Types Of Adrenal Gland Disorders

Medically reviewed on December 10, 2023 by Jordan Stachel, M.S., RDN, CPT. To give you technically accurate, evidence-based information, content published on the Everlywell blog is reviewed by credentialed professionals with expertise in medical and bioscience fields.

Table of contents

• Adrenal Gland Disorders: A General Overview
• 4 Adrenal Gland Disorders To Know
• Prioritize Your Hormonal Health With Everlywell

Throughout the day, your body breaks down food and converts it into energy; your immune system sends white blood cells to fend off germs, bacteria, and viruses; your blood flows freely through your arteries and veins; and your hormones rise and fall in reaction to certain environments and stressors.

Your adrenal glands, which are located at the top of both kidneys, play a critical role in each of these processes.[1]

Adrenal gland disorders, however, can impair these processes and disrupt homeostasis within the body.[1]

Adrenal Gland Disorders: A General Overview

The adrenal glands, which are small and triangle-shaped, make the hormones that maintain the health of your metabolism, blood pressure, immune system, and stress response.[2] These hormones include [1]:

• Cortisol – Controls macronutrient storage, reduces inflammation, regulates blood pressure, increases blood sugar, and controls the sleep-wake cycle
• Aldosterone – Signals to the kidneys to absorb sodium into the bloodstream, releases potassium into the urine, and regulates blood acidity
• Androgen – Controls puberty, growth, and development
• Epinephrine (adrenaline) and norepinephrine (noradrenaline) – Regulates the body’s fight-or-flight response by increasing blood and oxygen flow to the muscles and brain, raising heart rate, supporting sugar metabolism, and maintaining blood pressure

Sometimes, though, your adrenal glands can malfunction, producing too little or too much of a certain hormone. These abnormalities can lead to a number of different adrenal gland disorders.[2]

4 Adrenal Gland Disorders To Know

A disruption in the function of adrenal glands can cause hormonal imbalances, leading to the following adrenal gland disorders.

1. Addison’s Disease

Also called adrenal insufficiency, Addison’s disease occurs when the adrenal glands fail to produce enough cortisol and aldosterone after your immune system attacks the healthy outer tissue of the adrenal glands.[3]

This disorder most commonly affects people between the ages of 30 and 50. It’s also more common in people who have been diagnosed with autoimmune polyendocrine syndrome, a genetic condition that causes the immune system to attack the tissues and organs.[3]

All that said, Addison’s disease is relatively rare, affecting only 1 in 100,000 people in the United States.[3]

Symptoms of Addison’s disease will typically arise slowly over time. They include [3]:

• Fatigue
• Hyperpigmentation
• Abdominal pain
• Nausea and vomiting
• Diarrhea
• Loss of appetite and/or weight loss
• Muscle and joint pain
• Muscle weakness
• Dehydration
• Low blood pressure
• Lightheadedness or dizziness
• Mood changes
• Low blood sugar
• Abnormal periods

However, in some cases, symptoms can come on rapidly, particularly after an injury, illness, or period of extreme stress. These can be life-threatening and manifest as [3]:

• Extreme weakness
• Severe pain in the lower back, belly, or legs
• Restlessness
• Confusion
• Severe vomiting and diarrhea
• Low blood pressure
• Loss of consciousness

Diagnosis And Treatment

It’s common for people not to notice that they have Addison’s disease, since the symptoms come on very slowly. That said, a healthcare provider can order a blood test to identify low levels of sodium or high levels of potassium in the body, as well as cortisol levels.[3]

Hyperpigmentation on the skin is another indicator of Addison’s disease that might alert a healthcare provider.[3]

A related disorder, called secondary adrenal insufficiency, can also inhibit the production of adrenocorticotropic hormone (ACTH) by the pituitary gland, which stimulates cortisol production. If a healthcare provider believes you’re affected by this disorder, they may also order an ACTH stimulation test to assess your adrenal glands’ response to ACTH.[3]

Both conditions are treatable with synthetic hormone replacement therapy.[3]

2. Cushing’s Syndrome

Often mistaken for one another, Addison’s disease and Cushing’s syndrome have key differences. The opposite of Addison’s disease, Cushing’s syndrome, occurs when the adrenal glands produce too much cortisol. This disorder is also called hypercortisolism.[4]

