Adrenal Gland (Human Anatomy): Image, Functions, Diseases, and Treatments

The superior portion of the kidneys is home to the endocrine glands known as the adrenal glands. These include cortisol, aldosterone, and adrenaline, among many other crucial chemicals. The body's reaction to stress, blood pressure, metabolism, and other bodily processes are all controlled by the adrenal hormones.

There are two components to the adrenal glands. Cortex and medulla are the names of the outer and inner halves, respectively. Each component is in charge of making a variety of hormones that carry out diverse bodily activities.The sympathetic nervous system also controls the release of adrenaline and noradrenaline from the adrenal glands, and the brain and pituitary gland are responsible for further controlling aldosterone production by the adrenal glands.

The adrenal glands produce the glucocorticoid hormone cortisol, which has a number of significant functions. It aids in regulating how the body uses carbohydrates, proteins, and lipids. Additionally, it reduces inflammation, controls blood pressure, raises blood sugar, and aids in regulating the sleep-wake cycle.

When under stress, the adrenal glands produce cortisol to provide the body an energy boost and help it cope with the emergency situation better.

Aldosterone is a mineralocorticoid hormone that is essential for maintaining blood pressure, salt, and potassium levels in the blood. By regulating these levels, it also aids in controlling the pH of the blood. DHEA and androgenic steroids are weak male hormones that have little biological effect. In the ovaries, they are changed into estrogens, and in the testes, they are changed into androgens. Although androgens are often associated with men, the female body also naturally generates a tiny amount of androgens. The 'fight or flight' hormones, noradrenaline and adrenaline, are classified as catecholamines.

Adrenaline and noradrenaline have the power to speed up and strengthen heartbeats, boost blood supply to the muscles and brain, and support glucose metabolism. They also regulate vasoconstriction, which supports blood pressure maintenance. These are released at times of physical and mental stress.

• Adrenal Gland Tumours: These are aberrant, non-cancerous growths on the adrenal glands. They often don't produce symptoms or need care. However, hormone levels may become excessively high as a result of a number of hormones produced by adrenal gland tumours.
• Cushing's Syndrome: Caused by adrenal tumours that generate too much cortisol, leading to primary hyperaldosteronism and elevated amounts of the hormone aldosterone in the body. The most frequent cause is the use of steroid medications, although it may also be brought on by the adrenal glands producing too much cortisol.
• Adrenocortical Carcinoma: This malignant adrenal tumours often appears in the adrenal gland's outer layer. Adrenal cancerous tumours are often discovered years after they first appear, by which time the disease has already spread to other organs.
• Congenital Adrenal Hyperplasia (CAH): This hereditary condition causes the body to produce insufficient cortisol. It's possible for CAH patients to also have other hormonal abnormalities. For instance, their bodies may produce too much androgen, which encourages the excessive growth of male sexual organs, rather than enough aldosterone to maintain control over blood pressure, potassium, and salt levels.
• Pheochromocytoma: This particular sort of tumour appears in the adrenal medulla, the gland's interior. It causes the body to create large amounts of the hormone adrenaline. The tumours are often not malignant and do not spread to other body areas. However, in a small number of instances, the tumours are malignant and may affect other tissues by spreading to them.
• Adrenal Gland Suppression: When patients use steroid drugs like prednisone, hydrocortisone, or dexamethasone, which behave like cortisol in the body, the natural activity of the adrenal glands may be suppressed, diminished, or lowered. Extreme exhaustion, weight loss, reduced appetite, hyperpigmentation, low blood pressure, even fainting, a need for salt, hypoglycemia, nausea, vomiting, or diarrhoea, and stomach discomfort are just a few of the symptoms that may be present.
• Hyperaldosteronism: This condition develops when the body creates excessive amounts of aldosterone, a hormone that regulates blood pressure as well as salt and potassium levels in the body. A tumour, which generally affects one adrenal gland, or 'hyperplasia,' a disease when both adrenal glands develop abnormally, both of which generate additional aldosterone.
• Aldosterone Producing Adenoma: An adenoma that generates excessive amounts of aldosterone and is benign but not malignant. This disease may result in dangerously high blood pressure. Low potassium levels, high blood pressure, headaches, exhaustion, and muscular weakness are symptoms. In rare cases, an excess of sex hormones may also be secreted.
• Hereditary Paraganglioma Pheochromocytoma: It is a hereditary disorder that results in several tumour forms that produce hormones like adrenaline and others. Some tumours have a malignant potential. Coughing, ear hearing loss, and trouble swallowing are some of the symptoms.
• Suppression of the Adrenal Glands: Using steroids may cause the suppression of the adrenal glands. Steroids may signal the adrenal glands to produce less cortisol because they imitate the hormone. The adrenal glands could not get the signal to start producing cortisol when steroid therapy is abruptly stopped. Adrenal insufficiency, which results in inadequate production of cortisol and, in some circumstances, aldosterone, is the result of a hormonal imbalance that may develop and last for weeks or even months before the adrenal glands are able to restore their normal hormonal balance.

