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The Adrenal Glands |

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The adrenal glands are two small organs that sit on top of the kidneys. They produce hormones like adrenaline and cortisol, which help regulate blood pressure, heart rate, and other functions in the body.

The adrenal cortex is a pair of glands that are found on top of the kidneys. They produce hormones that help regulate blood pressure, heart rate, and other bodily functions.

Bandwagons. You have to adore them. Bandwagons, on the other hand, are plentiful. Every sector has one, and far too many individuals are injured as a result of attempting to jump on one.

The health-care industry is no exception.

The issue with bandwagons is that they often provide overly simplistic solutions to complex issues. A recent example of a health industry bandwagon is vitamin D. Every week, a new study emerges highlighting the usefulness of Vitamin D in a variety of conditions, including depression, diabetes, and cancer. And it’s said that taking Vitamin D supplements will fix everything. Maybe, but I don’t think so. The majority of the time, the answers are a little more complicated.

The adrenal glands could also be thought of as a bandwagon because doctors feel they’re to blame for almost every ailment imaginable. But, when it comes to health, is relying on the adrenal glands a valid strategy or a simple explanation for a much more nuanced problem? Yes, yes, yes, yes, yes, yes, yes, yes, yeah, yes

An introduction to the adrenal glands

The adrenal glands are small, triangular-shaped glands that sit atop your kidneys, earning them the nickname “suprarenal glands” (from the Latin supra, which means “above”). The adrenal glands control our body’s stress response in a variety of ways.


The outer adrenal cortex and the inner adrenal medulla are the two primary portions of the adrenal glands.

The three layers of the adrenal cortex are further separated.

  • Mineralcorticoid production (i.e. aldosterone) takes place in the zona glomerulosa, which serves to maintain the body’s sodium/potassium balance.
  • The Zona fasciculata is the site of glucocorticoid (cortisol) production, which aids in blood sugar regulation.
  • The generation of sex hormones takes place in the Zona reticularis (i.e. DHEA, androstenedione)

(One way we learned to remember these three levels in medical school was to say, “Salt, sugar, sex… the deeper it goes, the sweeter it gets.”) It’s unimportant, but it’s catchy.)

The inner adrenal medulla has a direct connection to the brain, which makes the adrenal glands unique. The message to produce a hormone is sent to practically all other hormone-producing glands in the body via a chemical messenger that travels via the bloodstream. TSH, for instance, is a hormone that instructs the thyroid to create thyroid hormone. The hormone ACTH instructs the adrenal cortex to release cortisol.

The adrenal medulla, on the other hand, is a different story. There is a nerve that connects the brain to the adrenal glands directly. To Batman, it’s like Commissioner Gordon’s red phone. This is reasonable. You want your body to respond rapidly when you’re in a high-stress situation (like when the Penguin flees).

Adrenal glands that have malfunctioned

Let’s divide adrenal function into two areas for simplicity’s sake:

  1. Overactive
  2. Underactive

Cortisol and perhaps other adrenal hormones are frequently produced in excess by overactive adrenal glands (i.e. epinephrine, aldosterone). Cortisol plays a role in blood sugar elevation, hence this is frequently accompanied with a rise in blood sugar. This could lead to illnesses like insulin resistance and metabolic syndrome over time.

Underactive adrenal glands, on the other hand, produce insufficient amounts of hormones, particularly cortisol, to keep the body in a state of equilibrium. Hypoglycemic symptoms caused by blood sugar swings are a typical clinical condition with underactive adrenal glands. When blood sugar levels drop between meals or overnight while sleeping, normal, healthy bodies release cortisol to aid liberate glucose to maintain the operations of our brain, organs, and cells. When cortisol isn’t accessible, glucose levels drop to dangerously low levels. As a backup, the adrenal glands release epinephrine (also known as adrenaline). Low blood sugar produces lightheadedness, shakiness, and irritability, which is why persons with low blood sugar frequently wake up in the middle of the night.

What causes adrenal gland dysfunction? Unfortunately, a variety of factors contribute to this: mental/emotional stress, food allergies, blood sugar imbalances, parasite and bacterial infections, excessive exercise… basically anything that causes the body to feel stressed.

Physiology of the adrenal glands in the twenty-first century

Medical practitioners believed that the adrenal glands proceeded through stages of overactivity (alarm phase), decline (resistance phase), and finally underactivity (underactivity phase) forty years ago (exhaustion phase).

This is a reasonable model, however it isn’t supported by current evidence. We now know that the adrenal glands can go straight into overactivity or underactivity under the influence of specific metabolic processes, bypassing the first two phases.

A viral infection, for example, might cause the adrenal glands to become underactive due to a series of metabolic events. Food sensitivities, on the other hand, appear to encourage the body’s physiology to enhance adrenal hyperactivity.

Adrenal gland function is examined.

Make your own version at home!

If you have a blood pressure monitor, there is one rather simple test you can perform. The orthostatic hypotension test is what it’s called. Take your blood pressure after lying down for around 5 minutes and note the systolic pressure (the top number). Then get up and check your blood pressure once more.

