The adrenal glands secrete hormones that help maintain balance in your body. But, if these hormones are over- or under-secreted, disease can develop. In this lesson, you will learn about disorders of the adrenal glands, including Addison’s disease and Cushing’s syndrome, as well as their treatments.

Adrenal Glands

The adrenal glands are endocrine glands. This means they secrete hormones into the blood. Hormones are secreted based on the needs of the body and are important in maintaining homeostasis, or internal balance. In a healthy body, endocrine glands such as the adrenal glands secrete just the right amount of hormones at just the right times. However, problems can arise that result in the secretion of too much or too little of certain hormones, and this can lead to disease. In this lesson, we will focus on the hyper- and hypo-secretions of the adrenal glands and the conditions that result.

Adrenal glands need to secrete just the right amount of hormones to maintain homeostasis.
Adrenals Maintain Homeostasis

The adrenal cortex secretes steroid hormones. The term ‘steroid’ is probably something you are familiar with. We often think of a hulking body builder who is juiced up on steroids – or, if you or someone you know has ever dealt with a chronic disease, you may be familiar with steroid medication such as prednisone, which we will discuss later in this lesson. Natural steroid hormones from the adrenal cortex help control a wide range of processes in your body, from inflammation and immune function to salt and water balance and your ability to handle stress.

Cushing’s Syndrome

One type of steroid hormone secreted by the adrenal cortex is glucocorticoids. The most important glucocorticoid in your body is called cortisol. Cortisol is very helpful when secreted in normal amounts because it regulates glucose metabolism and has anti-inflammatory and immunosuppressive properties.

However, if your body produces too much cortisol, the result can be a condition called Cushing’s syndrome. Cushing’s syndrome is defined as a disorder that occurs when your body is exposed to high levels of cortisol. The condition results in some hallmark symptoms that include facial roundness referred to as a ‘moon face,’ fat accumulation on the upper-back referred to as a ‘buffalo hump,’ weight gain above the waist, a thinning of the arms and legs, and purple stretch marks on the skin. Because Cushing’s syndrome leads to fat accumulation in different parts of the body, it may help you think of Cushing’s syndrome as making the body ‘soft’ or ‘cushy.’

Physical signs of excessive cortisol production.
Cushings

Prednisone

The most common cause of Cushing’s syndrome is taking too much corticosteroid medications and, in particular, prednisone. Prednisone is a synthetic steroid drug prescribed for the treatment of severe inflammation or for immunosuppression.

Synthetic glucocorticoid medications, like prednisone, are helpful for treating diseases such as rheumatoid arthritis, severe allergies, and other chronic illnesses. And, they are designed to mimic cortisol’s anti-inflammatory and immunosuppressive properties. But, as we see in the case of Cushing’s syndrome, too much of a good thing can lead to disease.

Treatment for Cushing’s syndrome aims to lower cortisol levels in your body. If the cause of Cushing’s syndrome is overuse of corticosteroid medication, then reducing corticosteroid medication use under a doctor’s direction is often enough to treat the condition. If the disorder is due to a tumor or other disorder, then surgery, radiation, or the use of cortisol-inhibiting drugs may be used.

Addison’s Disease

With Cushing’s syndrome, there is too much hormone being secreted by the adrenal glands. With Addison’s disease, there is too little. Therefore, Addison’s disease is a condition caused by insufficient secretions of adrenal cortex hormones. In fact, this disease is also referred to as adrenal insufficiency. Because a person with Addison’s disease does not have enough of the adrenal hormones, it might help you remember this term by thinking that a person with Addison’s needs to ‘add’ hormones.

The two main steroid hormones that are underproduced are glucocorticoids, such as cortisol, and mineralocorticoids, such as aldosterone. Aldosterone helps regulate the salt and water balance in the body. So, when these hormones are produced in low amounts, we get imbalances within the body that lead to the slowly developing symptoms of Addison’s disease, which are muscle weakness, weight loss, nausea, fatigue, low blood pressure, low blood sugar, and patchy darkening of the skin. To help you remember these symptoms, notice how all of them make you feel down or ‘low,’ and in Addison’s disease, hormones are low.

Too little glucocorticoids and mineralocorticoids can lead to adrenal insufficiency.
Addisons

Addison’s disease is often the result of an autoimmune disorder, which means that the body’s immune system mistakenly attacks the adrenal glands thinking they’re foreign tissue that do not belong. Because the gland is destroyed, a person with Addison’s disease will need to take hormone pills for the rest of their life to compensate for the insufficient amounts of natural hormone production. If the person is underproducing cortisol, they will need to take oral doses of a synthetic glucocorticoid such as hydrocortisone tablets. If the person is underproducing aldosterone, they will need to take oral doses of a synthetic mineralocorticoid. These medications allow a person with Addison’s disease to lead a fairly normal life. However, they’re always encouraged to carry a medical alert bracelet along with medication, because missing a dose of medication could cause low blood pressure or low blood sugar and be life-threatening.

Lesson Summary

Let’s review.

The adrenal cortex secretes steroid hormones that help maintain homeostasis in the body. Cortisol is a glucocorticoid that is secreted by the adrenal cortex. When it is secreted in proper amounts, it regulates glucose metabolism and has anti-inflammatory and immunosuppressive properties. Because cortisol is so good at controlling inflammation, synthetic medications are made to mimic the functions of this hormone. Prednisone is one of these medications and is defined as a synthetic steroid drug prescribed for the treatment of severe inflammation and for immunosuppression.

If steroid medication, such as prednisone, is taken too often, it can result a disease called Cushing’s syndrome, which is a disorder that occurs when the body is exposed to high levels of cortisol. This condition results in some hallmark symptoms that include a ‘moon face’ and a ‘buffalo hump.’

Addison’s disease is a condition caused by insufficient secretions of adrenal cortex hormones. The two main steroid hormones that are underproduced are cortisol and aldosterone. The adrenal gland is destroyed due to an autoimmune disease and requires hormone pills for the rest of life.

Learning Outcomes

After this video, you will be able to:

  • Explain the major functions of the adrenal glands
  • List the causes and symptoms of Cushing’s syndrome and Addison’s disease
  • Summarize the function of synthetic medications such as prednisone