10 Common Adrenal Problems – When to Worry and When to See a Doctor

10 Common Adrenal Problems – When to Worry and When to See a Doctor

Clinically Reviewed by Dr. Andrew Stein MD, Consultant Physician. Last updated: April 2026

The adrenal glands, two small triangle-shaped organs sitting atop your kidneys, are the body’s primary chemical factories.

They produce essential hormones like cortisol (the stress hormone), adrenaline, and aldosterone (which controls blood pressure).

Because these glands influence almost every organ, adrenal problems can be “great mimics,” appearing as common issues like fatigue or high blood pressure. Early diagnosis by an Endocrinologist (hormone specialist) is vital for long-term health.

1. Cushing’s Syndrome (Cortisol Excess)

Cushing’s occurs when the body has far too much cortisol. This can be caused by a tumor on the adrenal gland, a tumor on the pituitary gland (Cushing’s Disease), or long-term use of steroid medications (like prednisolone).

• Key Symptoms: Rapid weight gain in the face (“moon face”) and abdomen, a fatty hump between the shoulders, purple stretch marks, and high blood sugar.

• When to Worry: If you develop “brittle” skin that doesn’t heal, or severe muscle weakness in the hips and shoulders.

• See a Doctor: If you have these physical changes alongside newly diagnosed hypertension or type 2 diabetes.

2. Addison’s Disease (Primary Adrenal Insufficiency)

This is the opposite of Cushing’s; the glands are damaged (often by the immune system) and cannot produce enough cortisol or aldosterone.

• Key Symptoms: Extreme exhaustion, unexplained weight loss, and “bronzing” of the skin (hyperpigmentation) that looks like a tan even in non-sunny areas.

• When to Worry: Intense salt cravings or frequent fainting spells.

• See a Doctor: If you experience chronic low blood pressure that makes you feel dizzy every time you stand up.

3. Adrenal (Addisonian) Crisis

This is the most dangerous adrenal condition. It happens when someone with adrenal insufficiency faces a sudden stressor (like an infection or surgery) and their body cannot produce the “life-saving” cortisol needed to cope.

• Key Symptoms: Sudden, severe pain in the lower back or legs, vomiting, and mental confusion.

• When to Worry: This is a medical emergency.

• See a Doctor: Go to A&E immediately if someone with known adrenal issues becomes drowsy or has a dangerously low blood pressure/pulse.

4. Phaeochromocytoma (Adrenaline-Producing Tumor)

This is a rare, usually non-cancerous tumor of the inner part of the adrenal gland. It releases bursts of adrenaline (epinephrine).

• Key Symptoms: The “Classic Triad”: sudden pounding headaches, profuse sweating, and heart palpitations.

• When to Worry: If your blood pressure “spikes” to very high levels suddenly and then returns to normal.

• See a Doctor: If you have anxiety-like attacks that occur even when you aren’t feeling stressed.

5. Conn’s Syndrome (Primary Hyperaldosteronism)

In this condition, the adrenal glands produce too much aldosterone, which tells the kidneys to keep too much salt and get rid of too much potassium.

• Key Symptoms: Persistent high blood pressure that doesn’t respond to standard medications, muscle cramps, and frequent urination.

• When to Worry: If a blood test shows unexplained low potassium (hypokalaemia).

• See a Doctor: If you are under 40 and have high blood pressure, as this is a common “hidden” cause.

6. Congenital Adrenal Hyperplasia (CAH)

CAH is a group of genetic disorders present from birth. The body lacks an enzyme needed to make cortisol, often producing too much androgen (male-type hormones) instead.

• Key Symptoms: In infants, ambiguous genitalia; in children, very early puberty or rapid growth followed by short adult stature.

• When to Worry: If a newborn shows signs of “salt-wasting” (dehydration and vomiting).

• See a Doctor: Pediatric endocrinologists should manage this from birth.

7. Adrenal Incidentaloma

With the rise of modern scanning (CT and MRI), doctors often find small lumps on the adrenal glands by accident while looking for something else.

• Key Symptoms: Usually none; they are found “incidentally.”

• When to Worry: If the mass is larger than 4cm or shows “irregular” borders on a scan.

• See a Doctor: Every incidentaloma needs a “work-up” to ensure it isn’t secreting hidden hormones or masking a malignancy.

8. Hypoaldosteronism

This is a deficiency in aldosterone. It is often linked to kidney disease or certain medications (like ACE inhibitors or NSAIDs).

• Key Symptoms: High potassium levels (hyperkalemia) and low blood pressure.

• When to Worry: If you experience heart palpitations or “skipping beats,” which can be caused by high potassium.

• See a Doctor: Especially if you have diabetes or chronic kidney disease (CKD), as your electrolyte balance is more fragile.

9. Adrenoleukodystrophy (X-linked ALD)

This is a serious genetic condition that affects the adrenal glands and the fatty covering (myelin) of the nerve cells in the brain.

• Key Symptoms: Behavioral changes, loss of vision, or difficulty with coordination, often appearing in childhood.

• When to Worry: If a child with known adrenal insufficiency starts struggling with school or motor skills.

10. Rare Adrenal Masses & Secondary Cancers

While primary adrenal cancer is very rare, the adrenal glands are a common site for “metastasis” (cancer spreading from elsewhere, like the lungs or breast).

• Key Symptoms: Flank pain or a feeling of fullness in the abdomen.

• When to Worry: If you have a history of cancer elsewhere and a new adrenal lump is found.

• See a Doctor: Specialists will use PET scans or biopsies to determine if the mass is benign or requires surgery.

Summary: Adrenal Health Checklist

Adrenal issues are complex because their symptoms (fatigue, weight change, blood pressure) are so common. Use the table below to help prioritize your concerns: