The adrenals are two glands above each kidney that produce a number of important hormones. The adrenals can be divided into the outer cortex, which produces hormones such as cortisol, aldosterone, testosterone, DHEA, DHEAS, androstenedione and estrogens, and the inner medulla, which produces epinephrine and norepinephrine (adrenaline).
Tumors of the adrenal medulla which produce excess epinephrine and norepinephrine are called pheochromocytomas, while deficiencies of the adrenal medulla do not give rise to clinical problems.
The hormones, cortisol and aldosterone, are two of the most important hormones the body makes and excesses and deficiencies of these hormones result in important clinical problems.
Cortisol, a glucocorticoid, is the stress hormone and is involved in weight control, fighting infections, quality of skin and bones and heart function. Its levels are the highest in the morning and it goes up with stress and severe illness.
Too much cortisol from any cause leads to Cushing’s syndrome; the symptoms and signs of which include weight gain, stretch marks, bruising, extra hair growth, irregular periods in women, loss of muscle, trouble sleeping and emotional problems, such as depression.
Too little cortisol is part of the syndrome called Addison’s disease, in which there is often low energy, joint and abdominal pain, weight loss, diarrhea, fever and electrolyte disturbances.
If the adrenal is making too little cortisol, the pituitary compensates and makes more of the hormone, ACTH. If the pituitary is not working, both ACTH an cortisol may be low.
Aldosterone is the salt-retaining hormone and is a mineralocorticoid. Excess of aldosterone leads to high blood pressure and low potassium.
Deficiencies of aldosterone are much less appreciated compared to deficiencies of cortisol and lead low blood pressure and high pulse, especially on standing, the desire to eat salt (salt-craving), dizziness or light-headedness on standing, and palpitations.
Severe cases may lead to high potassium and low sodium in blood tests. When the adrenal is not making aldosterone, the kidney hormone, renin, increases.