Overview of the Adrenal Glands

The adrenal glands rest on the top and inner side of each kidney at the 11th and 12th thoracic vertebrae, or around the middle back. Like other endocrine glands, they have excellent blood flow.

Each adrenal gland is made of two different glands in one capsule: the adrenal cortex on the outer surface and the adrenal medulla on the inside. Disorders of the adrenal glands affect an individuals’ ability to respond to stress, maintain fluid and electrolyte balance, and development of sexual characteristics.

Parenchyma Cortex Medulla Perirenal fat Capsule Ureter Pelvis of kidney Renal artery and Renal vein Hilus Calyx

• The adrenal cortex has three regions that produce hormones called mineralocorticoids, glucocorticoids, and the androgens and estrogens. 
• Aldosterone is one of the mineralocorticoids, and regulates fluid and electrolyte balance.
• Cortisol is one of the glucocorticoids, and one of its many functions is to maintain the body’s blood sugar levels in response to stress.  In a normal response, cortisol “kicks in” and gives the body sugar when it needs it most.  However, diabetic patients under high stress will need to increase drug dosages to compensate for the increased blood sugar levels.
• Androgen and estrogen are responsible for secondary sex characteristics in both sexes.

• The adrenal medulla consists of cells which produce and release epinephrine (adrenaline), and norepinephrine (noradrenaline). 
• These hormones regulate the “fight or flight” reaction in response to life threatening situations.

Adrenal gland dysfunction is typically related to a maladaption to stress, whether physical or emotional, chronic or acute, as first reported by Hans Selye, former director of  Experimental Medicine and Surgery at the University of Montreal, in the general adaptation syndrome theory.

When the adrenals are in hypofunction, they secrete decreased amounts of adrenal hormones. The body loses its ability to respond to stress. 

When the adrenals are in hyperfunction, they secrete excess amounts of adrenal hormones. 

Long-term use of steroids plays a role in both hyper- and hypofunction of the adrenals.

The adrenal glands typically go through a number of stages when responding to stress.  These stages are typically known as “alarm,” “resistance,” and “exhaustion.”

Both low adrenal function and low thyroid function can reduce the metabolic energy available to the body, creating the symptom of fatigue.  In this way, the two are often confused.

Lab testing may be helpful to help assess the level of adrenal fatigue , to differentiate the “resistance” from the “exhaustion” phase of adrenal dysfunction, and to monitor recovery.

Restorative medicine through the use of stress reduction, adaptogenic herbs, acupuncture, nutritional and hormonal supplements, and dietary support and  has shown to be effective in the treatment of adrenal metabolism disorders.