Adrenal Hyperplasia

What is Adrenal Hyperplasia?

Adrenal hyperplasia is a condition where your adrenal glands grow larger than normal and produce too much of certain hormones. Your adrenal glands are small organs that sit on top of your kidneys. They make hormones that control your blood pressure, metabolism, stress response, and sexual development.

When these glands become enlarged, they can overproduce hormones like cortisol and DHEA. Cortisol is your main stress hormone. It helps regulate blood sugar, reduce inflammation, and control your sleep-wake cycle. DHEA is a hormone that your body converts into other hormones like testosterone and estrogen. Too much of either hormone can disrupt many body systems.

There are different types of adrenal hyperplasia. Some people are born with it, which is called congenital adrenal hyperplasia. Others develop it later in life due to tumors or other conditions affecting the adrenal glands. Early detection through blood testing helps you manage hormone levels and prevent complications.

DHEA (Dehydroepiandrosterone), Unconjugated, LC/MS/MS

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Symptoms

Weight gain, especially around the midsection and face
High blood pressure that is difficult to control
Muscle weakness and fatigue
Excessive hair growth on face and body in women
Irregular or absent menstrual periods in women
Purple or pink stretch marks on skin
Mood changes including anxiety and depression
Easy bruising and slow wound healing
Thinning skin and acne
Loss of bone density leading to fractures

Some people with mild adrenal hyperplasia may not notice symptoms for years. Hormone imbalances can develop slowly over time. This makes regular blood testing important for catching the condition early.

Causes and risk factors

Adrenal hyperplasia develops when something triggers the adrenal glands to grow and overproduce hormones. Congenital adrenal hyperplasia is caused by inherited genetic mutations that affect hormone production enzymes. These mutations are passed from parents to children. Non-congenital forms can develop from benign tumors called adenomas that grow on the adrenal glands. Sometimes the pituitary gland produces too much ACTH, a hormone that signals the adrenal glands to make cortisol. This excess ACTH can cause the adrenal glands to enlarge.

Risk factors include a family history of adrenal disorders or endocrine conditions. Long-term use of steroid medications can also affect adrenal function. Chronic stress may play a role in some cases, though it is not a direct cause. Women are more likely to develop certain types of adrenal hyperplasia. The condition can occur at any age, from newborns to older adults.

How it's diagnosed

Doctors diagnose adrenal hyperplasia through blood tests that measure hormone levels. A morning cortisol test is particularly useful because cortisol levels are naturally highest in the early morning. Higher than normal cortisol AM values can indicate adrenal hyperplasia. DHEA testing also helps identify the condition, as elevated levels may suggest excessive adrenal activity. Rite Aid offers both cortisol AM and DHEA testing as add-ons to help you monitor your adrenal health.

Your doctor may also order additional tests like ACTH stimulation tests or imaging studies. CT scans or MRI can show if your adrenal glands are enlarged or if tumors are present. A 24-hour urine collection may measure total cortisol output over a full day. Some people need genetic testing if congenital adrenal hyperplasia is suspected. Early diagnosis allows you to start treatment before complications develop.

Treatment options

Hormone replacement therapy to balance cortisol and other hormone levels
Medications like hydrocortisone, prednisone, or dexamethasone to reduce excess hormone production
Anti-androgen medications for women with excess hair growth or irregular periods
Blood pressure medications if hypertension develops
Surgery to remove adrenal tumors or enlarged glands in some cases
Stress management techniques including meditation and deep breathing exercises
Regular sleep schedule to support healthy cortisol rhythms
Balanced diet rich in whole foods and low in processed sugars
Regular physical activity to maintain healthy weight and metabolism
Routine blood testing to monitor hormone levels and adjust treatment

Frequently asked questions

Congenital adrenal hyperplasia is an inherited genetic condition you are born with that affects enzyme production. Acquired adrenal hyperplasia develops later in life, usually from tumors or pituitary gland problems. Both types cause enlarged adrenal glands and excess hormone production. Treatment approaches differ based on the underlying cause.

Congenital adrenal hyperplasia cannot be cured but can be managed effectively with lifelong hormone therapy. Acquired forms may be cured if caused by a tumor that can be surgically removed. Most people need ongoing treatment to keep hormone levels balanced. Regular monitoring helps prevent complications and maintain quality of life.

Testing frequency depends on your treatment status and symptom control. People newly diagnosed may need testing every 3 to 6 months. Once hormone levels are stable, annual or biannual testing is often sufficient. Your doctor will recommend a schedule based on your individual needs and medication adjustments.

Weight gain is a common symptom, especially around the midsection, face, and upper back. Excess cortisol changes how your body stores fat and affects metabolism. Weight gain can occur even without changes in diet or exercise. Proper treatment helps manage this symptom and may lead to weight stabilization or loss.

Yes, adrenal hyperplasia can disrupt reproductive hormones and affect fertility in both men and women. Women may experience irregular periods or lack of ovulation. Men may have reduced sperm production. Proper hormone management often restores fertility, and many people with the condition have successful pregnancies.

Adrenal hyperplasia can cause Cushing's syndrome, but they are not the same thing. Cushing's syndrome is a collection of symptoms caused by too much cortisol from any source. Adrenal hyperplasia is one possible cause of Cushing's syndrome. Other causes include pituitary tumors or long-term steroid medication use.

Untreated adrenal hyperplasia can lead to serious health problems over time. These include severe high blood pressure, diabetes, osteoporosis, heart disease, and increased infection risk. Chronic high cortisol weakens your immune system and damages multiple organs. Early treatment prevents most complications and improves long-term health outcomes.

While stress does not cause adrenal hyperplasia, it can worsen symptoms and hormone imbalances. Stress triggers your body to produce more cortisol naturally. When your adrenal glands already overproduce cortisol, additional stress compounds the problem. Managing stress through lifestyle changes is an important part of treatment.

A balanced diet supports overall adrenal health and helps manage symptoms. Focus on whole foods, lean proteins, healthy fats, and plenty of vegetables. Limit processed sugars and refined carbohydrates that spike blood sugar. Adequate salt intake is important for some forms of the condition. Work with a nutritionist familiar with endocrine disorders for personalized guidance.

Yes, congenital adrenal hyperplasia is one of the most common genetic disorders in children. Newborn screening programs test for severe forms at birth in many states. Symptoms in children may include early puberty, rapid growth, or genital abnormalities. Early diagnosis and treatment help children develop normally and prevent life-threatening adrenal crises.