Types of Adrenal Disease and Health | Endocrinology

Adrenal Disease

What are adrenal disease and health?

Adrenal disease and health, also known as adrenal insufficiency, is an abnormal disorder that occurs when your body does not make enough hormones. In Addison’s disease, the adrenal glands above the kidneys produce very little cortisol and often very little aldosterone.

The adrenal disease occurs in all ages and in both sexes and can be fatal. Treatment consists of taking hormones to replace the missing ones. The adrenal gland consists of two parts: the outer part is called the adrenal cortex and the inner part is called the adrenal medulla.

The function of the adrenal glands

The two parts of the adrenal glands, namely the adrenal cortex and the adrenal medulla, perform different functions. The adrenal cortex produces glucocorticoids (ie, cortisol), mineral corticosteroids (aldosterone), and androgens (DHEA and androstenedione). The hormone cortisol, which is essential for life, has important effects on the heart, blood pressure, immune system, metabolism, bones, and nervous system.

Both cortisol deficiency and overproduction can cause major problems. Aldosterone is necessary for fluid and electrolyte (salt) balance and has additional clinical consequences. Adrenal androgen hormones mainly cause problems when overproduction occurs in women. The medulla is responsible for producing epinephrine and norepinephrine (adrenaline) with effects on blood pressure, heart, and metabolism. The problems are due to excessive spinal function.

Regulation of hormones of the adrenal glands

Cortisol is secreted by the adrenal glands in response to circadian and stress-induced stimuli by adrenocorticotropic hormone (ACTH) secreted by the pituitary gland. The pituitary gland is the “master” gland of the endocrine system at the base of the brain. Aldosterone secretion is regulated by a system called renin-angiotensin and by potassium, but the pituitary gland is only a small modulator.

In summary, adrenal gland disorders, adrenal insufficiency (secretion deficiency, especially cortisol), overproduction of adrenal hormones mainly adrenal tumors (pheochromocytoma, aldosteronism, androgen-producing tumors), and other adrenal glands that do not produce overproduction of hormones. Adrenal cancer and metastasis

Adrenal cancer (primary adrenal carcinoma) is a rare and aggressive form of cancer in which cancer cells are found in the adrenal cortex, the outer layer of the adrenal gland.

Types of adrenal gland disorders

There are many types of adrenal gland disorders, which are the following:

Adrenal gland tumors

Most adrenal gland tumors (abnormal growths in the adrenal glands) are not cancerous. They often do not cause symptoms or require treatment. However, adrenal gland tumors can produce a wide variety of hormones, and hormone levels can be very high.

Carcinoma of the adrenal cortex

It is a cancerous adrenal tumor that develops in the outer layer of the adrenal gland. Cancerous adrenal tumors usually appear a few years after they begin to grow, during which time cancer has spread to other organs.

Cushing’s syndrome

Cushing’s syndrome is a rare disease caused by an excess of the hormone cortisol in the body. In some cases, Cushing’s syndrome develops from the chronic use of steroid drugs (drugs that act like cortisol in the body). In other cases, the body also makes more cortisol. This overproduction occurs for several reasons, including the presence of tumors (abnormal growth):

  • Pituitary gland tumor
  • Adrenal gland tumor
  • Tumor in another part of the body (these are called “ectopic” tumors and are most often found in the pancreas, lungs, or thyroid gland).

Congenital adrenal hyperplasia (CAH)

CAH is a common genetic disorder in which the body makes too little cortisol. People with CAH can also have other hormonal imbalances. For example, their bodies may not make enough aldosterone (which regulates blood pressure and levels of body salt and potassium), but they can make more androgens (which promote the development of male sex organs).

Pituitary gland

The pituitary gland is located at the base of the brain. Releases hormones that affect many functions of the body. Among these hormones is the adrenocorticotropic hormone (ACTH), which stimulates the adrenal glands to release the hormone cortisol.

Sometimes benign (non-cancerous) pituitary tumors or, very rarely, cancerous tumors, can grow in the pituitary gland and cause a variety of complications. Some pituitary tumors release more ACTH, which causes the adrenal glands to make more cortisol. Cushing’s disease refers to the pituitary tumors that cause Cushing’s syndrome.

Pheochromocytoma

Pheochromocytomas are part of a family of large tumors called paragangliomas. Pheochromocytoma is a tumor that develops in the adrenal medulla, the inner part of the adrenal gland. It produces adrenaline, which causes the body to overproduce this hormone. 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 become cancerous and spread.

