Adrenal glands: How they function and potential problems

The adrenal glands are an essential to the body’s healthy operation. What happens if dysfunction occurs?

In this eye-opening article, esteemed consultant endocrinologist Dr Anand Velusamy answers questions about conditions related to disorders in the adrenal glands, possible eventualities if they go untreated and what can be done to solve them.

What do adrenal glands do?

They make a variety of steroid hormones that are indispensable for survival. In medical terms, amongst others, the main ones are:

• Aldosterone
• Cortisol
• Adrenaline and noradrenaline

What happens when adrenal glands aren’t functioning properly?

As with any other endocrine gland, optimal functioning of the adrenal gland with production of appropriate levels of hormones is essential to lead a normal healthy life. For example, Addison’s disease, which was first described in 1855, refers to the primary destruction of the adrenal gland by various mechanisms. This is an endocrine emergency that can result in death without appropriate timely management using replacement steroids.

On the other hand, excessive production of steroids from the adrenal glands, often referred to as Cushing’s syndrome can result in multiple co-morbidities such as:

• Diabetes
• Obesity
• Hypertension
• Osteoporosis
• Heart failure
• Kidney disease

Therefore, prompt recognition of symptoms and appropriate management is vital.

What are some of the potential problems of untreated adrenal glands?

A worst-case scenario, without timely recognition of adrenal gland problems, varies from death (from adrenal insufficiency) to development of various cardiovascular co-morbidities such as:

• Heart attacks
• Strokes
• Diabetes
• Fracture of the bones, poor quality of life with poor mental health and eventually, premature death from unrecognised Cushing’s.

Are problems hereditary?

Addison’s disease, also known as primary adrenal insufficiency, in the developed world is usually autoimmune (innate anti-body mediated). It can attack the native tissues including:

• The thyroid
• Small bowels
• Joints
• Skin
• Eyes
• Pancreas

This can be hereditary and sometimes, genetic aberrations (mutations or pathogenic variants in medical term) can be passed on to subsequent generations, resulting in an over- or under-functioning adrenal gland.

Can you live without any of the adrenal glands?

You can, but you will need replacement steroids that can substitute their place. These are often synthetic formulations of steroids which had to be taken, which are available in tablet formulations, every day. Nevertheless, it is often difficult to mimic physiology and the patients often end up getting slightly over replaced.

Is adrenal gland surgery dangerous?

Definitely not in the hands of an experienced surgeon who has done thousands of adrenal gland surgical procedures. The procedure is often performed using key hole (laparoscopic) and sometimes robot-assisted surgery in tertiary centres. The outcomes are not significantly different between the two and overall, the hospital stay for a benign adrenal surgery is less than two nights.

If you need adrenal gland treatment or are worried about related symptoms, get reassuring, expert assistance from Dr Velusamy. Visit his Top Doctors profile to arrange an appointment.