• 17-Hydroxyprogesterone Test: It is used to detect the presence of 17-hydroxyprogesterone (17-OHP) in the blood. The adrenal glands produce the hormone in question. The adrenal glands produce a number of hormones, including cortisol, which is vital for regulating blood pressure, blood sugar, and a few immune system activities.
• Test for Aldosterone: This procedure determines the level of aldosterone in the blood or urine. Aldosterone, often known as ALD, is a hormone produced by the adrenal glands that aids in blood pressure regulation and maintaining normal sodium and potassium levels. ALD levels that are abnormally high or low may indicate a significant medical condition.
• Cortisol Test: A cortisol test determines the amount of cortisol present in the blood, urine, or saliva to determine if the levels are normal. If a person consumes significant dosages of certain steroid medications, high levels of cortisol may also result.
• DHEA Sulphate Test: Blood levels of DHEA sulphate (DHEAS) are measured using a DHEA sulphate test. Dehydroepiandrosterone sulphate is referred to as DHEAS. DHEAS is crucial in the production of the sex hormones oestrogen and testosterone in both men and women.
• Renin Test: This examination determines the quantity of renin in the body. The kidneys produce the hormone renin. It regulates the adrenal glands' ability to produce the hormone aldosterone, which is another hormone. The test is particularly helpful in identifying primary aldosteronism, a condition brought on by an excess of aldosterone.
• Insulin-Induced Hypoglycemia Test: It is advised for those who have secondary adrenal insufficiency or adrenal insufficiency brought on by pituitary illness. After an insulin infusion, the blood sugar and cortisol levels are measured. Glucose levels drop and cortisol levels rise in healthy individuals.
• 17-Hydroxyprogesterone Test1: These check hormone levels and reveal if the body is overproducing cortisol. The expert could be requested to collect urine throughout a 24-hour period for the urine test. Samples of blood and urine will be sent to a lab for evaluation.
• Saliva Test: Tested in the saliva, cortisol levels often fluctuate throughout the day. Cortisol levels in those without Cushing syndrome decrease dramatically in the evening. Doctors may determine if cortisol levels are excessively high by analysing cortisol levels from a brief saliva sample taken late at night.

• Radiation Therapy: It is a treatment for cancer that includes exposing patients to high-energy x-rays or other kinds of radiation in order to eliminate cancer cells or inhibit the formation of new cancer cells. Radiation therapy is also known as ionising radiation therapy.
• Chemotherapy: Chemotherapy is a cancer treatment that employs medications to kill cancer cells or prevent them from proliferating in order to limit the development of cancer cells. Chemotherapy that is administered systemically enters the circulation whether it is either orally or administered through injection into a vein or muscle.
• Combination Chemotherapy: Combination chemotherapy is a kind of cancer treatment that makes use of many anticancer medications. Treatment for paragangliomas and pheochromocytomas involves systemic chemotherapy.
• Cryoablation: Cryoablation is a technique that involves the freezing of tissue in order to kill off aberrant cells. In order to freeze the tissue, either liquid nitrogen or liquid carbon dioxide is used.
• Radiofrequency Ablation: A technique for heating and eliminating aberrant cells using radio waves. The radio waves pass via electrodes, which are little electrically powered objects. Cancer and other diseases may be treated using radiofrequency ablation.
• Embolization Treatment: It is a procedure that may be used to relieve a blockage in the artery that supplies blood to the adrenal glands. Blocking the blood flow to the adrenal glands is an effective way to prevent the spread of cancerous cells to those glands.
• Adrenalectomy: If the adrenal gland is releasing too much hormone or is malignant, it may be surgically removed. The adrenalectomy is often carried out by tiny incisions, while it may also be done as an open procedure.

• Hormonal supplements for reducing abnormalities in Adrenal Gland: Fludrocortisone is a mineralocorticoid that raises blood pressure and volume of blood. Along with mechanical and postural interventions including increasing fluid and salt intake and using venous compression techniques, fludrocortisone is regarded as the first or second line pharmaceutical therapy for orthostatic hypotension.
• Supplements for reducing inflammation of Adrenal Gland: If the patient is hypoglycemic, the rehydration solution has to have dextrose added to it after the bolus dosage in order to avoid hypoglycemia from happening. This is done in order to prevent hypoglycemia from occurring.
• Mifepristone for treating infection of Adrenal Gland: Mifepristone is a known therapy option for patients with Cushing syndrome who also have type 2 diabetes or glucose intolerance. These patients may be candidates for mifepristone. Mifepristone does not inhibit the production of cortisol, despite the fact that it is able to stop cortisol from having any effect on the tissues.
• Chemotherapeutic medicines for Adrenal Gland: Tyrosine kinase inhibitors are the medicines which stop the signals that tumours require to develop. For metastatic and recurring pheochromocytoma, sunitinib, axitinib, and cabozantinib have been utilised as palliative treatments.
• Replacement for Cortisol: Alternatives to cortisol include hydrocortisone, prednisone, and methylprednisolone, which are all used. These hormones are delivered according to a predetermined schedule in order to simulate the naturally occurring 24-hour fluctuation of cortisol levels.