Blood tests for the level of adrenal hormones are prescribed for signs of decreased or increased function to confirm the diagnosis of hormone-producing tumors. The most specific tests are cortisol, aldosterone and catecholamines.
To increase the reliability of diagnosis, it is recommended to follow the rules for donating blood: giving up smoking, eating, physical activity, and others. Evaluation of results and treatment of deviations from the norm is carried out by an endocrinologist.
Functions of hormones
The adrenal glands are a paired organ of the endocrine system located at the upper pole of the kidneys. Function: production of hormones, participation in metabolic processes, adaptation of the body to unfavorable, stressful conditions. The organ consists of a cortical and medulla layer, the activity of which is regulated by the central nervous system. The first layer produces corticosteroids: cortisol, corticosterone. Their function: regulation of metabolism, salts, conversion of proteins into carbohydrates, increasing the body's endurance. The organ's cortex consists of 3 layers, which also produce hormones:
- Glomerular. Produces mineralocorticoids: aldosterone, corticosterone, deoxycorticosterol.
- Puchkovogo. Synthesizes glucocorticoids.
- Mesh. Produces sex hormones - androgens, which differ from the hormone produced by the sex glands.
The medulla synthesizes catecholamines: adrenaline, norepinephrine. They are responsible for adaptive reactions, regulate the activity of the cardiovascular system, and participate in metabolic processes. The body releases them into the blood during a strong emotional outburst and preparation for extreme situations. Therefore, when they are released into the blood, blood pressure changes, the heart muscle strengthens or relaxes, and the bronchi narrow or widen. At rest, the level of hormones in the blood is minimal.
Glucocorticoids affect almost all metabolic processes. They enhance the production of glucose from fat cells, amino acids, reduce the severity of inflammatory and allergic processes, as well as:
- increase the sensitivity of the senses;
- enhance the functioning of the nervous system;
- influence the rate of red blood cell synthesis in the bone marrow;
- retain chlorine, water, sodium in cells, remove potassium, calcium;
- inhibit the production of antibodies;
- inhibit the growth of scar tissue;
- reduce the rate of formation of free radicals;
- inhibit the work of lymphoid cells, the production of lymphokines, autoantibodies;
- reduce the permeability of vascular walls and tissue barriers.
Mineralocorticoids enhance the absorption of sodium, chlorine, water and the excretion of potassium. Due to them, the volume of fluid in the vessels increases, the pressure increases.
Important! The most important hormones of the adrenal glands are: aldosterone, cortisol, DHEA (dehydroepiandrosterone).
What kind of doctor examines women and men, children
Due to the variety of functions of the adrenal glands (formation of corticosteroids, sex hormones, catecholamines), suspicion of endocrine pathology may arise among doctors of different profiles:
- therapist, cardiologist;
- nephrologist;
- gynecologist or urologist, andrologist;
- psychiatrist (unmotivated aggression, depression, panic attacks).
In children, the first symptoms are determined by the pediatrician. In all cases, the patient is advised to be examined by an endocrinologist, who will order further examination, receive its results, determine the diagnosis and prescribe therapy. Some diseases can only be treated surgically, so in the future the patient can be referred to a surgeon who has experience in removing the adrenal glands or to an oncologist.
Aldosterone
It is part of the renin-angiotensin-aldosterone system, since the production and release of aldosterone is influenced by angiotensin, an oligopeptide hormone. Aldosterone is involved in the regulation of sodium and potassium levels and supports water-salt metabolism. The main target of its action is the kidneys; aldosterone retains sodium and increases the excretion of potassium in the urine. Due to the hormone, the volume of circulating fluid increases and blood pressure increases. When its amount increases, edema, hypertension, and congestive heart failure occur.
Reasons for the increase
An increase in aldosterone levels is called hyperaldosteronism. The condition develops due to the proliferation of adrenal cortex cells. The excess cells begin to quickly produce the hormone; the larger the volume of the organ, the more aldosterone. Possible reasons:
- low sodium diet;
- frequent vomiting;
- pregnancy;
- taking hormonal medications;
- congenital disease of the adrenal glands - Conn's disease;
- tumors;
- hypertonic disease;
- atherosclerosis;
- narrowing of the lumen of blood vessels;
- heart failure;
- lack of iodine;
- hepatitis;
- cirrhosis;
- renal failure;
- glomerulonephritis;
- androgen syndrome.
The condition is manifested by a decrease in potassium in the blood and an increase in blood pressure. Signs are associated with an imbalance of water-salt metabolism and disturbances in electrolyte levels. Due to the rapid release of potassium in the urine, fluid is retained in the body, edema occurs, degenerative processes occur in the kidney tissues, muscles, and blood pressure increases or decreases. Other symptoms: dizziness, headache, heart rhythm disturbances, numbness of the extremities, weight loss, darkening of the skin, abnormal bowel movements, thirst.
