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Adrenal glands, anterior (left) and posterior (right) surface. The adrenal glands are located on both sides of the body in the retroperitoneum, above and slightly medial to the kidneys. In humans, the right adrenal gland is pyramidal in shape, whereas the left is semilunar or crescent shaped and somewhat larger. [8]
Besides mediating the function of adrenal glands, medications may also be given to destroy the gland internally for hyperadrenalism to lower hormone levels. Mitotane is administered to promote apoptosis at the adrenal gland with the downregulation of P450 enzymes and accumulation of free cholesterol which direct cell oxidation rapidly, causing ...
Causes can include certain medications, sepsis, and bleeding into both adrenal glands. [1] [8] Addison's disease is generally diagnosed by blood tests, urine tests, and medical imaging. [1] Treatment involves replacing the absent or low hormones. [1] This involves taking a synthetic corticosteroid, such as hydrocortisone or fludrocortisone.
Adrenal insufficiency is a condition in which the adrenal glands do not produce adequate amounts of steroid hormones. The adrenal glands—also referred to as the adrenal cortex—normally secrete glucocorticoids (primarily cortisol), mineralocorticoids (primarily aldosterone), and androgens.
Congenital adrenal hyperplasia, diseases in the production of cortisol; Nelson's syndrome, the rapid enlargement of the ACTH producing pituitary after the removal of both adrenal glands; Adrenoleukodystrophy, can be accompanied by adrenal insufficiency; West syndrome ("infantile spasms"), a disease where ACTH is used as a therapy
If decreased blood pressure is detected, the adrenal gland is stimulated by these stretch receptors to release aldosterone, which increases sodium reabsorption from the urine, sweat, and the gut. This causes increased osmolarity in the extracellular fluid, which will eventually return blood pressure toward normal.
[1] [10] A single adrenal gland may also be removed in cases where only one is enlarged. [4] In cases due to enlargement of both glands, treatment is typically with medications known as aldosterone antagonists such as spironolactone or eplerenone. [1] Other medications for high blood pressure and a low salt diet, e.g. DASH diet, may also be needed.
This in turn results in an increase of blood pressure and blood volume. Aldosterone is produced in the zona glomerulosa of the cortex of the adrenal gland and its secretion is mediated principally by angiotensin II but also by adrenocorticotrophic hormone (ACTH) and local potassium levels.
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