Adrenal Disorders (Addison’s Disease & Cushing’s Syndrome)
What are Adrenal Disorders?
Adrenal disorders are conditions that arise when adrenal gland function is impaired. The adrenal glands are hormone-producing glands that regulate several bodily functions via the secretion of the following hormones: glucocorticoids (eg, cortisol), mineralocorticoids (eg, aldosterone), catecholamines (eg, epinephrine), and adrenal androgens (eg, dehydroepiandrosterone [DHEA]).
Disordered adrenal function can have significant adverse effects. Two major adrenal gland disorders are Addison’s disease (reduced adrenal function, often autoimmune) and Cushing’s syndrome (overactive adrenal function, often due to a tumor).
Natural interventions such as melatonin, calcium, and vitamin D may help support adrenal function.
What are the Causes and Risk Factors for Adrenal Disorders?
- Autoimmune disease
- Genetic abnormalities
- Overtreatment with glucocorticoid medications
- Certain drugs that interfere with adrenal hormone production
What are the Signs and Symptoms of Adrenal Disorders?
- Weakness and fatigue
- Low blood pressure upon standing
- Skin hyperpigmentation and bluish discoloration inside the mouth
- Rounded “moon” face
- Weight gain around the trunk with slender arms and legs
- Skin appears bruised
- Muscle weakness
- Anxiety and/or depression
- Abnormal hair growth and menstrual disorders in women
- Reduced libido in men
What are Conventional Medical Treatments for Adrenal Disorders?
- Hormone replacement therapy (eg, hydrocortisone or other glucocorticoids)
- Surgery to remove tumor, if possible
- Mifepristone to treat high blood sugar in people with Cushing’s who are not surgical candidates or who had failed surgeries
- Adrenal enzyme inhibitors (eg, ketoconazole) for patients with nonresectable tumors
- Mitotane to prevent the production of steroids in patients who cannot be cured surgically
- Pasireotide, a drug that can bind to adrenal cortex tumor cells and prevent the release of adrenocorticotropic hormone (ie, the hormone that regulates production and secretion of adrenal hormones)
What are Emerging Therapies for Adrenal Disorders?
- Stem cell therapy
What Dietary and Lifestyle Changes Can Be Beneficial for Adrenal Disorders?
- Avoid simple carbohydrates
- Maintain a healthy, well-balanced and steady diet; avoid “yo-yo dieting”
- Limit intake of stimulants (eg, caffeine)
- Exercise regularly
- Manage stress effectively; work to maintain a positive attitude and good self-esteem
- Get enough good quality sleep
What Natural Interventions May Be Beneficial for Adrenal Disorders?
- Melatonin. Cushing’s syndrome is associated with low melatonin levels and disruption of its circadian secretion. A study in healthy men showed that melatonin reduced cortisol secretion in response to an ACTH stimulation test.
- Calcium and vitamin D. Vitamin D supports calcium absorption, and its deficiency can contribute to osteoporosis. High cortisol levels and long-term glucocorticoid treatment lead to osteoporosis as well. Vitamin D and calcium supplements are recommended for people receiving long-term corticosteroids.
- Potassium. Potassium levels are low in individuals with Cushing’s syndrome, and low potassium levels are a significant determinant of cardiovascular complications in this population. People on ketoconazole treatment for Cushing’s syndrome should avoid potassium supplements, however, since it can also increase potassium levels.
- Other natural interventions that may help people with adrenal disorders include vitamin A, curcumin, licorice, DHEA, pantothenic acid, and coenzyme Q10.