such as muscle weakness, fainting, weight loss or increase, mood disturbances, problems with pressure, numbness in the limbs, headaches and dizziness, decreased immunity, bone pain, and increased thirst or constant hunger are usually present.

In the case of adrenal gland diseases diagnostics usually include hormonal tests, imaging tests or a biopsy:

1. hormonal tests – determination of the level of cortisol, aldosterone or sex hormones in blood serum and urine, as well as determination of the level of adrenaline metabolites – vanillinmandelic acid or methoxycatecholamines in the daily collection of urine and in the blood serum;
2. imaging tests – in the case of suspicion of a tumor on the adrenal glands, or to assess its size or location, abdominal ultrasound examination, computed tomography, magnetic resonance imaging or scintigraphic examinations are performed;
3. adrenal gland biopsy – it involves taking a small sample of tissue, usually only one adrenal gland.

What hormonal tests should every woman perform? Check: Hormones under control, i.e. the hormonal profile for women

Diseases of the adrenal glands

Diseases that affect the adrenal glands can be divided as follows:

1. diseases associated with abnormalities in the secretion of hormones;
2. diseases associated with disorders of mineralocorticoid secretion;
3. androgen excess diseases;
4. adrenal gland tumors;
5. adrenal cancer;
6. phaeochromocytoma.

In the next part of the article, a short description of the diseases that are associated with the adrenal glands will be presented.

Diseases of the adrenal glands – phaeochromocytoma

Pheochromocytoma is a rare and usually benign tumor located on the adrenal glands. In this case, the diagnosis is extremely important because an undiagnosed and untreated phaeochromocytoma may lead to a heart attack or hemorrhagic stroke.

The causes of pheochromocytoma

The occurrence of phaeochromocytoma in patients has not been clearly investigated and described. However, it is assumed that this condition may be genetically determined. In addition, the tumor develops from pheochromocytomas that produce hormones. These hormones affect the work of the heart, blood pressure, but also increase blood glucose levels.

Symptoms of pheochromocytoma

Pheochromocytoma with varying severity manifests itself in different people. The most characteristic symptoms of pheochromocytoma are:

1. high arterial pressure – the test shows very high pressure values ​​of a constant and paroxysmal character;
2. trembling of the limbs;
3. palpitations;
4. pale skin;
5. increased sweating;
6. headaches which are closely related to high blood pressure.

Treatment of pheochromocytoma

Treatment of phaeochromocytoma consists in its complete surgical removal. However, before the operation takes place, the patient must take appropriate medications for a while to regulate blood pressure and slow down the heart rate.

More information about pheochromocytoma can be found here: Pheochromocytoma

Diseases of the adrenal glands – Cushing’s syndrome

Cushing’s syndrome is a disease that presents a variety of symptoms related to increased levels of the glucocorticosteroids produced by the adrenal glands.

The causes of Cushing’s syndrome

The most common cause of Cushing’s syndrome is long-term treatment with glucocorticoids. People who struggle with diseases such as rheumatoid arthritis or dermatitis are at risk. Cushing’s syndrome can also be caused by an over-synthesis of cortisol in the adrenal glands.

Symptoms of Cushing’s syndrome

The symptoms of Cushing’s syndrome are symptoms that always happen when you have too much cortisol in your blood. This excess can cause:

1. obesity, where fat accumulates on the face and torso, especially around the nape and abdomen;
2. muscle atrophy of the lower and upper extremities;
3. skin blemishes – erythema on the face, wide and red stretch marks on the abdomen, thighs, buttocks or breasts, acne, frequent bruises, swelling, and excessive male hair in women;
4. excessive appetite;
5. getting tired quickly;
6. high blood pressure along with headaches;
7. mental disorders such as depression, insomnia, and emotional problems;
8. menstrual disorders, loss of libido and male impotence;
9. blurred vision.

Treatment of Cushing’s syndrome

Treatment of Cushing’s syndrome depends on the cause of the disease. If Cushing’s syndrome was caused by a tumor of the adrenal gland, surgical removal of the entire adrenal gland is the optimal treatment. In the case of a pituitary tumor, it is necessary to remove the tumor itself. Moreover, before undergoing surgery, the patient is recommended to use drugs that inhibit cortisol synthesis. Effective treatment reduces most of the symptoms of Cushing’s syndrome. However, it is worth remembering that some of the symptoms require different treatment, such as removing scars from stretch marks.

