The adrenal glands are typically found just above the kidneys
and play important roles in making hormones that help control
blood pressure, help the body respond to stress and illness,
and help with sexual vitality. The adrenal glands can fail due
to a number of causes or develop tumors that may secrete
excessive amounts of hormones. In addition, such tumors may
be benign or malignant.
Evaluation of adrenal function includes a careful history for
suggestive symptoms and blood tests including levels of
hormones made by the adrenal glands. Imaging by CT and/or
MRI scanning can also be helpful in making a proper diagnosis
and is typically required for planning an optimal treatment.
Adrenal insufficiency can be due to failure of the glands
themselves ("primary" AI) or failure of the pituitary gland to
stimulate the adrenal glands ("secondary" AI). Symptoms
commonly include weight loss, fatigue, abdominal pain, nausea,
vomiting, dizziness and dehydration.
Primary AI is due to destruction of the outer part of the adrenal gland, called the cortex. This is most commonly due to an autoimmune disease called Addison's disease, caused by an immune response against the adrenal cortex.
Secondary AI is sometimes caused by the use of excessive steroid medications such as prednisone.