adrenal treatment options overview

Overview

Your adrenal glands are small, triangle-shaped organs on top of each kidney. They make hormones that help regulate blood pressure, blood sugar, stress responses, and the balance of salt and water in your body. When these glands make too much, too little, or the wrong amount of hormones, it can cause a range of symptoms. Treatment depends on the specific problem and is designed to restore hormone balance and relieve symptoms.

Some adrenal conditions are rare, but others such as small adrenal nodules are found more often as people get older. Overall, adrenal disorders affect a small percentage of the population, but they can happen at any age.

Adrenal conditions can affect children, adults, and older people. Some types are caused by genetic changes you are born with, while others develop over time due to autoimmune disease, infection, medication use, or growths on the glands.

Symptoms

Common symptoms

• Ongoing tiredness or weakness
• Unintended weight loss or weight gain
• Low blood pressure or dizziness when standing up
• Abdominal pain and nausea
• Changes in body hair or skin
• Muscle and joint aches

Symptoms in children

• Poor growth and slow weight gain
• Delayed puberty
• Low blood sugar episodes
• Nausea and poor appetite

Symptoms in older adults

• Confusion or sudden weakness
• Falls due to dizziness
• Loss of appetite and fatigue
• Lower body weight or muscle loss

Causes

Main causes

• Autoimmune disease, where the body's immune system attacks the adrenal glands
• Infections that damage the adrenal glands
• Growths or tumours on the adrenal glands (most are non-cancerous)
• Genetic conditions that affect how the adrenal glands form or work
• Injury or surgery involving the adrenal glands
• Long-term use of certain steroid medicines, which can make the glands stop producing adequate hormones

Risk factors

• Having an autoimmune condition such as type 1 diabetes or thyroid disease
• Taking steroid medicine for a long time
• A family history of adrenal disorders
• A history of tuberculosis or other infections
• Cancer that spreads to the adrenal glands

When to see a doctor

See a doctor urgently if:

• Severe dizziness, fainting, or confusion
• Vomiting that continues for more than a few hours
• Injury or infection that makes your symptoms much worse

Book a routine appointment if:

• Make an appointment if you have persistent fatigue, unexplained weight changes, low blood pressure, or other symptoms that aren't getting better.

Diagnosis

Your doctor will start by asking about your symptoms, medical history, and any medicines you take. If adrenal disease is suspected, you will have blood and urine tests to measure hormone levels. Imaging scans of the adrenal glands and stimulation tests may also be used.

Tests that may be done

• Blood tests to measure cortisol and aldosterone
• Urine tests to check hormone levels over 24 hours
• ACTH stimulation test, which measures how the adrenal glands respond to a hormone signal
• CT or MRI scan of the adrenal glands

What to expect at your appointment

Most tests are done as an outpatient. Some hormone tests require you to be at the clinic for an hour or two, and others require collecting urine over a full day. Your doctor will explain how to prepare for each test and when to expect results.

Treatment

Treatment for an adrenal condition depends on whether your glands are producing too little hormone, too much hormone, or have a growth that needs investigation. The goal is to restore normal hormone balance, manage symptoms, and prevent complications.

Self-care at home

• Take your prescribed hormones exactly as your healthcare team advises
• Wear a medical alert bracelet or carry a card that says you have an adrenal condition
• Learn a sick-day plan so you can adjust your medicines during illness, injury, or stress (with your doctor's guidance)
• Avoid sudden or extreme stress when possible
• Keep regular appointments for hormone monitoring

Medical treatments

If the adrenal glands do not produce enough hormones, hormone replacement therapy is used. This means taking medications that replace the missing hormones, usually in pill form or as an injection. If the glands produce too much hormone, treatment may include medications that block or reduce hormone production. Your doctor will tailor the approach to your specific condition, health, and preferences.

When is surgery considered?

Surgery may be recommended if a tumour on the adrenal gland is causing symptoms, if the gland is overactive and medicine is not enough, or if a growth has suspicious features. The surgeon may remove one gland or part of it, depending on the situation.

Living with this condition

Many people with adrenal conditions live active, full lives by keeping a consistent daily routine and sticking to their treatment plan. It helps to know your typical symptoms and to have a plan for when you feel unwell.

Lifestyle tips

• Keep a regular sleep and activity schedule
• Pack snacks and water if you are prone to low blood sugar
• Carry important health information about your adrenal condition
• Review your sick-day plan with your doctor regularly
• Find ways to manage stress, such as breathing exercises, walking, or talking to friends

Diet and exercise

Eating a balanced diet that includes enough salt (as advised by your doctor) can help maintain blood pressure if your adrenal function is low. Regular, moderate exercise is encouraged, but avoid extreme exertion without discussing it with your healthcare team. Make sure to stay hydrated.

Mental health and emotional wellbeing

Living with a chronic hormone condition can be emotionally challenging. It can be frustrating to manage daily symptoms and medicines. If you feel anxious, depressed, or overwhelmed, talk to your healthcare team. They can connect you with counselling or mental health support.

Prevention

Most adrenal disorders cannot be prevented, especially those caused by genetic changes or autoimmune disease. However, you can prevent some serious complications by following your treatment plan, getting regular check-ups, and acting quickly when you get ill.

Vaccines

Keep your routine vaccinations up to date. If you have adrenal insufficiency, an infection can be more dangerous, so preventing infection with recommended vaccines is important. Talk to your healthcare provider about which vaccines you need.

Complications

If left untreated

• Untreated adrenal insufficiency can lead to a life-threatening adrenal crisis with very low blood pressure and shock.
• Uncontrolled overproduction of adrenal hormones can cause high blood pressure, diabetes, and bone thinning.
• In children, untreated adrenal disorders can cause growth failure and permanent developmental problems.

Long-term outlook

With early diagnosis and the right treatment, most adrenal conditions can be managed well. Many people regain their energy and live full, active lives. Maintaining a good relationship with your healthcare team is important for long-term health.

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