Adrenal Disorders

(Addison's disease, adrenal virilism, aldosteronism. Conn's syndrome, Cushings syndrome, pheochromocytoma)

The adrenal glands produce a number of hormones, complex chemical substances that regulate many vital functions of the body. These include adrenaline, also called epinephrine, and other hormones released during stress; hydrocortisone and other steroids, which help control the immune system as well as regulate blood glucose levels and blood pressure; aldosterone, which maintains fluid and chemical balances; and androgens, progesterone, and estrogen, which are essential for reproduction. Some of these hormones are also produced elsewhere in the body, but the adrenal cortex is the sole source of epinephrine, aldosterone, and hydrocortisone.

Symptoms of adrenal disorders vary. In Addison's disease, the adrenal glands are gradually destroyed, resulting in severe weight loss, darkened skin, fatigue, low blood pressure, and sometimes low glucose levels.

Excessive androgen production is the cause of premature sexual development in boys and masculinization -- beard growth, deepening of the voice, acne, and perhaps balding -- in women.

In Conn's syndrome, increased aldosterone upsets the body's sodium and potassium balance, leading to muscle weakness, high blood pressure, and excessive thirst and urine production.

Cushing's syndrome, which is often due to the long-term use of steroid drugs, is marked by excessive cortisone, which causes thinning of the skin and bones, easy bruising, mood changes, high blood pressure, and weight gain, especially on the trunk and upper back.

A pheochromocytoma is a tumor that produces excessive adrenaline and other stress hormones. This overproduction leads to erratic high blood pressure, palpitations, profuse sweating, and extreme anxiety.

Diagnostic Studies and Procedures

Adrenal disorders are diagnosed by characteristic symptoms and blood and urine tests to measure hormone levels. In some instances, all of the patient's urine is collected for a 24-hour period, then analyzed for the presence of potassium, sodium, and hormones.

Medical Treatments

The objective is to restore normal hormonal levels and function. In some disorders, such as Addison's disease, this requires lifelong replacement of hormones.

When Cushing's syndrome is the result of taking steroid medications, it can be reversed by slowly tapering off these drugs. This process must be done under a doctor's supervision, because stopping the medication too abruptly can lead to shock. Adrenal virilism is treated with medications that suppress overproduction of androgen, or by surgery if a tumor is the source of the excessive hormones.

Conns syndrome and pheochromocytoma usually are treated surgically to remove the hormone-producing tumors. But drugs may also be used to suppress hormone production.

Alternative Therapies

Adrenal disorders are potentially life threatening, so alternative therapies should be used only with the approval of the primary physician and as adjuncts to medical treatment.

Herbal Medicine

An herbalist may recommend licorice, which contains a chemical that increases the output of hormones in patients who have Addison's disease. A physician should be consulted before self-treating with licorice extract, which can send blood pressure soaring if taken in large amounts for any length of time.

Reflexology

Reflexologists believe that adrenal disorders can be alleviated by gently pressing the adrenal point, situated on the narrowest part of the sole, about midway between the heel and toes, and simultaneously rotating the foot. Another adrenal point is on the palm, just below the middle finger.

Self-Treatment

Addison's disease is a lifelong condition, and it is important to recognize symptoms of an impending adrenal crisis -- profound weakness, fatigue, dizziness or fainting, and severe pain in the abdomen. Infection, an injury, or other physical stress can precipitate a crisis unless extra cortisone is taken. Patients should wear a Medic-Alert bracelet or pendant and avoid sports in which they risk a fracture or other injury. Swimming, walking, and use of exercise machines are usually safe.

Treatment of adrenal virilism reverses some of the masculine changes such as new beard growth. However, it does not get rid of existing facial hair; this can be removed by electrolysis. Avoid plucking, which irritates skin and worsens the acne that often accompanies adrenal virilization.

Other Causes of Adrenal Symptoms

In diagnosing an adrenal disorder, a doctor should rule out tumors of the pituitary and other hormone-producing glands. He should also investigate the overuse of steroid drugs.