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A little gland makes a lot of difference

Updated: May 27, 2021

The adrenal glands are located on top of the kidneys. The adrenal glands consist of the medullar the inner section and the cortex which surrounds it. The cortex contains 3 layers; the zona glomerulosa on the outside, zona fasciculata and the innermost layer the zona reticularis. These produce various hormones that are involved in the regulation of blood sugar, sex hormones and blood volume.

Primary adrenal insufficiency, also known as Addison’s disease is a condition that affected the adrenal glands so they do not produce enough steroid hormone. The cause of this is usually the autoimmune destruction of the adrenal glands. This destruction might not be clinically apparent for a number of years as the adrenal glands have an amazing ability to compensate in the production of hormones.

Addison’s disease is more commonly picked up when the patient is put through a major stressor such as surgery and the body is unable to produce glucocorticoids as a response, this is known as an Addisonian crisis. This results in hypotension (a drop in blood pressure) that can result in clinical shock. Due to the adrenal glands control of electrolytes within the kidneys, an Addisonian crisis results in a drop in pH within the blood leading to metabolic acidosis. This crisis can be fatal so as soon as it is suspected treatment of hydrocortisone should be commenced in high doses.


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