Find out more about Cushing’s syndrome here: Cushing’s syndrome – causes, symptoms, treatment

Diseases of the adrenal glands – Addison’s disease

Addison’s disease is different primary adrenal insufficiency. Addison’s disease is a group of symptoms caused by a chronic deficiency of the hormones produced by the adrenal cortex.

The causes of Addison’s disease

The cause that is most often mentioned in the presence of Addison’s disease is autoimmune cortitis. Addison’s disease may also develop as a concomitant disease in such cases as: tuberculosis, infectious diseases, neoplastic metastases, metabolic disorders, adrenal gland damage or haemorrhagic diathesis.

Symptoms of Addison’s disease

The symptoms of Addison’s disease relate primarily to skin lesions. Skin discoloration that occurs in the course of this disease is brown spots in places exposed to the sun, elbows, flexion lines of the hands, scars or areola nipples. Other symptoms of Addison’s disease include:

1. chronic fatigue, which may also include fainting;
2. lack of willingness to exercise and physical activity;
3. lack of resistance to stress and problems with coping with stressful situations;
4. weight loss;
5. nausea and vomiting;
6. lack of appetite;
7. muscle pain and decreased muscle strength;
8. menstrual disorders;
9. low blood pressure;
10. decreased blood glucose levels;
11. high levels of calcium in the blood;
12. polyuria.

Treatment of Addison’s disease

The methods of treating Addison’s disease are associated with the fact that most often we deal with irreversible damage to the adrenal cortex. Therefore, treatment is based on replenishing the hormones that should be produced by the adrenal glands. Drugs are administered in specific doses and at specific times of the day to simulate the physiological secretion of certain hormones. Treatment involves corticosteroid, mineralocorticoid and androgenic substitution.

If you want to know more about Addison’s disease, check out: Addison’s disease (primary adrenal insufficiency)

Diseases of the adrenal glands – hyperaldosteronism

Hyperaldosteronism is a disease that is associated with the overproduction of aldosterone synthesized by the adrenal glands. According to the latest studies, hyperaldosteronism occurs in even 5-10% of all patients with arterial hypertension.

The causes of hyperaldosteronism

There are three main causes of hyperaldosteronism. The first is adrenal adenoma, which causes an excessive secretion of aldosterone. This form of the disease is called Conn’s team. The second is bilateral adrenal hyperplasia, the cause of which is unknown. On the other hand, the third case is familial hyperaldosteronism, which is genetically determined, but is very rare.

Symptoms of hyperaldosteronism

The most commonly recognized symptom of hyperaldosteronism is markedly elevated blood pressure, which is resistant to any pharmacotherapy. This high blood pressure causes a number of other symptoms, including:

1. paroxysmal headaches;
2. blurred vision;
3. pain in the chest
4. Heart arythmia;
5. muscle weakness;
6. painful muscle spasms;
7. numbness in the arms, legs, feet and hands.

Treatment of hyperaldosteronism

Treatment of hyperaldosteronism consists in regulating blood pressure and normalizing the level of potassium in the blood. Therefore, the chosen method of treatment is related to the cause of the disease itself. If the diagnosis shows bilateral adrenal hyperplasia, treatment is based on taking medications and changing the lifestyle. If, on the other hand, the cause of hyperaldosteronism is a tumor of the adrenal gland, the chosen method of treatment is the surgical removal of the adrenal gland together with the tumor. The operation is usually performed by laparoscopy.

If you want to know more about hyperaldosteronism read on: Hyperaldosteronism

Androgen excess syndromes – hirsutism

Hirsutism is a group of disorders in which hirsutism is observed in women in areas where hair is usually absent, i.e. on the chin, upper lip, chest, nipples, back or abdomen.

The causes of hirsutism

The main cause of hirsutism is the action of male sex hormones or the excessive use of androgenic drugs. Hirsutism may appear as a symptom of diseases of the ovaries and adrenal glands. It accompanies the polycystic ovary syndrome, a tumor of the adrenal glands and Cushing’s syndrome.

