Adrenal disorders encompass a range of hormonal conditions arising from dysfunction of the adrenal glands, which are responsible for producing cortisol, aldosterone, and adrenal androgens. Two clinically significant adrenal disorders are Cushing’s syndrome, caused by excess cortisol, and Addison’s disease, resulting from adrenal hormone deficiency. Both conditions profoundly affect metabolism, cardiovascular health, immune function, and stress response.

Cushing’s syndrome occurs when the body is exposed to chronically elevated cortisol levels. This may result from prolonged corticosteroid use or endogenous overproduction due to adrenal tumors, pituitary adenomas, or ectopic hormone secretion. Excess cortisol disrupts glucose metabolism, promotes fat redistribution, weakens bones, and suppresses immune function.

Patients with Cushing’s syndrome often present with weight gain, central obesity, facial rounding, muscle weakness, easy bruising, hypertension, diabetes, osteoporosis, and mood changes. Diagnosis requires specialized hormonal testing to confirm cortisol excess and identify its source. Untreated disease significantly increases cardiovascular risk and mortality.

Addison’s disease, or primary adrenal insufficiency, is caused by destruction or dysfunction of the adrenal cortex, most commonly due to autoimmune processes. This leads to deficient cortisol and aldosterone production. Symptoms develop gradually and include chronic fatigue, weight loss, low blood pressure, salt craving, gastrointestinal symptoms, and skin hyperpigmentation.

Diagnosis of Addison’s disease involves demonstrating low cortisol levels with elevated adrenocorticotropic hormone (ACTH), along with electrolyte abnormalities such as low sodium and high potassium. Prompt diagnosis is essential, as untreated adrenal insufficiency can progress to adrenal crisis, a life-threatening emergency characterized by shock and severe electrolyte imbalance.

Management of adrenal disorders depends on the underlying condition. Cushing’s syndrome treatment focuses on removing or suppressing the source of cortisol excess, while Addison’s disease requires lifelong hormone replacement therapy. Patient education regarding stress dosing and emergency management is a cornerstone of adrenal care.

With appropriate diagnosis and specialized endocrine management, individuals with adrenal disorders can achieve hormonal stability and significantly improved quality of life.