Adrenal glands: functions, characteristics and diseases.

These glands are in charge of producing hormones that fulfill a series of fundamental functions.

Our endocrine system is made up of a set of organs and tissues that are responsible for regulating vital functions for our organism through the release of different hormones.

Aspects as important for survival as the proper functioning of the metabolism or the immune system depend, to a large extent, on the adrenal glands, two small organs responsible for secreting hormones such as cortisol, adrenaline or noradrenaline into the bloodstream.

In this article we explain what the adrenal glands are, what their structure is, what their functions are and what they do.What is their structure, what are their functions in our body and what are the most common diseases and disorders related to a malfunction of these glands.

Adrenal glands: definition and structure

The adrenal glands are small, triangular-shaped endocrine organs located on top of both kidneys.. These glands are responsible for producing hormones that help regulate metabolism, the immune system, blood pressure, stress response and other essential functions.

Each person has two adrenal glands, which can be divided into two parts: the outer portion, called the adrenal cortex; and the inner portion, which is called the adrenal medulla. The adrenal cortex is responsible for creating three different types of hormones: mineralocorticoids that conserve sodium in the body, glucocorticoids that increase blood glucose levels, and gonadocorticoids that regulate sex hormones such as estrogen.

The adrenal cortex and adrenal medulla are enveloped in a fatty capsule that forms a protective layer around the adrenal gland. The adrenal cortex is essential for our survival; if it were to cease to function properly, collapse and death would most likely result, as it controls basic metabolic processes for life.

The adrenal medulla, which is located within the adrenal cortex in the center of the gland, is responsible for secreting "stress hormones" such as adrenaline and noradrenaline. Let us take a closer look at what these and other hormones produced in the adrenal glands consist of and what their functions are.

Hormones of the adrenal glands

The role of the adrenal glands in our body is to release certain hormones directly into the bloodstream.many of which have to do with how the body responds to stress, and as we have discussed above, some of which are vital for survival.

Both parts of the adrenal glands, the adrenal cortex and the adrenal medulla, perform distinct and separate functions, and each area of the adrenal cortex secretes a specific hormone. Here are the key hormones produced by the adrenal cortex:

1. cortisol

Cortisol is a glucocorticoid hormone produced by the zona fasciculata that plays several important roles in the body. It helps control the body's use of fats, proteins, and carbohydrates; suppresses inflammation; regulates blood pressure; increases blood sugar; and may also decrease bone formation. This hormone also controls the sleep-wake cycle and is released in times of stress to help the body get an energy boost and better handle an emergency situation.

The adrenal glands produce hormones in response to signals from the pituitary gland in the brain, which reacts to signals from the hypothalamus. This is known as the hypothalamic-pituitary-adrenal axis. For the adrenal gland to produce cortisol, the following occurs: first, the hypothalamus produces corticotropin-releasing hormone (CRH) which stimulates the pituitary gland to secrete adrenocorticotropic hormone (ACTH).

ACTH then stimulates the adrenal glands to produce and release cortisol into the blood (if there is too much or too little cortisol, these glands respectively change the amount of CRH and ACTH that is released, in what is known as a negative feedback loop). Excessive cortisol production can occur from nodules in the adrenal gland or excessive ACTH production from a pituitary tumor or other source.

2. Aldosterone

Aldosterone is a mineralocorticoid hormone produced by the zona glomerulosa of the adrenal cortex and plays a central role in the regulation of blood pressure and certain electrolytes (sodium and potassium).

This hormone sends signals to the kidneys, causing them to absorb more sodium into the bloodstream and release potassium into the urine. This means that aldosterone also helps regulate blood pH by controlling electrolyte levels in the blood.

3. DHEA and androgenic steroids

DHEA and androgenic steroids are produced by the zona reticularis of the adrenal cortex.and are precursor hormones that are converted in the ovaries into female hormones (estrogens) and in the testes into male hormones (androgens).

However, the ovaries and testes produce estrogens and androgens in much larger quantities.

4. Adrenaline and noradrenaline

The adrenal medulla controls the hormones that initiate the fight or flight response.. The main hormones secreted by the adrenal medulla include epinephrine (adrenaline) and norepinephrine (noradrenaline), which have similar functions.

Among other functions, these hormones are able to increase heart rate and the strength of cardiac contractions, increase blood flow to the muscles and brain, relax smooth muscles in the airways, and aid in glucose (sugar) metabolism.

They also control the compression of blood vessels (vasoconstriction), which helps maintain blood pressure and increase blood pressure in response to stress. Like other hormones produced by the adrenal glands, adrenaline and noradrenaline are often activated in situations of physical and emotional stress when the body needs extra resources and energy to withstand unusual strain.

Functions

The adrenal glands are an intricate part of the hypothalamic-pituitary-adrenal axis.. The hypothalamus acts as the body's thermostat and senses most of the important physiological elements involved in homeostasis, sending signals to correct perceived harmful variations.

It connects directly to the pituitary gland, which essentially picks up orders from the hypothalamus and sends signals to various organs and glands, including the adrenal glands, to carry out these orders.