Reasons for the decline
A decrease in aldosterone concentration is called hypoaldosteronism. Causes:
- failure of the production of enzymes that are involved in the synthesis and control of aldosterone levels;
- immunity of receptors to the hormone and disruption of communication with them;
- removal of formation in the adrenal glands;
- genetic disorders;
- removal of the adrenal glands;
- exposure to toxins, poisons, radiation on the body.
When aldosterone decreases, sodium decreases, potassium is retained, therefore muscle tone decreases, heart rate slows down, and the amount of blood flowing to organs decreases. Neurological symptoms occur due to cerebrovascular insufficiency.
Important! Aldosterone has a connection with two hormones: angiotensin and renin. In general, they create the renin-angiotensin-aldosterone system.
Common signs of organ problems
How to check the adrenal glands, and what is needed for this? Often the first signs of problems in an organ can be noticed independently. The following symptoms will help you not only detect problems in the body in time, but also prevent more dangerous diseases:
- Dizziness when you suddenly stand up.
- Sensitivity to bright light and loud sounds, especially if, for example, you move from a dark room to a light one and take a long time to get used to the new lighting.
- Fragility of the nail plates.
- Insomnia and other sleep problems.
- Desire to eat only salty foods.
- Low libido.
- Allergy. If you react strongly to blooms and certain types of foods, then you should have your adrenal glands checked.
- Constant fatigue.
- Frequent illnesses.
- Pain, especially in the pelvis, knees, feet and ankles.
Of course, the above symptoms may indicate many other diseases. But still, it would not be a bad idea to check the adrenal glands; the earlier problems are detected, the greater the chances of completely curing them.
Cortisol
Cortisol is otherwise called the stress hormone, as its level increases with negative emotions. It is found in the blood in 2 forms: bound and unbound. The first form is an inactive hormone that does not affect the body and is a cortisol depot. It is released when necessary (stress and other factors). The unbound form is involved in the regulation of the hypothalamic-pituitary-adrenal system and reduces the level of glucocorticoids.
Indications for cortisol testing
Hormone analysis in women and men is prescribed for:
- osteoporosis;
- the appearance of discolored areas of the skin;
- suspected Addison's disease;
- increased pigmentation of the skin in open areas of the body, folds;
- long-term muscle weakness;
- acne in adults;
- a sharp decrease in body weight for no apparent reason;
- high blood pressure in the absence of pathologies of the heart and blood vessels.
Additional indications for women: establishing the cause of menstrual irregularities, excess body hair growth, early menstruation in girls.
Reasons for the increase
An increase in the indicator occurs when the function of the adrenal glands increases - hypercortisolism; an increase can also be triggered by a number of medications that a person takes for diseases not related to the endocrine system. Other reasons:
- benign, malignant formations;
- Itsenko-Cushing's disease;
- disruption of the pituitary gland;
- decreased levels of adrenocorticotropic hormone;
- puberty;
- pronounced excess or deficiency of body weight;
- liver failure;
- hepatitis;
- cirrhosis;
- pregnancy;
- cysts in the ovaries;
- alcoholism.
Important! An increase in cortisol may be associated with mental disorders due to severe stress and depression.
Reasons for the decline
Low cortisol levels can be caused by:
- sudden weight loss;
- Addison's disease;
- disruption of the endocrine system;
- congenital adrenal insufficiency;
- androgenital syndrome;
- liver failure;
- tumors;
- systemic pathologies;
- disruption of the pituitary gland.
Cortisol may decrease while taking certain medications that artificially reduce the amount of the hormone.
Indications for research
Analysis of adrenal hormones is prescribed for many pathological conditions. With congenital pathologies of the gland, accompanied by impaired production of steroid hormones, children experience disorders of sexual development, characterized by a number of symptoms. The appearance of such signs is an indication for analysis. In addition, these glands and hormonal levels should be examined if the following symptoms appear:
- low or high blood pressure;
- elevated potassium levels;
- tachycardia;
- nervous excitability;
- muscle weakness;
- increased fatigue;
- darkening of the mucous membranes;
- sleep disorders;
- dehydration;
- decreased appetite;
- thirst;
- frequent urination;
- frequent attacks of nausea;
- fainting conditions;
- attacks of dizziness;
- skin hyperpigmentation.
Tests are required in case of decreased vision or convulsive syndrome. What the pathology will be called depends on the results obtained during diagnosis.