Adrenal gland suppression

When people take steroid drugs (drugs that act like cortisol in the body) such as prednisone, hydrocortisone, or dexamethasone they can suppress or reduce the normal activity of the adrenal glands. Steroid medications, usually prednisone, are prescribed to treat certain types of arthritis, severe allergic reactions, asthma, autoimmune diseases, and other conditions.

In general, anyone taking steroids will gradually take lower and lower doses, over time until they stop taking the drug completely. This is called a “cap” dose. When steroid medications are stopped abruptly, especially after several weeks or more, the adrenal glands may not be able to produce adequate amounts of steroid hormones (especially cortisol) for weeks or months. This condition can cause health problems due to an imbalance in hormone levels until the adrenal glands begin to function.

Symptoms of adrenal diseases

Some common symptoms of adrenal diseases are:

  • Fear
  • Chronic fatigue
  • Digestive problems
  • Aches and pains
  • Mild headache
  • Low blood pressure
  • Weight Loss
  • Hair loss

Adrenal disease is also associated with adrenal insufficiency. Symptoms of adrenal insufficiency:

  • Chronic fatigue
  • Lack of appetite
  • Abdominal pain
  • Muscular weakness
  • Unexplained weight loss

In more severe cases of adrenal disease, you may experience:

  • Disappointment
  • Nausea
  • Vomiting
  • Diarrhea
  • Low blood pressure
  • Hyperpigmentation
  • Foods to avoid

If you decide to try a healthy adrenal gland diet, doctors recommend limiting foods and beverages high in refined and processed sugar and unhealthy fats while maintaining blood sugar.

Some foods to avoid:

  • White sugar
  • White flour
  • Alcohol
  • Caffeine
  • soda
  • Fried food
  • Processed foods
  • Fast food
  • Artificial sweeteners
  • Mealtime is also important. Helps control blood sugar and adrenal glands.
  • It helps to eat breakfast and eat regularly throughout the day. Skipping breakfast and lunch will force your body to burn stored nutrients and lower your energy levels.
  • By eating balanced meals and healthy snacks on a regular basis, you can maintain your energy and cortisol levels throughout the day.
  • Food to eat
  • A well-balanced diet is the best way to keep your body healthy and regulate your sugar levels. Doctors recommend balancing protein, healthy fats, and high-quality, nutrient-rich carbohydrates.
  • Increase your vegetable intake to get the necessary amount of vitamins and minerals. Also, foods high in vitamin C, vitamin B (especially B-5 and B-6), and magnesium can help keep the adrenal glands healthy.

Some foods to eat on the adrenal fat diet:

  • Fine meats
  • Fish
  • Eggs
  • Vegetables
  • Walnuts
  • Vegetables and collard greens
  • Cereals
  • Milk
  • Low sugar fruits
  • Sea salt is moderate
  • Healthy fats like olive oil, coconut oil, and grapeseed oil
  • Boiling is also important. Dehydration affects your stress levels and forces your adrenal glands to produce cortisol.

Causes of adrenal diseases

Damage to the adrenal glands causes adrenal disease, which results in a deficiency of the hormone cortisol, and often not enough aldosterone. Your adrenal glands are part of your endocrine system. They produce hormones that give instructions to virtually every organ and tissue in your body.

Your adrenal glands are made up of two sections. The interior (medulla) produces hormones such as adrenaline. The outer layer (cortex) produces a group of hormones called corticosteroids. Corticosteroids:

Glucocorticoids: These hormones, which contain cortisol, affect your body’s ability to convert food into energy, play a role in your immune system’s inflammatory response, and help your body respond to stress.

Mineral corticosteroids: These hormones, which contain aldosterone, help maintain your body’s sodium and potassium balance to maintain normal blood pressure.

Androgens: These male sex hormones are produced in small amounts by the adrenal glands in both men and women. They cause sexual development in men and affect muscle mass, sex drive (libido), and feelings of well-being in both men and women.

Primary adrenal insufficiency: When the cortex is damaged and does not produce enough adrenocortical hormones, this condition is called primary adrenal insufficiency. It is the result of an attack on the body (an autoimmune disease). For unknown reasons, your immune system sees the adrenal cortex as something foreign, something to attack and destroy. People with Addison’s disease are more likely to have another autoimmune disease than others.

Other causes of the adrenal disease include:

  • Tuberculosis
  • Other adrenal gland infections
  • Spread of cancer to the adrenal glands
  • Bleeding in the adrenal glands, In this case, you may have an Addisonian crisis with no previous symptoms.