There’s a probability you don’t have adequate adrenal medulla function or epinephrine secretion if your systolic pressure stayed the same or dropped. Epinephrine is generally secreted when we stand to assist keep our blood pressure up and prevent gravity from dragging blood away from our brain. If your blood pressure lowers, it’s possible that epinephrine isn’t working properly.

Change in systolic pressure Possibility of discovery
Increases in pressure by 6-10 mm/Hg Adrenal function that is healthy
Changes nothing Adrenal function is normal.
1-10 mm/Hg drops Adrenal dysfunction
Drops of more than ten millimeters per hour Exhaustion of the adrenal glands

The paradoxical pupillary reflex is another at-home test you can perform. Take a flashlight and shine it into one eye at a 45 degree angle from the side while standing in front of a mirror in a dark room. Keep an eye on your pupil.

Your pupil should be dilated when you’re in the dark (open). It should constrict when you shine the light on it. Although there are other reasons for a favorable result on this test, the duration of constriction can indicate adrenal function. Repeat with the other eye after 30 seconds in the dark. (Chew some wintergreen Lifesavers if you grow bored while waiting.)

Constriction of the pupils Possibility of discovery
Constriction lasts at least 20 seconds Adrenal function that is healthy
After 10 seconds, fasciculates (pulses). Adrenal function is normal.
In 5-10 seconds, fasciculates (pulses). Adrenal dysfunction
Pulsation and dilation occur immediately. Exhaustion of the adrenal glands

Testing in the lab

Laboratory testing can be used to examine function of the adrenal gland in a number different ways. The adrenal salivary test is by far the most popular. It collects four salivary samples during the day and analyzes salivary cortisol and DHEA levels. The adrenal salivary test, along with patient history, symptomaology, and clinical observation, is one of the most effective approaches to assess adrenal gland function and determine a treatment plan.

As a side note, think twice about using hormone replacement therapy.

People frequently inquire about hormone replacement therapy in practice and on the Forum. Before considering HRT, there are three things that must be in good working order:

  1. adrenal gland function
  2. equilibrium of blood sugar; and
  3. gastrointestinal health

Adrenal gland management

If your adrenal glands are bothering you, the first thing you should do is eliminate or address the source of stress. This could include removing food allergies, treating an infection, relieving mental/emotional stress, or anything else is causing the adrenal glands to malfunction.

These are some therapy choices based on the results of the adrenal salivary test after you’ve addressed the source of stress:

  • Adaptogenic herbs — A variety of botanicals are known as “adaptogens” because of their remarkable capacity to aid the body’s stress response. They can assist to reduce the stress response in adrenal glands that are overactive and raise the response in adrenal glands that are underactive.
  • Licorice root – This plant is primarily used in the treatment of underactive adrenal glands, and it can assist to raise circulating cortisol levels until the adrenal glands are restored to normal function. It is not suggested for those with high blood pressure because of its effects on aldosterone, but I believe it can be used safely when supervised by a skilled medical professional.
  • Phosphytidylserine is most known for its ability to reduce cortisol levels. Its effects, however, are understated. Because of its substantial effects on the hypothalamus, which is a critical regulator in the feedback loop between the pituitary and adrenal glands, PS should be administered in both hyperactive and underactive adrenal glands. Though orally taking 600-800 mg of PS appears to be beneficial, I prefer to use a topical application of PS to acquire even larger doses while keeping prices down.
  • Pregnenolone and DHEA are two hormones that are sometimes advised for mending the adrenal glands, notwithstanding my minor disapproval of hormone replacement. Please don’t use them unless you’re under the care of a trained medical expert.


The adrenal glands and their hormones have significant physiological effects on human bodies, such as bone metabolism, hormonal balance, gastrointestinal function, thyroid function, brain health, blood sugar balance, inflammation, immune system function, and so on. However, in today’s world, sustaining one’s adrenal glands is significantly more difficult than it was in the past. To help our bodies cope with stress, thorough testing, examination of many various physiological systems in the body, and nutritional support are required. Unfortunately, traditional medical practitioners are unaware of this, and many alternative doctors rely on outmoded adrenal gland models.

Author information

Dr. Bryan P. Walsh is a Naturopathic Doctor that focuses on nutritional biochemistry, functional laboratory testing, and natural medicine. He is currently an advisor to the team and a guest lecturer at the University of Maryland School of Medicine. He has also presented at national conferences. Click here for additional information.

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The adrenal glands are a pair of endocrine glands that sit on top of each kidney. They produce hormones that help control the body’s response to stress and maintain normal levels of blood sugar, salt, and water. Reference: does kidney disease affect adrenal glands.

Frequently Asked Questions

What are the signs of adrenal gland problems in females?

Signs of adrenal gland problems in females include fatigue, weight loss, dry skin, and hair loss.

What happens when the adrenal gland is not functioning properly?

The adrenal gland is a small, pear-shaped gland that sits on top of the kidney. It produces hormones that help control blood pressure, heart rate, body temperature, and sugar levels. When the adrenal gland is not functioning properly it can lead to low blood pressure, high blood pressure, low body temperature, and an increased risk of diabetes.