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What are the Adrenal glands?

These are triangular shaped glands that sit superior to or on top of the kidneys like a hat around the 11^th and 12^th thoracic vertebrae.  These are known as the endocrine glands and are actually two different glands in one. The cortex and the medulla are encapsulated inside each other.  They secrete hormones such as mineralocorticoids, glucocorticoids, cortisol and androgens.

What is the major function of the Adrenal gland?

Medulla:

• Release Adrenaline (epinephrine) – fight or flight response function, increase blood pressure and insulin resistance
• Release Noradrenaline norepinephrine) – Vigilant concentration, increases contraction of the heart

Cortex:

• Glucocorticoids, hydrocortisone (cortisol) – Weakness, fatigue, anorexia nausea, trouble sleeping
• Testosterone, Androgens – Weakness, fatigue, lack of sex drive
• Mineralcorticoids, aldosterone – Hypertension

What happens when this gland is dysfunctional?

One can experience hypo function of the adrenal gland itself and hyper function of specific hormones of the adrenal gland. Adrenal insufficiency is less serious but can cause major lifestyle dysfunction.

Hypo Function

• Addison’s Disease – a failure of the adrenal cortex which can be caused by external triggers, infection, trauma, toxic chemical exposure and psychological stress (considered autoimmune)
  • Symptoms:  hyperpigmentation (mouth, areolae, perineum), weight loss, depression, postural hypotension causing vertigo and Azotemia (kidney failure and urea)
    • Test:  Serum cortisol, 24 hour free cortisol and ACTH stimulation test, standard electrolytes may be imbalanced potassium and depressed sodium
    • Adrenal Insufficiency Syndrome – caused in Western culture due to psychological stress and poor nutrition which depletes adrenal reserve
      • Symptoms:  Excessive fatigue, PMS, irritability, salt craving, confusion, poor memory, weakness, palpitations, insomnia, constipation or diarrhea
        • Tests:  Saliva or Urinary Cortisol usually done in 4 saliva tests or a 24-hour urine sample.  Also Test Testosterone, DHEA-S, Glucose, Serum Na, Serum K, BUN high normal or elevated

Hyper function

• Cushing’s Disease – Excessive adrenocortical hormone production.  Adrenocortical production increases when a stressor occurs and then cortisol is released usually, cortisol is released until the stressor goes away, but in Cushings disease release of hormone is excessive and constant.  Some suffer from a low level of Cushing’s called hypercortisolism.  It is thus triggered by stress.
  • Symptoms in full blown cases:  Redistribution of the fat on the face and truncal (chest area) area (moon faces), hypertension, osteoporosis, weak connective tissue, insulin resistance, decreased immunity, mood disorders, poor wound healing, virilism (secondary male characteristics) in women.
    • Tests:  24-hour cortisol test, EKG, Elevated Na levels, K levels, Eosinophil levels low
    • Primary Aldosteronism (Conn’s Syndrome) – Excessive aldosterone is produced by the adrenal gland.  Most commonly caused by stress and seen in the majority of hypertensive patients.  Can occur secondarily to renal artery stenosis and thus a build up of a product called rennin or a begin tumor called an adenoma.
      • Symptoms:  Hypertension, women in 30-50 years old, heart palpations, weakness, muscle cramping, headaches, parasthesia, polydipsia and polyuria
        • Tests:  Potassium serum testing, blood pressure measurement, ECG, Serum aldosterone, urinary aldosterone, CT Abdominal, plasma renin levels
        • Pheochromocytoma – Tumor of the adrenal medulla that secretes high levels of norepinephrine, epinephrine and dopamine.  It is relatively rare.
          • Symptoms:  Headaches, diaphoresis, palpitation and hypertension
            • Tests:  Urinary measurement of Neuropinephrine and Epinephrine, CT scan Abdomen

How would I determine if I have Adrenal Insufficiency?

Adrenal insufficiency is a common diagnosis heavily related to everyday function and is especially prevalent in individuals with Thyroid conditions.  It is often under diagnosed since it is generally not recognized in conventional medicine.

Testing is done either through serum blood or saliva. Saliva testing is preferable because you can do it easily at home taking four separate samples throughout the day allowing you to see a daily rhythm. This is important as this gives us clinical knowledge to see if, and at what point in time, your cortisol level needs support or supplementation.

Sample of what a normal healthy cortisol level should look like.

                         

 

 

 

 

 

 

What is the treatment for Adrenal Insufficiency?

The treatment is usually some lifestyle modifications coupled with a group of herbs called adaptogens.  A doctor will determine what types of adaptogens are needed based on your lab results and symptoms.  Lifestyle modifications include diet, sleep habits and stress reduction techniques.

What happens if I don’t treat Adrenal issues?

Since they are largely caused by autoimmune and stress response, people who are left untreated can face the following problems:

• Hypertension
• Thyroid issues start or become worse
• Sleep issues
• Hormone imbalances
• Increased cancer risk

Our clinic prides ourselves on helping manage your health. It is our passion and it should be your goal.  You can fill out the hormone checklist on our website and email it to info@in-healthclinic.com for scoring to see what risk factors you may have.  We do cortisol and hormone testing in office and even offer 10-minute free phone consults to determine if we are a right fit for you.