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Overview of the Adrenal Glands

By Ashley B. Grossman, MD, Emeritus Professor of Endocrinology;Professor of Neuroendocrinology;Consultant NET Endocrinologist, University of Oxford; Fellow, Green-Templeton College;Barts and the London School of Medicine;Royal Free Hospital, London

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The body has two adrenal glands, one near the top of each kidney. Each adrenal gland has two parts.

  • Medulla: The inner part secretes hormones, such as adrenaline (epinephrine), that help control blood pressure, heart rate, sweating, and other activities also regulated by the sympathetic nervous system

  • Cortex: The outer part secretes different hormones, including corticosteroids (cortisone-like hormones, such as cortisol) and mineralocorticoids (particularly aldosterone, which controls blood pressure and the levels of salt [sodium chloride] and potassium in the body). The adrenal cortex also stimulates the production of androgens (testosterone and similar hormones).

A Close Look at the Adrenal Glands

The adrenal glands are controlled in part by the brain. The hypothalamus, a small area of the brain involved in hormonal regulation, produces corticotropin-releasing hormone (CRH) and vasopressin (also known as antidiuretic hormone). Vasopressin and CRH trigger the pituitary gland to secrete corticotropin (also known as adrenocorticotropic hormone or ACTH), which stimulates the adrenal glands to produce corticosteroids. The renin-angiotensin-aldosterone system, regulated mostly by the kidneys, causes the adrenal glands to produce more or less aldosterone (see Figure: Regulating Blood Pressure: The Renin-Angiotensin-Aldosterone System).

The body controls the levels of corticosteroids according to need. The levels tend to be much higher in the early morning than later in the day. When the body is stressed, due to illness or otherwise, the levels of corticosteroids increase dramatically.

Adrenal disorders

Disorders of the adrenal gland can involve the secretion of too little or too much hormone.

When too little hormone is secreted, it may be because of a problem with the adrenal gland itself (a primary disorder, such as Addison disease). Or it may be due to a problem elsewhere in the body, such as the pituitary gland or the hypothalamus. For example, a problem with the pituitary gland could mean that the adrenal glands are not being stimulated to secrete hormones.

When too much hormone is secreted (oversecretion), the disorder that results depends on the hormone:

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