What causes adrenal disorders?
The adrenal gland can be affected by different problems. Each type of adrenal disorder has somewhat different causes and symptoms. Some of the most common disorders include:
- Addison’s disease is a rare disorder caused when the adrenal glands don’t make enough cortisol, or in most cases, enough aldosterone hormone. Addison’s is an autoimmune disease, meaning the immune system mistakenly attacks the body’s own cells and tissues. This reaction can damage the adrenal glands.
- Adrenal gland suppression can occur when someone takes steroid medications (prednisone, hydrocortisone, dexamethasone), which act like cortisol in the body. If you are prescribed steroids, you would normally take gradually lower doses. If steroids are stopped suddenly, the adrenal glands may be unable to produce enough cortisol for several weeks or months, causing health problems.
- Congenital adrenal hyperplasia (CAH) is a common genetic disorder that causes the cortisol level to be too low, and aldosterone and androgen hormone imbalances. Mild CAH may not cause symptoms and may never be diagnosed.
- Cushing syndrome is a rare disease caused by having too much cortisol. It can develop due to long-term or overuse of steroids, or if the body produces too much cortisol. Cortisol overproduction can occur if there are tumors of the pituitary or adrenal glands, lung, pancreas or thyroid.
- Hyperaldosteronism occurs when the body produces too much aldosterone. This hormone controls blood pressure and regulates salt and potassium levels. Extra aldosterone can be produced by a tumor on one or both adrenal glands, called hyperplasia.
- Virilization can occur when the body produces too much of the male sex hormones. It’s only apparent in females or males before puberty.
If the adrenal gland develops tumors, these conditions can occur:
- Adrenal gland tumors can disrupt hormone output, but are usually not cancerous. The tumors can produce different hormones and cause hormone levels to be too high. If the tumors produce too much cortisol, they can cause Cushing’s syndrome; primary hyperaldosteronism if they create too much aldosterone; and pheochromocytoma if they produce too much adrenaline.
- Adrenocortical carcinoma is a rare, slow-growing cancer that forms on the outer layer of the adrenal gland.
- Pheochromocytoma causes the glands to produce excess epinephrine and norepinephrine which can raise blood pressure or make the heart race.
- Pituitary gland tumors are abnormal growths on the pituitary gland that cause a disruption in the amounts of hormones made by the adrenals, and causes hormone deficiency. They are not cancerous.
- Pheochromocytoma and paraganglioma are rare tumors; 90% are noncancerous. Pheochromocytomas form in the adrenal glands, and paragangliomas form in cells of the neuronal origin, which is located throughout the neck, chest, abdomen and pelvis. Both types of tumors can produce hormones that control heart rate, blood pressure and the body’s stress reaction.
What is adrenal gland insufficiency?
Primary adrenal insufficiency can happen when the adrenal glands don’t produce enough cortisol or aldosterone. The cause is destruction of the adrenal glands’ outer layer, which can be caused by an autoimmune disease that attacks the glands, from tumors, or tuberculosis or other infections.
Secondary adrenal insufficiency is more common, and is caused when the pituitary gland doesn’t produce enough ACTH. If there’s insufficient ACTH, the adrenal glands don’t make enough cortisol. It’s most commonly caused when the patient has taken glucocorticoids (prednisone) for a long time and then stops too quickly, without tapering the dosage. It can also be caused by surgery or radiation to the pituitary gland, or by tumors in the pituitary gland.