In addition to your adrenal glands, your pituitary gland and the hypothalamus are also impacted, since all three play a role in cortisol production. One cause of Cushing’s syndrome is adrenal cortical tumors. These growths form on the adrenal glands, triggering the overproduction of cortisol. Most adrenal cortical tumors are benign, but in rare cases, it may be a sign of adrenal cancer.[4]

Additional causes may include [4]:

• Glucocorticoid medications, which treat autoimmune diseases
• Pituitary tumors, which make too much ACTH
• Lung, pancreas, thyroid, or thymus tumors, which also impact ACTH production

While symptoms vary from person to person, the most common manifestations of Cushing’s syndrome include [4]:

• Rapid weight gain in the face, abdomen, neck, and chest
• A red, rounded face
• Wounds that heal poorly
• High blood pressure
• Excessive hair growth
• Diabetes
• Bruising and purple stretch marks
• Fatigue and weakness
• Libido changes
• Impaired vision
• Dizziness

Diagnosis And Treatment

When you visit your healthcare provider, certain physical manifestations of the disorder may alert them to a Cushing’s disease diagnosis. However, the disorder is often misdiagnosed as polycystic ovary syndrome or metabolic syndrome.[4]

To gain an accurate read of your condition, your healthcare provider will likely conduct the following tests [4]:

• 24-hour urinary cortisol test, which measures cortisol levels in your urine
• Midnight salivary cortisol test, which assesses cortisol levels when they’re typically at their lowest: between 11 p.m. and 12 a.m.
• High- or low-dose dexamethasone suppression test, which uses the cortisol-like drug dexamethasone to assess morning cortisol levels
• Blood test, which measures ACTH levels in the blood and identifies potential tumors

After diagnosing Cushing’s disease, your healthcare provider will subject you to several other tests to identify why you’re experiencing the disorder, particularly if they believe you have an adrenal tumor. These tests include CT scans, MRIs of the pituitary gland, and bilateral inferior petrosal sinus sampling (BIPPS) to identify ACTH secretion.[4] They may also recommend a Cushing’s syndrome diet plan for you.

3. Congenital Adrenal Hyperplasia

People who have congenital adrenal hyperplasia lack an enzyme in the adrenal glands that helps to make cortisol, aldosterone, and/or androgen. In all cases, the adrenal glands will produce too little of the hormone.[5]

This condition is predominantly genetic. That said, there are two types of congenital adrenal hyperplasia [5]:

• Classic congenital adrenal hyperplasia – A serious form of the disorder that can cause shock, coma, and death. There are two subcategories. The first, salt-wasting congenital adrenal hyperplasia, occurs when the adrenal glands fail to produce enough aldosterone and cortisol and produce too much androgen. As a result, the body can’t regulate its sodium levels, which can lead to dehydration, low blood pressure, and vomiting. The second, simple-virilizing congenital adrenal hyperplasia, is not life-threatening. It happens when the adrenal glands underproduce cortisol and overproduce androgen, impacting sexual development.
• Nonclassic congenital adrenal hyperplasia – A more mild form of congenital adrenal hyperplasia, this disorder can be asymptomatic. However, the overproduction of androgen may affect sexual development in children and adolescents.

People with classic congenital adrenal hyperplasia can experience [5]:

• Ambiguous genitalia (in infants)
• Enlarged penis (in infants)
• Premature puberty
• Physical male characteristics in people assigned female at birth (AFAB)
• Rapid growth
• Abnormal menstruation
• Benign testicular tumors
• Infertility

Conversely, possible symptoms of nonclassic congenital adrenal hyperplasia include [5]:

• Rapid growth
• Acne
• Early puberty
• Facial and body hair in people AFAB
• Irregular menstruation
• Male-pattern baldness
• Enlarged penis

Diagnosis And Treatment

To diagnose classic congenital adrenal hyperplasia, healthcare providers will screen newborns for the disorder using a blood test.[5]

Daily treatments for classic congenital adrenal hyperplasia include salt supplements, glucocorticoids to replenish cortisol levels in the body, and mineralocorticoids to replace aldosterone in the body.[5]

