What causes adrenal gland disorders?

Adrenal gland disorders are caused by problems with one or both adrenal glands or by problems with other glands, such as the pituitary gland.

Specific disorders can develop when the adrenal glands produce too few or too many hormones, or when too many hormones are introduced from an outside source.1

Cushing's syndrome occurs when the body is exposed to high levels of the hormone cortisol over a long period of time.

Sometimes Cushing's syndrome develops when people take certain hormones for asthma, rheumatoid arthritis, lupus, and other inflammatory diseases. The syndrome also can occur when hormones are taken to suppress the immune system so that a patient's body will not reject a transplanted organ.

Other people develop Cushing's syndrome because their bodies produce too much cortisol.2 Other causes of Cushing's syndrome include pituitary adenomas (a type of benign tumor), ectopic adrenocorticotropic hormone syndrome, adrenal tumors, or familial Cushing's syndrome.2 Cushing's syndrome due to tumors occurs more commonly in women.2

CAH is a group of inherited disorders of the adrenal glands. It affects men and women equally. Both parents must carry the gene in order for a child to be born with CAH.3

Scientists have not yet discovered what causes pituitary tumors. Most pituitary tumors are not inherited; only a small percentage of cases run in families. 4,5

Most of the time, pheochromocytoma and paraganglioma tumors are "sporadic," meaning why they develop is not associated with any known risk factor or genetic mutation. However, research increasingly shows that a number of patients, possibly up to one-quarter, have genetic mutations responsible for tumor development.6,9 In these patients, family members may also be affected.

In all cases of Addison's disease, the adrenal glands do not produce enough of the hormone cortisol. In most cases, the glands also make too little of the hormone aldosterone.7 This is also termed primary adrenal insufficiency. This disease can be caused by an autoimmune disorder, infection (for example, tuberculosis), or other rare diseases that cause infiltration and thus destruction of the adrenal glands (for example, sarcoidosis or amyloidosis). The most common cause of Addison's disease in developed countries is autoimmune disorders.

There are two causes of hyperaldosteronism. One cause is an excessive growth of normal cells in both adrenal glands. The other cause is a non-cancerous tumor in one of the glands.8 There are no known gene mutations associated with this disorder at this time. However, rarely, hyperaldosteronism can run in families.

Citations

  1. New York Times Health Guide. (2008). Exogenous adrenal insufficiency. Retrieved May 25, 2016, from http://www.nytimes.com/health/guides/disease/exogenous-adrenal-insufficiency/overview.html external link
  2. National Endocrine and Metabolic Diseases Information Service, National Institute of Diabetes and Digestive and Kidney Diseases. (2012). Cushing's syndrome. Retrieved May 25, 2016, from https://www.niddk.nih.gov/health-information/endocrine-diseases/cushings-syndrome
  3. Endocrine Society (2022). Congenital adrenal hyperplasia. Retrieved February 13, 2024, from https://www.endocrine.org/patient-engagement/endocrine-library/congenital-adrenal-hyperplasia external link.
  4. Asa, S. L., & Ezzat, S. (2002). The pathogenesis of pituitary tumours. Nature Reviews Cancer, 2, 836–849.
  5. Melmed, S. (2011). Pathogenesis of pituitary tumors. Nature Reviews Endocrinology, 7, 257–266.
  6. Chen, H., Sippel, R.S., O'Dorisio, M.S., Vinik, AI., Lloyd, R.V., Pacak, K.; et al. The North American Neuroendocrine Tumor Society consensus guideline for the diagnosis and management of neuroendocrine tumors: pheochromocytoma, paraganglioma, and medullary thyroid cancer. Pancreas, 39, 775-783. Retrieved March 2, 2018, from https://www.ncbi.nlm.nih.gov/pubmed/20664475
  7. Society for Endocrinology. (2015). Addison's disease. Retrieved May 25, 2016, from https://www.yourhormones.info/endocrine-conditions/addisons-disease/ external link
  8. Society for Endocrinology. (2013). Hyperaldosteronism. Retrieved May 25, 2016 from http://www.yourhormones.info/endocrine-conditions/primary-hyperaldosteronism/ external link
  9. Chen, H., Sippel, R.S., O'Dorisio, M.S., Vinik, AI., Lloyd, R.V., Pacak, K.; et al. The North American Neuroendocrine Tumor Society consensus guideline for the diagnosis and management of neuroendocrine tumors: pheochromocytoma, paraganglioma, and medullary thyroid cancer. Pancreas, 39, 775-783. Retrieved March 2, 2018, from https://www.ncbi.nlm.nih.gov/pubmed/20664475
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