Secondary adrenal insufficiency: The pituitary gland produces a hormone called adrenocorticotropic hormone (ACTH). ACTH stimulates the adrenal cortex to produce its hormones. Benign pituitary tumors, inflammation, and pre-pituitary surgery are common causes of insufficient production of pituitary hormones.

Even if your adrenal glands are not damaged, too little ACTH leads to the glucocorticoids and androgens that your adrenal glands normally produce. This is called secondary adrenal insufficiency. The production of mineral corticosteroids is not affected by very low levels of ACTH.

Many of the symptoms of secondary adrenal insufficiency are similar to the symptoms of primary adrenal insufficiency. However, people with secondary adrenal insufficiency do not have hyperpigmentation and are less likely to develop severe dehydration or low blood pressure. They are more likely to have low blood sugar levels.

People taking corticosteroids (eg, Prednisone) to treat chronic conditions such as asthma or arthritis may have a temporary cause of secondary adrenal insufficiency when they stop taking corticosteroids all at once instead of using the tape.

Diagnosis of adrenal diseases

Your doctor will first talk to you about your medical history and your signs and symptoms. You will be subjected to some of the following tests:

Blood test: The tests can measure your blood levels of sodium, potassium, cortisol, and adrenocorticotropic hormone (ACTH), which stimulate the adrenal cortex to produce its hormones. A blood test can also measure the antibodies associated with autoimmune Addison’s disease.

ACTH stimulation test: ACTH refers to the adrenal glands producing cortisol. This test measures the level of cortisol in your blood before and after a synthetic ACTH injection.

Insulin-induced hypoglycemia test: Doctors may do this test if they think you have adrenal insufficiency as a result of pituitary disease (secondary adrenal insufficiency). The test will check your blood sugar (blood glucose) and cortisol levels after taking insulin. In healthy individuals, glucose levels drop and cortisol levels rise.

In some cases, doctors may perform alternative tests for secondary adrenal insufficiencies, such as a low-dose ACTH stimulation test, a chronic ACTH stimulation test, or a glucagon stimulation test.

Imaging tests: A computed tomography (CT) scan of your abdomen may be done to check the size of your adrenal glands and look for other abnormalities. You may have an MRI of the pituitary gland if the test indicates that you have a secondary adrenal defect.

Treatment of adrenal diseases

All treatment for adrenal disease includes medication. Hormone replacement therapy will be given to correct the levels of steroid hormones that your body does not make. Some treatment options include oral corticosteroids:

  • Cortisol is replaced by hydrocortisone (Cortef), prednisone, or methylprednisolone. These hormones are given on a schedule to mimic the normal 24-hour fluctuations in cortisol levels.
  • Fluidrocortisone acetate instead of aldosterone.
  • You should get a lot of salt (sodium) in your diet, especially when you’re exercising a lot when it’s hot, or if you have gastrointestinal problems like diarrhea.
  • Your doctor may also prescribe a temporary increase in your dose of action if your body is stressed, such as during an operation, infection, or minor illness. If you are vomiting and cannot reduce oral reactions, you may need corticosteroid injections.

Other treatment recommendations for the adrenal disease include:

  • Carry a medical alert card and bracelet with you at all times. The Steroid Emergency Card and Medical Alert ID will tell emergency medical personnel what kind of care they need. Also, include a written action plan.
  • Keep extra medications easy. It is dangerous to miss even one day of medication, so carry a small amount of medication with you when you travel.
  • Bring a glucocorticoid injection kit. The injection form of the needle, the syringe, and the corticosteroids in the kit are used in emergency cases.
  • Stay in touch with your doctor. Maintain an ongoing relationship with your doctor to make sure the dose of hormone replacement hormones is adequate, but not excessive. If you have ongoing problems with your medication, you may need to adjust your medication dose or schedule.
  • Carry out annual checks. See your doctor or endocrinologist once a year. Your doctor may recommend annual checkups for many autoimmune diseases.

Treatment for an Addison crisis, which is a medical emergency, usually involves intravenous injections:

  • Corticosteroids
  • Saltwater
  • Sugar (dextrose)
  • Future treatments

Researchers are working to develop a late-release corticosteroid that works like a human body. They also work with pumps placed under the skin, which can deliver steroids in more precise doses.

The use of adrenocortical stem cells in combination with immunomodulatory therapy at the end of future treatment, modifying the immune response of the immune system, as well as gene therapy.

 

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