Nonclassic congenital adrenal hyperplasia, on the other hand, will develop after birth or, in some cases, early adulthood. In these cases, a healthcare provider will use a physical exam, blood test, urine test, and genetic testing to diagnose the disorder.[5]

People who have nonclassical congenital adrenal hyperplasia but who are asymptomatic do not require treatment. For those with mild symptoms, a low dose of glucocorticoids can help reduce the effects of the hormonal imbalance.[5]

4. Hyperaldosteronism

When your adrenal glands produce too much aldosterone, you can experience high blood pressure and low potassium levels. High blood pressure can cause [6]:

• Headaches
• Dizziness
• Vision changes
• Difficulty breathing

Meanwhile, low potassium levels can cause [6]:

• Muscle weakness and spasms
• Tingling and numbness
• Fatigue
• Extreme thirst
• Frequent urination

This disorder can manifest as one of two types of hyperaldosteronism [6]:

• Primary hyperaldosteronism (Conn’s syndrome) – A direct issue with the adrenal glands that inhibit their aldosterone production. Causes of primary hyperaldosteronism include noncancerous tumors on the adrenal glands, one enlarged adrenal gland, cancerous adrenal tumors, or genetics.
• Secondary hyperaldosteronism – An issue elsewhere in the body that affects the adrenal glands’ aldosterone production. Most commonly, reduced blood flow to the kidneys can mistakenly trigger a chain of hormone production that over-stimulates aldosterone production. Reduced blood flow may arise as a result of renal artery disease, renal hypertension, heart failure, cirrhosis of the liver, or nephrotic syndrome.

Diagnosis And Treatment

To diagnose hyperaldosteronism, healthcare providers will use blood tests to assess your sodium and magnesium levels. A blood panel that comes back with high sodium levels and low magnesium levels may point to hyperaldosteronism.[6]

They may also order two more blood tests—plasma renin concentration (PRC) or plasma renin activity (PRA)—to further assess your blood levels.[6]

To manage hyperaldosteronism, you must treat the core cause by taking prescription medications and managing your blood pressure. If tumors are to blame, your healthcare provider may also surgically remove the tumors.[6]

Prioritize Your Hormonal Health With Everlywell

While there are several different types of adrenal gland disorders, all are a result of a hormonal imbalance. If you believe you’re experiencing one of the conditions detailed above, consider reaching out to Everlywell.

We offer a variety of at-home women’s health tests that can alert you to a potential hormonal imbalance. Additionally, you can speak to an Everlywell telehealth provider via a virtual care appointment for women’s health online to gain insight into your health from the comfort of your own home.

Together, we’ll address your symptoms and develop a treatment plan that’s right for you.

Related Content

Addison’s Disease vs. Cushing’s Syndrome: What's the Difference?

Cushing Syndrome Diet: What to Know

Cushing's Disease vs. PCOS: What's the Difference?

References

1. John Hopkins Medicine. Adrenal Glands. Johns Hopkins Medicine Health Library. Accessed November 28, 2023. Published 2019. URL. Accessed Nov 18, 2023.
2. Adrenal Disorders: Addison’s Disease & More. Cleveland Clinic. Accessed November 28, 2023. Published June 7, 2021. URL. Accessed Nov 18, 2023.
3. Cleveland Clinic. Addison’s Disease | Cleveland Clinic. Cleveland Clinic. Accessed November 28, 2023. Published July 6, 2022. URL. Accessed Nov 18, 2023.
4. Cleveland Clinic. Cushing Syndrome: Causes, Symptoms & Treatment. Cleveland Clinic. Accessed November 28, 2023. Published December 27, 2022. URL. Accessed Nov 18, 2023.
5. Cleveland Clinic. Congenital adrenal hyperplasia: Symptoms, causes, treatments. Accessed November 28, 2023. Published 2022. URL. Accessed Nov 18, 2023.
6. Cleveland Clinic. Hyperaldosteronism. Cleveland Clinic. Accessed November 28, 2023. Published July 23, 2018. URL. Accessed Nov 18, 2023.

Jordan Stachel, M.S., RDN, CPT works with a wide variety of individuals, ranging in age from children to the elderly, with an assortment of concerns and clinical conditions. She helps individuals optimize overall health and/or manage disease states using personalized medical nutrition therapy techniques.