Adrenal Gland
LOCATION
Adrenal Gland
The adrenal glands (also known as
suprarenal glands) are the triangle-shaped
and orange-colored endocrine glands and
measure about one-half inch in height
and 3 inches in length located on the top
of both kidneys at the level of the 12th
thoracic vertebra .
Structure of The Adrenal Glands
Each adrenal gland consists of :
 Adrenal medulla .
 Adrenal cortex .
The Adrenal Medulla
adrenal medulla is the inner part of the
adrenal gland and surrounded by the adrenal
cortex and helps a person in coping with
physical and emotional stress.
Adrenal medulla hormones
The adrenal medulla secretes the following hormones :

epinephrine (also called adrenaline) :
Epinephrine is a hormone produced in the body by
the adrenal glands. It is released at times of acute
stress to enhance our capability . this hormone
increases the heart rate and force of heart contractions,
facilitates blood flow to the muscles and brain, causes
relaxation of smooth muscles, helps with conversion of
glycogen to glucose in the liver.
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norepinephrine (also called noradrenaline):
this hormone has little effect on smooth
muscle, metabolic processes, and cardiac
output, but has strong vasoconstriction
effects, thus increasing blood pressure.
The Adrenal Cortex
The adrenal cortex is the outer portion of the
adrenal gland consists of three different
regions, with each region producing a
different group or type of hormones that
carry out specific functions throughout your
body.
Adrenal Cortex hormones

The adrenal cortex produces three major
groups of steroid hormones collectively
called ( corticosteroids):
1)
Mineralocorticoids (outermost )
Glucocorticoids (middle )
sex hormones (innermost )
2)
3)
Adrenal Cortex
MINERALOCORTICOIDS
Mineralocorticoids are secreted by the
outermost region of the adrenal cortex. The
principal mineralocorticoid is aldosterone,
which is the major hormone controlling the
sodium and potassium levels, Aldosterone
responsible for the reabsorption of sodium and
stimulates the excretion of potassiumand thus
fluid balance, within your bloodstream.
GLUCOCORTICOIDS
Glucocorticoids are secreted by the middle
region of the adrenal cortex.which include
cortisone and cortisol.Cortisol controls or
greatly influences the metabolism of fats,
proteins to maintain blood glucose within a
narrow optimal range and keep it there even
under stressful conditions.
SEX HORMONES
sex hormones are secreted by the innermost
region of the adrenal cortex.
Androgens (Male hormones)
 Estrogens (female hormones)

Cushing's Syndrome

Cushing's syndrome is the result when your
body makes too much cortisol and commonly
affects adults aged 20 to 50. An estimated 10 to
15 of every million people are affected each
year.
Causes of Cushing's syndrome


The most common cause is taking cortisone-like
medicines orally (by mouth) every day for weeks to
months. Prednisone for asthma, rheumatoid
arthritis is the most common medicine that's taken
this way.
Cushing's disease is common cause of Cushing
syndrome because excessive production of the
hormone ACTH by the pituitary gland. ACTH
stimulates the adrenal glands to produce cortisol.
symptoms of Cushing's
syndrome
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The following are the most common symptoms:
increased fat around neck.
fragile and thin skin.
stretch marks on abdomen, thighs, arms, and breasts.
bone and muscle weakness.
severe fatigue.
irritability and anxiety.
irregular or stopped menstrual cycles in women
Treatment
Treatment depends upon the cause of the disorder:
 In Cushing syndrome caused by drug therapy , the
drug dose must be slowly decreased under medical
supervision.

In Cushing's disease caused by a pituitary tumor,
surgery to remove the tumor is recommended.
Cushing's syndrome diagnosed

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x-rays to locate any tumors.
24-hour urinary test to measure for corticosteroid
hormones.
Cortisol levels are higher in the morning than at night.
 Reference range of cortisol:
 In morning: 250 - 850 nmol/L
 At night: 110 - 390 nmol/L

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Reference range of ACTH:
7 – 40 m IU/L
Addison's Disease

Occurs when the adrenal glands do not produce
enough of the hormone cortisol and in some cases
aldosterone. can start at any age .The disease is also
called adrenal insufficiency.
Causes of Addison's Disease
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Disorder of the adrenal glands.
Tuberculosis.
Adrenal cancer.
surgical removal of the adrenal glands
Autoimmune disorders.
Irritability and depression
Symptoms of Addison's Disease
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weight loss.
loss of appetite.
muscle weakness.
nausea .
vomiting .
Diarrhea.
Treatment

Cortisol is replaced orally with hydrocortisone
tablets taken once or twice a day.

Aldosterone is also replaced with oral doses of a
fludrocortisone.
Diagnosis

Determine the levels of cortisol.

Reference range of Aldosterone :
In blood : 4 – 9 microgram/100mL
In urine : 2 – 18 microgram/24 hours
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