There are several types of adrenal gland disorders, each with its own symptoms and treatments.
Most adrenal gland tumors—abnormal growths on the adrenal glands—are not cancerous. They often do not cause symptoms or require treatment. However, adrenal gland tumors can produce a variety of different hormones, leading hormone levels to get too high.
Adrenal tumors can cause:
- Cushing's syndrome, by producing cortisol so that body levels get too high
- Primary hyperaldosteronism, by creating high levels of the hormone aldosterone (controls blood pressure and body salt and potassium levels)
- Pheochromocytoma, by producing too much adrenaline (regulates the "fight-or-flight" response)
This is a cancerous adrenal tumor that tends to develop in the outer layer of the adrenal gland. Cancerous adrenal tumors are often found years after they start growing, at which point the cancer have spread to other organs.
Cushing syndrome is a rare disease that results from having too much cortisol hormone in the body. In some cases, Cushing syndrome develops from long-term or overuse of steroid medications(medicines that act like cortisol in the body). In other cases, the body itself produces too much cortisol. This overproduction can happen for several reasons, including the presence of tumors(abnormal growths) such as a:
- Tumor of the pituitary gland (this is called Cushing disease)
- Tumor of the adrenal gland (as explained above)
- Tumor in another part of the body (these are called "ectopic" tumors and are more commonly found in the pancreas, lung, or the thyroid gland)
CAH is a common genetic disorder in which the body makes too little cortisol. People with CAH may also have other hormone imbalances. For example, their bodies might not make enough aldosterone (controls blood pressure and body salt and potassium levels), but might make too much androgen (promotes the development of male sexual organs).
The pituitary gland is located at the base of the brain. It releases hormones that affect many of the body's functions. Among those hormones is the adrenocorticotropic (pronounced a-DREE-noh kawr-tuh-koh-TRO-pic) hormone (ACTH), which stimulates the adrenal glands to release the hormone cortisol.
Sometimes, benign (noncancerous) pituitary tumors or—more rarely cancerous tumors1—may grow on the pituitary gland, which can cause a variety of problems. Some pituitary tumors release too much ACTH, which, in turn, can cause the adrenal glands to produce too much cortisol. Cushing's disease refers to pituitary tumors that cause Cushing's syndrome.
Pheochromocytomas (pronounced fee-oh-kroh-moh-sigh-TOH-muhs) are part of a larger family of tumors, called paragangliomas (pronounced pair-uh-gang-lee-OH-muhs). Pheochromocytoma is a type of tumor that develops in the adrenal medulla, the inner part of the adrenal gland. It produces adrenaline, causing high levels of this hormone in the body. In most cases, the tumors are not cancerous and do not spread to other parts of the body. But in about 10% of cases, the tumors are cancerous and can spread.5
The normal activity of the adrenal glands can be suppressed—or reduced—when people take steroid medications (medicines that act like cortisol in the body) such as prednisone, hydrocortisone, or dexamethasone.2 Steroid medications, most often prednisone, may be prescribed to treat certain types of arthritis, severe allergic reactions, asthma, autoimmune (pronounced awh-toh-im-YOON) diseases, and other conditions.3
Ordinarily, someone taking steroids takes gradually lower and lower doses as time goes by until they stop taking the drug completely. This is called "tapering" the dose. When steroid medications are stopped suddenly, especially after being taken for several weeks or more, the adrenal glands may be unable to produce steroid hormones (most importantly, cortisol) in sufficient amounts for several weeks or even months.1 This situation can cause health problems because of the imbalance of hormone levels that continues until the adrenal glands start functioning normally again.
This rare disorder develops when the adrenal glands do not make enough cortisol. In most cases of Addison's disease, the body also doesn't make enough of the hormone aldosterone.
Addison's is an autoimmune disease—a condition in which the immune system, which is supposed to protect the body, mistakenly attacks the body's own tissues and cells. In the case of Addison's disease, this reaction results in damage to the adrenal glands.4 In the long term, this damage can get worse until eventually the adrenal glands aren't working at all.
This disorder occurs when the body produces too much aldosterone, a hormone that controls blood pressure and regulates the body's salt and potassium levels. The extra aldosterone is produced either by a tumor, which typically affects one adrenal gland, or by abnormal growth of both glands, a condition called "hyperplasia."
- American Society of Clinical Oncology. (March 2016). Pituitary gland tumor. Retrieved May 24, 2016, from http://www.cancer.net/patient/Cancer+Types/Pituitary+Gland+Tumor
- National Library of Medicine. (June 2012). Cushing syndrome. Retrieved May 24, 2016, from http://www.nlm.nih.gov/medlineplus/ency/article/000410.htm
- National Library of Medicine. (2011). Prednisone. Retrieved on May 24, 2016, from https://medlineplus.gov/druginfo/meds/a615042.html
- National Library of Medicine. (2012). Addison's disease. Retrieved May 24, 2016, from http://www.nlm.nih.gov/medlineplus/addisonsdisease.html
- Adjallé, R., Plouin, P.F., Pacak, K., Lehnert, H. (2009). Treatment of malignant pheochromocytoma. Hormone and Metabolic Research, 41, 687-696. Retrieved March 2, 2018, from https://www.ncbi.nlm.nih.gov/pubmed/19672813