Adrenal glands: quick fire questions | Top Doctors (2024)

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Written by: Professor Sze May Ng OBE

Published: 28/06/2024

Edited by: Aoife Maguire

Leading consultant paediatric endocrinologist and consultant paediatrician Professor Sze May Ng OBE answers your quick-fire questions about adrenal glands, including the causes of adrenal glands disorders, and how they can be treated.

Adrenal glands: quick fire questions | Top Doctors (2)

What are adrenal glands?

Adrenal glands are super renal glands situated above the kidneys, and are responsible for producing cortisol and aldosterone. Adrenal disorders often involve adrenal insufficiency, a rare condition characterised by inadequate production of these hormones. This disorder is rare, affecting an estimated 100 to 150 people per million, with an incidence rate of 5 to 6 per million per year. The adrenal glands are essential because they produce cortisol, a vital hormone for various bodily functions.

Why is the hormone cortisol important?

The hormone cortisol is important because it helps the body to respond to stress such as illness and infection, as well as when undergoing surgery. Cortisol helps to maintain blood pressure, blood sugar levels, and cardiovascular function, It also works to regulate the body's metabolism.

What is the importance of the hormone aldosterone?

The hormone aldosterone is crucial for regulating the balance of salt and water in the body. Additionally, it helps to also regulate blood pressure.

What are the causes of adrenal disorders and adrenal insufficiency?

The causes of adrenal insufficiency can be classified as primary, secondary, or due to chronic cortisol exposure. Primary adrenal insufficiency, commonly known as Addison's disease, occurs when the adrenal glands fail to produce enough cortisol. This can result from infections, bleeding into the glands, tumours, or autoimmune processes.

Secondary adrenal insufficiency happens when the pituitary gland fails to produce adequate Adrenocorticotropic Hormone (ACTH), which signals the adrenal glands to produce cortisol. Without enough ACTH, cortisol production drops. This can be caused by infections, pituitary tumours, congenital hypopituitarism from birth, or complications from surgery.

The third cause of adrenal insufficiency is prolonged exposure to high levels of cortisol, such as from taking steroid medications (orally or topically) for conditions like autoimmune diseases, cancer, or severe asthma. This prolonged exposure can suppress the adrenal glands, leading to reduced production of the body's own cortisol and resulting in adrenal insufficiency.

What investigations would be required?

The typical investigations a GP or clinician might conduct include measuring early morning plasma or blood cortisol levels. This serves as a screening test. The gold standard test, often requiring a short hospital admission, is the hormone dynamic function test known as the synacthen test.

What are treatment options?

Treatment for all forms of adrenal insufficiency typically involves hormone replacement therapy. This includes medications like hydrocortisone to replace cortisol and fludrocortisone to replace aldosterone. Specialists may prescribe different types of cortisol preparations based on the specific needs of the patient.

Treatments for all forms of adrenal insufficiency is generally replacement of the hormones made by the adrenal glands such as hydrocortisone medications to replace cortisol or fludrocortisone medications to replace aldosterone and there are different types of cortisol preparations that can be prescribed by the specialist.

What are the signs of adrenal disorders, Addison’s disease or adrenal insufficiency?

The signs of adrenal insufficiency can develop slowly over months. These signs may include extreme tiredness and unexplained weight loss, reduced appetite, darkening of the skin (hyperpigmentation), low blood pressure, low blood sugars, and in some cases, abnormal menstrual periods.

If you have any concerns about adrenal glands and would like to book a consultation with Professor Ng, you can do so by visiting her Top Doctors profile today.

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By Professor Sze May Ng OBE


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Professor Sze May Ng OBE is a highly respected consultantpaediatric endocrinologistand consultant paediatrician of international renown based in Liverpool. She is revered for her expertise in endocrine hormone disorders in children, as well as general paediatrics, growth and puberty.She is also a leading expert in paediatric endocrine disorders, thyroid, puberty, growth and diabetes and has written the books Me and My Hormones and A Guide to Type 1 Diabetes. Additionally she co...

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e-ConsultationCall to make an appointment

By Professor Sze May Ng OBE
Paediatric endocrinology, diabetes & metabolism

Professor Sze May Ng OBE is a highly respected consultantpaediatric endocrinologistand consultant paediatrician of international renown based in Liverpool. She is revered for her expertise in endocrine hormone disorders in children, as well as general paediatrics, growth and puberty.She is also a leading expert in paediatric endocrine disorders, thyroid, puberty, growth and diabetes and has written the books Me and My Hormones and A Guide to Type 1 Diabetes. Additionally she consults on as an expert witness in medicolegal matters.

Professor Ng has an extensive academic background, first qualifying in medicine at the University of Sydneyin 1999 before pursuing further training, both in Australia and the north of England. She completed her subspecialty training in paediatric endocrinology and diabetes at Alder Hey Children’s Hospital and following this, was awarded the highly prestigiousMedical Research Council UK fellowship. She has completed a Master’s in medical science, diabetes and endocrinology and a PhD in child health and neonatal endocrinology at the University of Liverpool. Professor Ng is also an accredited acupuncturistwith the British Academy of Western Medical Acupuncture and a Fellow of theRoyal College of Paediatrics. Her wealth of expertise and clinical experience have brought her international renown and she was awarded an OBE as part of Her Majesty The Queen’s 2022 Birthday Honours in recognition of her service to people with diabetes, autism and disabilities. Alongside her clinical responsibilities at Mersey and West Lancashire Teaching Hospitals Trust, she is also an associate medical director. Professor Ng sees private patients at Spire Liverpool Hospital.

Additional to her extensive medical education, Professor Ng holds a number of certifications relating to medicolegal matters and healthcare management, including a Master of Laws qualification, an advanced higher diploma in healthcare business and finance and a Master’s in business administration. Professor Ng regularly appears in court as an expert witness, sharing her specialist insight on cases involving general paediatrics, as well as paediatric endocrinology and diabetes. She is also a fellow of the Higher Education Academy and a senior fellow of the Faculty of Medical Leadership and Management. She holds a number of senior positions in medical education, including as honorary professor at Edge Hill University and honorary associate professor at the University of Liverpool.

Throughout her career, Professor Ng has been awarded a number of prizes in recognition of the excellence of her research and dedication to her practice, includingNational Clinical Excellence awards in 2018 and 2021 and Diabetes UK’sArnold Bloom andMary McKinnon Awards. She has also received theUniversity of Liverpool Alumni Awardand is a Diabetes Quality in Care winner. She serves as voluntary chief medical advisor for Action4Diabetes, a UK based charity which aids disadvantaged children who have diabetes in south east Asia.

Professor Ng maintains an active interest in research and holds the esteemed position of officer for research for the Royal College of Paediatrics and Child Health, and formerly was a training advisor for the College’s endocrinology and diabetes programmes. Professor Ng has been featured in the Lancet, the world's highest impact academic journal, in their In Focus Profile in 2023. She is also editor in chief for Diabetes Care for Children and Young People and regularly serves as a reviewer for the world’s leading academic journals. Additionally, she has published a wealth of her own academic papers throughout her esteemed career. She has also authored several books on topics within her specialist field, including diabetes management and the endocrine system and hormonal conditions.

Additionally, she has written a book on autism ‘A Journey with Brendan’, providing a first-hand account of bringing up a child with autism, bringing together a wide range of resources and practical advice to help families cope. She is an autism advocate, promoting awareness by regularly contributing to international parenting podcasts and magazines on the topic.

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