Adrenal Disorders in Sharjah
Medically reviewed by Dar Al Kamal Team
What are adrenal disorders?
Adrenal disorders are problems with the adrenal glands, two small glands that sit on top of the kidneys and make hormones the body relies on every day. Cortisol helps you cope with stress and illness and keeps blood sugar and blood pressure steady. Aldosterone controls salt, potassium and fluid. Adrenaline and related hormones prepare the body for sudden effort. At Dar Al Kamal Hospital, Sharjah, the endocrinology team investigates and treats adrenal disorders with medicine, and works with the surgical team when an operation is the right treatment.
The main adrenal disorders are:
| Condition | What is happening | Typical signs |
|---|---|---|
| Cushing's syndrome | too much cortisol | weight gain around the middle and face, wide purple stretch marks, thin skin, easy bruising, weak thigh muscles, high blood pressure and blood sugar |
| Addison's disease | the adrenal glands make too little cortisol and aldosterone | tiredness, weight loss, dizziness on standing, salt craving, darkening of the skin and gums |
| Primary aldosteronism | too much aldosterone | high blood pressure that is hard to control, sometimes with low potassium |
| Adrenal nodule | a lump in the gland, usually found by chance on a scan | often none; some nodules release hormones |
Two facts surprise many patients. The most common cause of Cushing's syndrome is steroid medicine itself, taken as tablets, injections, creams or inhalers over long periods. And low cortisol often comes from stopping long-term steroid tablets suddenly, because the adrenal glands have rested while the tablets did their work.
Who needs it
Adrenal assessment is worth arranging if you have:
- an adrenal nodule reported on a CT or MRI scan done for another reason, often called an adrenal incidentaloma
- high blood pressure at a young age, high blood pressure needing several medicines, or high blood pressure with low potassium
- features of Cushing's syndrome, especially several of them appearing together
- unexplained tiredness, weight loss, low blood pressure and salt craving, or darkening of the skin
- episodes of pounding heartbeat, headache and sweating with high blood pressure
- long-term steroid use and a plan to reduce or stop it
What happens
The endocrinology team takes a careful history, including every steroid-containing product you use, and examines your skin, muscles and blood pressure. Adrenal hormones follow a daily rhythm, so test timing matters and you receive exact instructions.
Common tests include:
- Morning cortisol, since cortisol peaks early in the day.
- An overnight suppression test: a tablet taken late in the evening, then a blood test the next morning, to see whether cortisol switches off as it should.
- A stimulation test: blood tests before and after an injection of a hormone that prompts the adrenal glands, to check they can respond to stress.
- Aldosterone and renin blood tests for high blood pressure, with advice on any blood pressure medicines to adjust beforehand.
- Urine or saliva collections for cortisol or adrenaline-related hormones.
Imaging of the adrenal glands, usually a CT scan, is arranged through Radiology. For an adrenal nodule the team answers two questions: is it releasing hormones, and does its appearance on the scan look harmless.
Treatment then follows the diagnosis. Addison's disease and other forms of low cortisol are treated with lifelong replacement tablets and clear sick-day rules. Overactive nodules and some larger nodules are considered for adrenal gland surgery, carried out by the general surgical team. Primary aldosteronism may be treated with surgery or with a medicine that blocks aldosterone. Blood pressure care continues alongside through hypertension management.
Preparing for it
Bring a list of every medicine, including steroid creams, inhalers, joint injections, eye drops and herbal products, since some contain hidden steroids. Bring any scan reports that mention the adrenal glands, and previous blood pressure and potassium results.
Follow the timing instructions for each test exactly. Some tests need an early morning appointment, and some blood pressure medicines are changed for a few weeks before aldosterone testing. If you use contraceptive pills containing oestrogen, mention them, because they affect cortisol results.
Afterwards
If you are started on cortisol replacement, the endocrinology team teaches you the sick-day rules: increasing the dose during a fever or illness, and using an emergency injection if you are vomiting. Carry a steroid emergency card or wear medical identification. Keep a spare supply of tablets when travelling.
The Sharjah summer and Ramadan both need planning. Heat, sweating and dehydration raise the body's need for salt and cortisol, and fasting changes the timing of doses, so discuss Ramadan with the team well before it begins.
Contact the hospital if you have a fever or illness and are unsure how to adjust your replacement tablets. **Go to the emergency department straight away if you have known adrenal insufficiency and develop vomiting, severe weakness, abdominal pain, confusion or collapse, as this can be an adrenal crisis.**
Cost and insurance
UAE insurance plans usually cover endocrinology consultations and standard hormone tests when there is a clinical reason. Dynamic tests such as suppression and stimulation tests, adrenal imaging and surgery commonly need pre-approval. Dar Al Kamal Hospital, Sharjah can help you check your cover on 06 599 7777.
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Frequently asked questions
What are the risks of adrenal disorders if left untreated?
Untreated adrenal disorders carry serious risks: low cortisol can lead to a life-threatening adrenal crisis during illness, while excess cortisol or aldosterone raises the risk of diabetes, bone thinning, heart disease and stroke. Adrenal surgery has its own risks, which the surgical team explains before any operation.
Is an adrenal nodule cancer?
Most adrenal nodules found by chance on a scan are harmless growths that release no hormones. A small number release hormones or have features on the scan that need closer attention, which is why every adrenal nodule is checked with blood or urine tests and a review of its appearance.
Can I stop my steroid tablets on my own?
Long-term steroid tablets should be reduced gradually under medical guidance rather than stopped suddenly, because the adrenal glands need time to restart their own cortisol production. Stopping abruptly can cause dangerously low cortisol.
Can I fast during Ramadan with adrenal insufficiency?
Some people with adrenal insufficiency can fast during Ramadan with an adjusted dose schedule, while others are advised against it because of dehydration and crisis risk. The endocrinology team assesses your situation before Ramadan and agrees a plan with you.
Is Addison's disease lifelong?
Addison's disease is lifelong, because the adrenal glands themselves are damaged and are unable to recover. With daily replacement tablets and sick-day rules, most people with Addison's disease lead full, active lives.
Why do I need to stop some blood pressure medicines before testing?
Some blood pressure medicines change aldosterone and renin levels and can make the result misleading. The endocrinology team tells you which medicines to adjust, for how long, and what to use instead to keep your blood pressure safe during testing.
Will I need surgery for an adrenal problem?
Surgery is needed for some adrenal problems, such as a nodule releasing excess hormone or a nodule with worrying features. Many adrenal disorders, including Addison's disease and harmless nodules, are managed with medicine or monitoring alone.
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