Center for Thyroid, Parathyroid, and Adrenal Disease

What are overactive adrenal glands or functional adrenal tumors?

When adrenal glands produce excessive amounts of certain hormones, they are called “functional.” Symptoms and treatment depend on which hormones are being overproduced:

Androgenic steroids (androgen hormones): An overproduction of androgenic steroids (such as testosterone and dihydrotestosterone) can lead to exaggerated male characteristics in both men and women, such as hairiness of the face and body, baldness, acne, deeper voice, and more muscularity.

Corticosteroids: An overproduction of corticosteroids can lead to Cushing’s syndrome or disease (see below). Cushing’s syndrome is the result of an adrenal gland tumor or bilateral hyperfunction while Cushing’s Disease is a result of a pituitary (brain gland) tumor.

Catecholamines and Metanephrines: An overproduction of catecholamines and metanephrines can cause a significant elevation in blood pressure, heart rate and metabolism. Sudden stress or other activities result in acute elevation of these hormone levels in blood stream and may results in heart attack or stroke.

Aldosterone: An overproduction of the aldosterone hormone can lead to high blood pressure and to those symptoms associated with low levels of potassium, such as weakness, muscle aches, spasms, and sometimes paralysis.

How are overactive adrenal glands diagnosed?

In addition to a complete medical history and medical examination, diagnostic procedures for overactive adrenal glands may include:

Specific blood tests to measure levels of hormones
Urine tests to measure levels of hormones

Treatment of overactive adrenal glands

Treatment of overactive adrenal glands depends on the cause of the disease. Most cases are treated surgically but also depends on:

• Extent of the disease
• Your tolerance for specific medications, procedures, or therapies
• Expectations for the course of the disease

Treatment usually includes surgical removal of growths or the adrenal gland(s) itself. Certain drugs that block the excessive production of certain hormones may also be administered.

What is Cushing’s syndrome?

Cushing’s syndrome is the result of the excessive production of corticosteroids by the adrenal glands. An overproduction of corticotrophin (ACTH) —the hormone that controls the adrenal gland— by the pituitary gland, which stimulates the adrenal glands to produce corticosteroids, may be one cause. In addition, certain lung cancers and other tumors outside the pituitary gland may produce corticotropins. Other causes include benign or cancerous tumors on the adrenal glands.

What are the symptoms of Cushing’s syndrome?

The following are the most common symptoms of Cushing’s syndrome. However, each individual may experience symptoms differently. Symptoms may include:

• Upper body obesity
• Round face
• Increased fat around neck
• Thinning arms and legs
• Fragile and thin skin
• Stretch marks on abdomen, thighs, buttocks, arms, and breasts
• Bone and muscle weakness
• Severe fatigue
• High blood pressure
• High blood sugar
• Irritability and anxiety
• Excess hair growth in women
• Irregular or stopped menstrual cycles in women
• Reduced sex drive and fertility in men

How is Cushing’s syndrome diagnosed?

In addition to a complete medical history and medical examination, diagnostic procedures for Cushing’s syndrome may include:

• Blood test. This test measures ACTH level.
• 24-hour urinary test to measure for corticosteroid hormones.
• Computed tomography (CT scan). A noninvasive procedure that takes cross-sectional images of the brain or other internal organs; to detect any abnormalities that may not show up on an ordinary X-ray.
• Magnetic resonance imaging (MRI). A noninvasive procedure that produces two-dimensional views of an internal organ or structure, especially the adrenal glands and brain.
• Dexamethasone suppression test. This test differentiates whether the excess production of corticotropins are from the pituitary gland or tumors elsewhere.
• Corticotropin-releasing hormone (CRH) stimulation test. This test differentiates whether the cause is a pituitary tumor or an adrenal tumor.
• Other laboratory tests
• Treatment for Cushing’s syndrome

Treatment for Cushing’s syndrome depends on its cause. Surgery may be needed to remove tumors or the adrenal glands. Other treatment may include radiation, chemotherapy, and use of certain hormone-inhibiting drugs.