Adrenal Gland Disorders
The adrenal glands are vital organs that help regulate critical bodily functions by secreting hormones. Imbalances in hormone production can negatively affect overall health, leading to problems in weight management, blood pressure and more.
If you have concerns about your adrenal health, schedule an appointment with our endocrinologist today or read on to learn more.
Types of Adrenal Gland Disorders
Adrenal gland disorders can affect hormone production, leading to conditions like adrenal insufficiency, Cushing’s syndrome, pheochromocytoma etc. Understanding these conditions is crucial for proper treatment and management.
Adrenal insufficiency
Adrenal insufficiency occurs when the adrenal glands fail to produce enough essential hormones like glucocorticoids (cortisol) and mineralocorticoids (aldosterone). These hormones regulate metabolism, blood pressure, and the body’s response to stress.
Causes
Adrenal insufficiency can be classified into two types: primary and central. Primary adrenal insufficiency occurs when the adrenal glands fail to produce enough hormones despite normal Adrenocorticotropic hormone (ACTH) levels, while central adrenal insufficiency results from insufficient ACTH production by the pituitary or corticotropin-releasing hormone (CRH) by the hypothalamus.
| Type | Details |
|---|---|
Primary adrenal insufficiency (Addison’s disease) |
|
Central adrenal insufficiency |
|
Symptoms
The specific symptoms of adrenal insufficiency vary depending on whether the condition is primary or central.
| Type | Symptom |
|---|---|
Primary adrenal insufficiency (Addison’s disease) |
|
Central adrenal insufficiency |
|
Cushing’s Syndrome
Cushing’s syndrome is caused by the overproduction of cortisol, a hormone produced by the adrenal glands. Cortisol is crucial in regulating metabolism, managing the body’s response to stress, and controlling inflammation. The incidence of Cushing’s syndrome varies by age and gender according to the different causes.
Causes
Cushing’s syndrome can occur due to various factors such as:
- Pituitary tumours: Benign tumours in the pituitary can lead to excess ACTH production, stimulating the adrenal glands to overproduce cortisol.
- Non-pituitary tumours: Some non-pituitary tumours, often in the lungs, can secrete ACTH, causing excessive cortisol production by the adrenal glands.
- Adrenal tumours or growths: Tumours or growths in the adrenal glands can directly cause them to produce too much cortisol, leading to Cushing’s syndrome.
- Prolonged glucocorticoid use: Long-term use of glucocorticoid medications like prednisone for autoimmune conditions or organ transplants can result in Cushing’s syndrome due to elevated cortisol levels.
Symptoms
Symptoms of Cushing’s syndrome can differ depending on the severity, duration of excess cortisol, and the underlying cause. Some common signs include:
| Symptom | Details |
|---|---|
Symptoms of metabolic issues |
|
Symptoms of excess androgens |
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Symptoms of connective tissue changes |
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Symptoms of mood and neurological issues |
|
Other symptoms | Frequent infections |
Hyperaldosteronism
Hyperaldosteronism is a condition where one or both adrenal glands produce too much aldosterone, a hormone that helps regulate blood pressure. Aldosterone controls blood pressure by balancing sodium and potassium levels in the body.
Excess aldosterone can result in high blood pressure (hypertension) and low potassium levels, which may cause symptoms such as muscle weakness, fatigue, and irregular heart rhythms.
Causes
There are two main types of hyperaldosteronism, where the causes vary:
| Type | Details |
|---|---|
Primary hyperaldosteronism |
|
Secondary hyperaldosteronism |
|
Symptoms
Symptoms of hyperaldosteronism can vary in severity. Some individuals may remain asymptomatic, while others may experience the following:
- Persistent headaches
- Dizziness
- Vision changes
- Difficulty breathing
- Muscle weakness or spasms
- Fatigue
- Tingling or numbness
Pheochromocytoma
A pheochromocytoma is a rare tumour that typically forms in or near the adrenal glands, located above each kidney. This tumour produces excessive amounts of adrenaline, leading to sudden episodes or “spells” marked by high blood pressure, rapid heart rate, headaches, and sweating.
While pheochromocytomas are rarely cancerous, they can cause serious complications due to the continuous release of adrenaline.
Causes
Pheochromocytomas are often associated with inherited conditions, such as multiple endocrine neoplasia (MEN) and von Hippel-Lindau disease. These tumours are also more commonly found in adults, though they can also occur in children.
