What are adrenal gland disorders?

The adrenal glands are two small endocrine glands that sit just above the kidneys. Despite their size, they play a crucial role in keeping the body functioning well. They produce several important hormones - including adrenaline, cortisol, and androgens - which help regulate blood pressure, blood sugar, metabolism, the body’s response to stress, and how the body uses fat and protein.

Adrenal gland disorders occur when the glands produce too much or too little of these hormones, or when their structure is affected by growths or genetic conditions. When this happens, the body’s hormonal balance is disrupted, leading to a range of symptoms and health concerns.

There are several types of adrenal gland disorders, including:

• Cushing’s syndrome
• Addison’s disease
• Adrenal gland tumours
• Hereditary or genetic adrenal conditions
• Congenital adrenal hyperplasia (CAH)
• Adrenal gland cancer
• Pheochromocytoma

What causes adrenal gland disorders?

Adrenal disorders can develop for many different reasons. In most cases, the glands either produce too much hormone or not enough. Common causes include:

• Tumours
• Infections
• Certain medications
• Genetic or hereditary conditions
• Problems in other endocrine glands, such as the pituitary gland

Because the endocrine system is interconnected, a problem in one gland can affect the function of another.

What are the symptoms?

Symptoms vary widely depending on the specific adrenal disorder. Below is an overview of common symptoms associated with some of the main conditions.

Cushing’s Syndrome

• Upper body weight gain
• High blood pressure
• Muscle and bone weakness
• High blood sugar levels
• Skin changes, such as acne or stretch marks
• Slow growth in children
• Irritability or low mood

Addison’s Disease

• Unexplained weight loss
• Fatigue
• Low blood pressure
• Salt cravings
• Feeling dizzy when standing
• Nausea or vomiting
• Weakness
• Darker patches of skin
• Depression

Congenital Adrenal Hyperplasia (CAH)

Mild CAH symptoms:

• Early puberty
• Acne
• Irregular periods
• Excess facial hair in women
• Shorter adult height

More severe CAH symptoms:

• Low blood pressure
• Low blood sugar
• Difficulty retaining salt
• Excess facial hair in women
• Benign testicular tumours or infertility in men
• Differences in genital development in girls
• Difficulty becoming pregnant

Pheochromocytoma

• Excessive sweating
• Rapid heartbeat
• Headaches
• High blood pressure
• Pale skin
• Nausea or vomiting
• Anxiety or panic‑like episodes

Are adrenal tumours common?

Adrenal tumours are not unusual, and many are found incidentally during scans for other reasons. Some tumours produce excess hormones—these are known as functioning tumours - and can cause significant symptoms because the hormone levels become too high. Others do not produce hormones but may still affect adrenal function by disrupting nearby structures.

Functioning adrenal tumours often require removal because excess hormone production can be harmful to the body.

How are adrenal gland disorders diagnosed?

Diagnosis usually involves a combination of hormone testing and imaging. Your doctor may recommend:

Hormone tests

• Blood tests to assess cortisol and other hormone levels
• Insulin tolerance tests
• Urine tests
• Saliva tests

Imaging tests

• X‑ray
• CT scan
• MRI scan
• MIBG scan (particularly for pheochromocytoma)

These tests help identify whether the adrenal glands are producing too much or too little hormone, and whether any tumours or structural changes are present.

What is the treatment?

Treatment depends on the specific adrenal disorder and the individual’s symptoms. Options may include:

• Medication to reduce excess hormone production
• Hormone replacement therapy
• Surgery to remove adrenal tumours
• Surgery to remove one or both adrenal glands
• Surgery to remove tumours in the pituitary gland (if they are affecting adrenal function)

Your endocrinologist will create a personalised treatment plan based on your diagnosis and overall health.

Can you live without adrenal glands?

Yes, it is possible to live without adrenal glands. In some cases, one or both glands need to be removed if they are producing too much or too little hormone or if a tumour is present.

• If one adrenal gland is removed, the remaining gland usually takes over hormone production. Temporary hormone replacement may be needed during recovery.
• If both adrenal glands are removed, lifelong hormone replacement therapy is essential, as the body can no longer produce these hormones naturally.

Recovery after adrenalectomy surgery varies depending on the reason for surgery, but most people return to normal activities within a few weeks. Light exercise, such as walking, is often encouraged to support recovery.