How the adrenal glands work – and what happens when they don’t

What do the adrenal glands do?

On top of the kidneys sit two small, triangular glands, one on each kidney, known as the adrenal glands. They are part of the endocrine system and are responsible for producing various hormones that influence almost all bodily functions. The adrenal glands consist of two main parts:

• Adrenal cortex: Produces cortisol (stress hormone), aldosterone (regulates blood pressure and fluid balance), and sex hormones.
• Adrenal medulla: Produces adrenaline and noradrenaline, which help the body handle stress and regulate blood pressure and heart rate.

Symptoms and signs of adrenal problems

So, what happens if the adrenal glands don’t function properly? This can lead to various symptoms, some of which may even appear on the face. Here are some common signs:

Fatigue, weight loss, low blood pressure, and darker skin patches can be symptoms of Addison's disease, a rare chronic condition affecting the adrenal glands. The disease results in insufficient production of cortisol and aldosterone.

Symptoms such as a rounder face (“moon face”), weight gain—especially around the abdomen—and thin skin with bruising may occur with Cushing’s syndrome, which is caused by high cortisol levels.

Another common term often used to describe adrenal issues is adrenal fatigue. This condition suggests that the body’s ability to handle stress is impaired because the adrenal glands have become "exhausted." Proponents claim that prolonged stress leads to insufficient cortisol production, resulting in symptoms like chronic fatigue, difficulty handling stress, dizziness, sugar cravings, and salt cravings.

However, while many people experience these symptoms, adrenal fatigue is not a recognized medical diagnosis. This is because there is no scientific evidence that the adrenal glands actually become exhausted or stop functioning normally due to stress. Research instead shows that the body’s stress response is more complex, and the symptoms may have other underlying causes.

Can the adrenal glands develop cancer?

Yes, although it is rare, the adrenal glands can develop cancer, known as adrenocortical carcinoma. Symptoms include abdominal pain, enlarged adrenal glands often detected via imaging, and hormonal imbalances such as overproduction of cortisol or aldosterone.

What does it mean to have enlarged adrenal glands?

Enlarged adrenal glands can be caused by various factors, including tumors, overactivity, or infections. This often requires further investigation with blood tests, hormone tests, and imaging diagnostics.

When should you seek medical care?

If you suspect problems with your adrenal glands, it is important to seek medical care. Signs that should be investigated include:

• Severe fatigue that doesn’t improve with rest
• Sudden weight changes
• Skin changes
• Unexplained blood pressure issues

The adrenal glands are small but powerful organs that play a central role in regulating bodily functions, including stress management, blood pressure, and fluid balance.

If you experience worrying symptoms such as extreme fatigue, unexplained weight changes, or prolonged sensitivity to stress, you should consult a doctor. To gain insight into your hormonal balance, you may consider taking a cortisol test, which shows if your cortisol levels are normal, high, or low. However, it is essential that a doctor interprets the results, as cortisol levels fluctuate throughout the day and are influenced by several factors beyond adrenal function.