Symptoms
Pheochromocytomas can cause a range of symptoms. These are some of the common symptoms:
- Headaches
- Sweating
- Fast or forceful heartbeat
- High blood pressure
- Tremors or shaking
- Pale appearance
- Shortness of breath or weakness
- Anxiety or fearfulness
- Belly pain or swelling
Diagnosing Adrenal Gland Disorders
Diagnosing adrenal gland disorders typically requires a combination of blood tests, urine tests, imaging scans, and specialised procedures. These tests are essential for evaluating hormone levels, detecting tumours or abnormalities, and determining whether there is excess or deficient hormone production.
Blood tests play a crucial role in diagnosing conditions such as Cushing’s disease, hyperaldosteronism, and pheochromocytoma. They measure various hormone levels, helping to identify imbalances in hormone production and regulation.
Urine tests, particularly 24-hour collections, are used to monitor hormone levels over time, which is especially important for conditions like Cushing’s disease and pheochromocytoma.
These tests are used to evaluate adrenal function and hormone feedback mechanisms, and are crucial for diagnosing disorders like Cushing’s disease and hyperaldosteronism.
For conditions such as Cushing’s syndrome and adrenal disorders, imaging scans can help detect tumours or abnormalities in the adrenal or pituitary glands.
Specialised tests, like petrosal sinus sampling, are often used to pinpoint the source of excess ACTH in Cushing’s Disease. This procedure measures ACTH levels from veins near the pituitary gland, providing precise information about the source of the hormone imbalance.
Treatment for Adrenal Gland Disorders
Treatment for adrenal gland disorders varies based on the specific condition and its underlying causes. Each disorder may require different approaches, including medication, lifestyle changes, surgery, or a combination of treatments.
- Glucocorticoid replacement: Hydrocortisone or prednisone, adjusted during stress, illness, or surgery
- Mineralocorticoid replacement: Fludrocortisone to manage blood pressure and electrolyte balance
- Surgery: Removal of pituitary, adrenal, or ectopic tumours
- Medications: Suppress cortisol production when surgery isn’t possible or before surgery
- Radiation therapy: For pituitary tumours that can’t be surgically removed
- Glucocorticoid tapering: Gradual reduction of glucocorticoid medications
- Surgery: Removal of any adrenal tumour
- Medications: Aldosterone blockers like spironolactone, eplerenone, or amiloride if surgery is unsuitable
- Treat underlying cause: Improving kidney function or managing heart failure
- Medications: Manage blood pressure and aldosterone levels
- Surgery: Removal of the tumour is the primary treatment
- Pre-surgery preparation: Medications for blood pressure and heart rate control for about two weeks before surgery
- Cancerous tumours: If cancerous, surgical removal followed by radiation or chemotherapy
Our Trusted Endocrinologist
Dr Linsey Gani
Consultant Endocrinologist
MBBS (Aust), B Med Sci, FRACP (Endocrine), FAMS (S’pore), MPH (Harvard), Clinical Assistant Professor (Duke-NUS Medical School)
Languages: English, Mandarin, Bahasa Indonesia
Dr Gani is a skilled endocrinologist with experience diagnosing and managing adrenal gland disorders. She is a fellow of the Royal Australian College of physician and the Academy of Medicine, Singapore.
Why Choose Us?
Our clinic offers a full suite of services focused on diagnosing, treating, and managing adrenal gland disorders.
We provide a comfortable, welcoming environment designed to make your healthcare visits as pleasant and stress-free as possible.
We offer customer-centric treatment plans for adrenal gland disorders, focused on your individual health needs to provide the most effective care.
FAQs About Adrenal Gland Disorders
Is Addison’s disease (primary adrenal insufficiency) hereditary?
Individuals with Addison’s disease may have a family history of autoimmune disorders, such as type 1 diabetes or thyroid diseases. A family history of these autoimmune conditions can increase the likelihood of developing Addison’s disease, suggesting a hereditary component in some cases.
Can stress cause adrenal insufficiency?
Adrenal fatigue is a medical myth and does not accurately describe how the adrenal glands function. While stress can impact overall health, it does not cause the adrenal glands to stop producing cortisol. In fact, during times of stress, the adrenal glands increase cortisol production to help the body cope with the demands.
Can adrenal insufficiency be treated?
Adrenal insufficiency is usually treated with hormone replacement therapy to restore the hormones the body is not producing. This typically involves taking medications to replace cortisol and, if necessary, aldosterone.
Book an Appointment
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Dr. Linsey Gani Endocrinology
10 Sinaran Drive, #10-08, Novena Medical Center, Singapore 307506
+65 6397 7101
+65 9128 7480
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Monday - Friday
08:30 - 12:30
14:00 - 17:30
09:00 - 12:00
Closed