The adrenal glands are small organs located on top of the kidney. According to the National Endocrine and Metabolic Diseases Information Service, the adrenals secrete cortisol, a hormone responsible for regulating the stress response, maintaining blood pressure and cardiac functions, metabolizing food and regulating blood sugar levels. Taber's Medical Cyclopedic Dictionary states that adrenal disorders may be difficult to diagnose without lab testing as signs of adrenal problems may be minimal until the development of specific disorders, such as Addison's disease or adrenal crisis.
Addison's Disease
Destruction of adrenal gland tissue or atrophy of the lining surrounding the adrenal gland will cause Addison's disease. Unfortunately, symptoms manifest only after 90 percent of the adrenal gland has been destroyed. The Johns Hopkins Guide to Symptoms and Remedies states that progressive fatigue, weakness, nausea, vomiting, decreased appetite, weight loss, abdominal pain and a darkening of freckles, skin or mucus membranes are signs and symptoms of adrenal insufficiency and impending failure--the hallmarks of Addison's disease. Addison's is not preventable by any means, and it strikes persons of all ages and backgrounds and both genders equally. The prognosis for recovery is good with lifelong replacement therapy of corticosteroids.
Secondary Adrenal Insufficiency
Secondary adrenal insufficiency involves the pituitary organ, as well as adrenal gland. The bean-sized pituitary organ located in the brain secretes adrenocorticotropin (ACTH), the hormone which triggers the release of cortisol by the adrenal glands. If the adrenals do not respond to ACTH release, lower than normal cortisol levels result. A blood test indicating low cortisol levels may be the first indication of adrenal problems. Additionally, low sodium levels, high potassium and calcium levels and increases in blood urea nitrogen, and red and white blood counts all indicate adrenal function compromise and impending failure.
Calcification (hardening) of the adrenal glands is another form of secondary adrenal insufficiency and may result from an infection. Evidence of calcification shows up on an x-ray of the lower back.
Adrenal Crisis
Adrenal crisis occurs when all of the body stores of glucocorticoids are exhausted. Adrenal crisis can be caused by extreme stress, possibly from a surgery or trauma. Patients who take replacement glucocorticoids must never forget to take their medication. The National Endocrine and Metabolic Diseases Information Service warns that a person in adrenal crisis needs immediate medical treatment. Extreme high fever, psychosis, shock, very low blood sugar, kidney failure, coma, and even death may result without immediate medical intervention. Unless the body receives an immediate injection of a glucocorticoid, there will be no recovery.
References
- "Complete Home Guide to Symptoms and Remedies;" Johns Hopkins; 2004
- "Taber's Cyclopedic Medical Dictionary;" F.A.Davis; 2009
- National Endocrine and Metabolic Diseases Information Service