Saliva analysis
Cortisol levels can be determined from saliva using rapid tests. Saliva is collected several times a day, and the hormone level is noted after the test. After the tests, the endocrinologist, based on the analysis results, evaluates the functioning of the adrenal glands at different times of the day. With the help of multiple saliva tests, it is possible to determine what factors indicate an increase or decrease in cortisol. Normal indicators:
- from 6 to 10 o’clock – the hormone level is high;
- from 10 to 14 o’clock – a sharp decrease;
- from 14 to 17 hours – moderate decline;
- from 17 to 21 hours – low concentration.
The indicated dynamics of decline and rise in cortisone are characteristic of normally functioning adrenal glands.
How to check the structure of the adrenal cortex
In the adrenal glands, the most common type of pathology is a tumor. In most cases, they are hormonally active, so visualization of the glands is prescribed to patients who have hormonal imbalances. But there are also “silent” formations - incidentalomas. Benign ones do not produce symptoms, but with malignant ones, cancerous intoxication appears and the size of the abdomen increases.
To study the structures of the adrenal glands, the following is used:
- Ultrasound,
- CT scan,
- selective angiography,
- tissue biopsy.
Watch the video about how an adrenal biopsy is performed:
Normal indicators when analyzing adrenal hormones
It is impossible to make a final diagnosis based solely on the deviation of the adrenal hormone from the norm; you can only put forward a preliminary diagnosis, which needs to be confirmed or refuted by additional research methods. The table shows the norm of the hormone aldosterone and cortisol by age.
| Age | Aldosterone in pg/ml | Cortisol in nmol/l |
| Infants from 1 to 12 months | 50-1700 | 25-1050 |
| Children from 1 to 3 years old | 70-900 | 25-950 |
| Children from 3 to 15 years old | 45-300 | 28-800 |
| Over 15 years old | 30-350 | 138-620 |
The level of DHEA in women is from 800 to 8650 nmol/l, in men from 3500 to 11650 nmol/l. When deciphering a cortisol analysis, you need to take into account that its level depends on the emotional state of a person. The hormone also has strong daily fluctuations, its maximum level is noted from 3 to 8 am, minimum from 9 to 3 pm.
Tests for adrenal hormones are prescribed by endocrinologists if a dysfunction of the organ is suspected or to determine the hormonal status. The name of the test for adrenal hormones can be prescribed by a therapist, endocrinologist, gynecologist and other related specialists. You can check the functioning of the organ yourself by contacting any private clinic or independent laboratory, and then contact a specialist for interpretation.
Interpretation of diagnostic results
For laboratory blood tests, normal hormone levels are:
- Cortisol. In the morning 91–235 mcg/l. In the evening – 18–101 mcg/l. Exceeding the norm indicates Cushing's disease, tumors and adrenal hyperplasia. A deficiency of the hormone is observed, for example, in Addison's disease.
- Aldosterone. The content in the blood of an adult is 100–400 pmol/l. Elevated aldosterone can be caused by a variety of diseases, such as aldosteronism or increased adrenal gland mass.
- Catecholamines. Adrenaline – up to 50 ng/l. Norepinephrine – 110–410 ng/l. Exceeding the norm may indicate pheochromocytoma.
Normal levels of hormones in urine:
- Cortisol. 28.5–213.7 mcg/day. The concentration of cortisol in urine, in addition to pathologies, may exceed the norm due to strong emotional stress. An excess can also be observed in hyperthyroidism and obesity. A decrease in concentration can be observed due to the use of corticosteroids, with Addison's disease and problems with the functioning of the pituitary gland.
- Aldosterone. 35–350 pg/ml. Changes in concentrations will indicate disturbances in the water-salt balance.
Checking at home
How to test the adrenal glands in women or men at home? This can be done using a few simple tests, which, of course, cannot be as accurate as laboratory tests. Lie down and rest for 5-10 minutes. Measure your resting blood pressure. Then stand up quickly and repeat the measurement while standing. If blood pressure drops by more than 10 points, the test indicates a decrease in adrenal function. Figures for a healthy body usually do not allow an increase of more than 10-20 points.
Another way to find out about problems with the adrenal glands is to check the reaction of your pupil. Darken the room and stay in it for 10-15 minutes until you begin to distinguish objects in the dark. Then turn on a bright light (you can use a not very powerful flashlight) and shine it into your eye for 30 seconds. If your adrenal glands are working normally, then your pupils should remain contracted as long as the flashlight shines through them.
You can also check the reaction on your skin. Draw a line in the abdomen area with your fingernail. If it remains white, this may indirectly indicate adrenal disease. Of course, this is not an indicator; to make an accurate diagnosis, you still need to do blood and urine tests.