A wide range of hormones, including estrogens, adrenaline and cortisol, are produced by the adrenal glands. One of the main activities of cortisol is to increase the glucose available to the nervous system by breaking down proteins and fats into glucose in the liver, helping to block glucose uptake in tissues other than the central nervous system.

Cortisol also has powerful Anti-Inflammatory and anti-allergic actions, and decreases the activities of the immune system to reduce inflammatory conditions.

Another of the most important functions of the adrenal glands is the fight or flight response. When a person is stressed or frightened, the adrenal gland releases a flood of hormones, such as adrenaline and cortisol.These hormones, such as adrenaline and cortisol, increase heart rate, raise blood pressure, increase energy supplies, sharpen concentration and slow down other bodily processes so that the body can escape or fight a threat.

However, an excessive stress response can be counterproductive. Excessive exposure to stress hormones from the adrenal gland can cause anxiety, depression, digestive problems, headaches, headaches, heart disease, sleep problems, weight gain, and impaired memory and concentration. The following are the most common disorders related to excess adrenal hormone production.

Related disorders

The two most common ways that the adrenal glands cause health problems are by producing too little or too much of certain hormones, leading to hormonal imbalances.

These abnormalities of adrenal function can be caused by various diseases of the adrenal glands or pituitary gland. Let us look at the main disorders related to abnormal functioning of the adrenal glands..

1. Adrenal insufficiency

Adrenal insufficiency is a rare disorder. It can be caused by a disease of the adrenal glands (primary adrenal insufficiency or Addison's disease) or by diseases of the hypothalamus or pituitary gland (secondary adrenal insufficiency). This condition is characterized by low levels of adrenal hormones and symptoms include: weight loss, lack of appetite, nausea and vomiting, fatigue, darkening of the skin (only in primary adrenal insufficiency) and abdominal pain, among others.

Causes of primary adrenal insufficiency may include autoimmune disorders, fungal and other infections, cancer (rarely) and genetic factors. Although adrenal insufficiency usually develops over time, it can also appear suddenly as an acute adrenal insufficiency (adrenal crisis). It has similar symptoms, but the consequences are more severe, and include life-threatening seizures and coma.

2. Congenital adrenal hyperplasia

Adrenal insufficiency can also result from a genetic disorder called congenital adrenal hyperplasia. Children born with this disease lack an essential enzyme needed to produce cortisol, aldosterone or both. At the same time, they often experience an excess of androgens, which can lead to masculine characteristics in girls and precocious puberty in boys.

Congenital adrenal hyperplasia can remain undiagnosed for years, depending on the severity of the enzyme deficiency. In more severe cases, infants may suffer from ambiguous genitalia, dehydration, vomiting and failure to thrive.

3. Cushing's syndrome

Cushing's syndrome is caused by excessive production of cortisol in the adrenal glands.

Symptoms may include weight gain and fat deposits in certain areas of the body, such as the face, under the back of the neck (called buffalo hump) and on the abdomen; thinning arms and legs; purple stretch marks on the abdomen; facial hair; fatigue; muscle weakness; easily bruised skin; high blood pressure; diabetes; and other health problems.

Excess cortisol production can also be triggered by overproduction of adrenocorticotropic hormone (ACTH), a benign tumor in the pituitary gland, or a tumor elsewhere in the body. This is known as Cushing's disease. Another common cause of Cushing's syndrome is excessive and prolonged use of external steroids, such as prednisone or dexamethasone, which are prescribed to treat many autoimmune or inflammatory diseases.

4. Hyperaldosteronism

Hyperaldosteronism is a disorder caused by overproduction of aldosterone in one or both adrenal glands.

This causes an increase in blood pressure that often requires many medications in order to be controlled. Some people may develop low levels of potassium in the blood, which can cause muscle aches, weakness and spasms.

5. Pheochromocytoma

Pheochromocytoma is a tumor that causes excess production of adrenaline or noradrenaline in the adrenal medulla. Occasionally, neural crest tissue (a structure of few cells that exists transiently in early embryonic development), which has a tissue similar to the adrenal medulla, may be the cause of the overproduction of these hormones, which is known as paraganglioma.

Pheochromocytomas can cause persistent or sporadic high blood pressure that may be difficult to control with common medications. Other symptoms include headaches, sweating, tremors, anxiety and rapid heartbeat. Some people are genetically predisposed to develop this type of tumor.

Bibliographic references:

• Fardella, B. (2001). Congenital adrenal hyperplasia. Revista chilena de pediatría, 72(5), 408-415.

• Rosol, T. J., Yarrington, J. T., Latendresse, J., & Capen, C. C. (2001). Adrenal gland: structure, function, and mechanisms of toxicity. Toxicologic pathology, 29(1), 41-48.

• Tsigos, C., & Chrousos, G. P. (2002). Hypothalamic-pituitary-adrenal axis, neuroendocrine factors and stress. Journal of psychosomatic research, 53(4), 865-871.