Symptoms of hirsutism

The symptoms of hirsutism are visible at a glance. Hirsutism manifests itself as an excessive amount of hair on the chin, upper lip or chest. In addition, the excess of male sex hormones in women causes male pattern baldness, skin changes, seborrhea, acne, menstrual disorders, obesity, infertility, and depression.

Treatment of hirsutism

Choosing a method of treating hirsutism is related to determining the cause of this ailment. If the cause is ovarian or adrenal tumors, a decision is made to surgically remove these lesions. If hirsutism is medication induced, treatment is based on discontinuation of the medication that caused the disease.

To remove hair permanently, electrolysis and laser therapy are used. The use of cosmetic procedures without proper diagnosis often does not bring the expected results due to the existing hormonal disorders. Therefore, it is important to establish the causes and apply appropriate hormone therapy.

If you want to know more about hirsutism, check out: Hirsutism: causes, symptoms, treatment

Diseases of the adrenal glands – Incidentaloma of the adrenal glands

An incidentaloma of the adrenal gland is a tumor that is diagnosed during an imaging test. Most tumors are non-functioning adenomas.

Causes of the adrenal gland tumor

The specific causes of an adrenal gland tumor have not been determined. However, it is indicated that the risk of a tumor on the adrenal glands increases in the case of obesity, diabetes or hypertension. A tumor on the adrenal glands is much more common in older people than in young people.

Adrenal tumor symptoms

Incidentaloma means that a patient’s tumor was discovered by chance while another condition was diagnosed. Nevertheless, a tumor of this type of adrenal gland can also cause various symptoms. Among them, the following can be indicated:

1. excessive secretion of cortisol – this is the case with Cushing’s syndrome. This ailment is associated with symptoms such as: abdominal obesity, diabetes, arterial hypertension, stretch marks and osteoporosis.
2. excessive secretion of methoxycatecholamines – which is manifested by paroxysmal increases in blood pressure, severe headaches, a rapid heartbeat and pale skin on the face;
3. excessive secretion of mineralocorticosteroids – which is manifested by high blood pressure and low levels of potassium in the blood;
4. excessive secretion of androgens – which is manifested by hirsutism, acne changes, male pattern baldness and menstrual disorders.

Treatment of a tumor of the adrenal gland

In the case of an incidental adrenal tumor, the endocrinologist decides about the choice of the treatment method. The choice of method takes into account the risk of malignancy of the tumor and its hormonal activity. Based on the radiological picture, patients are qualified for surgery. Usually, lesions suspected of being malignant and those larger than 4 cm are eligible for surgery.

What is an adrenal adenoma? Check: Adenoma of the adrenal gland: symptoms, treatment

Diseases of the adrenal glands – adrenal cancer

Adrenal cancer is a malignant tumor that may affect the adrenal cortex or its core. In rare cases, metastatic tumors that develop in other organs are diagnosed in the adrenal glands.

Causes of adrenal gland cancer

Malignant neoplasms of the adrenal glands are a very rare disease and the cause of their formation is genetically determined. Diseases in which adrenal cancer may develop are: multiple endocrine neoplasia type I, type IIA and IIB.

Symptoms of adrenal cancer

The symptoms of adrenal gland cancer are very diverse and depend on the hormones produced by the tumor. The symptoms of adrenal gland cancer usually include:

1. high blood pressure that cannot be controlled with drugs;
2. hirsutism and menstrual disorders in women;
3. enlargement of the mammary glands and decreased sex drive in men;
4. increasing body fat
5. skin problems;
6. chronic fatigue;
7. muscle spasms and muscle weakness;
8. diabetes;
9. sleep disturbance;
10. headache and dizziness;
11. pale skin;
12. excessive sweating.

Treatment of adrenal gland cancer

The primary treatment for an adrenal gland tumor is surgery. During the operation, not only the tumor is removed, but the entire adrenal gland is removed. If the tumor is not large, the procedure can be performed using the laparoscopic method. In cases where tumor removal is impossible, chemotherapy or radiotherapy is used.

1. How does chemotherapy affect the body? Check: Chemotherapy and its effects on the body

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