What Are Adrenal and Hormonal Imbalances—And How Do You Treat Them?

Feeling constantly fatigued, stressed, or out of sync with your body? You might be experiencing an adrenal or hormonal imbalance. These conditions occur when your body’s delicate hormone systems—especially those involving the adrenal glands—are disrupted, leading to symptoms like mood swings, low energy, weight changes, and sleep issues. 

In this article, Dr. Jabiz Behzadpour, endocrinologist at Riverside Healthcare, discusses what adrenal and hormonal imbalances are, what causes them, and how they can be diagnosed and treated to help restore your body’s natural rhythm and well-being. But first, it’s important to understand the field of endocrinology. 

What Does an Endocrinologist Do? 

Endocrinologists are essentially hormone doctors, treating a wide range of conditions caused by hormonal imbalances throughout the body. This includes diabetes—related to insulin—thyroid disorders, osteoporosis (involving bone-strengthening hormones), and reproductive issues like polycystic ovarian syndrome. They also manage conditions involving the adrenal glands which exist above the kidneys and the pituitary gland found in the brain—both of which play key roles in hormone production and regulation.

“It's quite a big variety, which keeps it interesting day to day,” states Dr. Behzadpour.

What Types of Problems Can Adrenal and Hormonal Imbalances Generate?

There are two types of glands in the body: those that release substances externally, like salivary glands, and those that produce hormones internally, like the adrenal glands. The adrenal glands, as mentioned above, are located above the kidneys and produce four main types of hormones: cortisol (a stress hormone), aldosterone (regulates blood pressure), fight-or-flight hormones (norepinephrine and epinephrine), and small amounts of sex hormones like testosterone. 

Hormonal imbalances in the adrenal glands can lead to conditions such as adrenal insufficiency, which is too little cortisol, Cushing syndrome, too much cortisol, or hormone-related high blood pressure due to excess aldosterone. Additionally, non-hormonal issues like adrenal adenomas—benign growths on the adrenal gland—can also occur, often discovered incidentally during imaging for unrelated conditions.

There can be a difference between a temporary hormonal imbalance and a more long-term adrenal disorder. Dr. Jabiz Behzadpour explains that some cases of adrenal insufficiency are caused by prolonged use of external steroids, such as joint injections or inhaled corticosteroids. When the body receives steroids from outside sources, it may stop producing its own, leading to adrenal insufficiency. 

However, if the external steroid use stops, some patients may be able to gradually reduce or stop their replacement medications—meaning the condition can be reversible, depending on the cause. “Sometimes, that can be temporary if the body wakes up and is able to do its job on its own,” she notes.

How Are Adrenal and Hormonal Imbalances Diagnosed?

Diagnosing hormonal imbalances in endocrinology is primarily lab-based. For adrenal function, doctors typically check a morning fasting cortisol level, since cortisol is highest early in the day. If excess cortisol is suspected, additional tests—such as blood, saliva, or urine tests—are used. For issues related to aldosterone and blood pressure, specific lab tests are also ordered. 

Imaging, usually through CT scans rather than X-rays or MRIs, may be used to detect structural issues like adrenal growths. Low steroid production is often caused by external steroid use (inhalers, injections, or creams), which can suppress the body's own hormone production and lead to symptoms like nausea or appetite loss. On the other hand, diagnosing Cushing syndrome is more complex, as its symptoms—like high blood pressure, weight gain, diabetes, and osteoporosis—can appear in people without hormonal disorders.

Treating Adrenal and Hormonal Imbalances

For patients with adrenal insufficiency who don’t produce enough cortisol, doctors prescribe steroid pills to replace what the body can't make. It's essential for these patients to take their medication consistently and adjust the dosage during times of illness, since the body naturally produces more cortisol under stress. 

For adrenal insufficiency, two main steroid pills are used: prednisone (taken once daily) and hydrocortisone (taken twice daily). Either can effectively replace the missing cortisol. If the issue involves aldosterone and high blood pressure, medications like spironolactone can help reduce aldosterone levels, though other blood pressure medications may also be used. 

If they’re sick enough to need urgent care, they may need to double or triple their dose temporarily. For those with Cushing syndrome, treatment focuses on managing symptoms like high blood pressure, diabetes, and weight gain, while also investigating the underlying cause—whether it's the adrenal glands overproducing or a signaling issue from the pituitary gland in the brain.

“Hormones can be kind of complicated because there are a lot of different symptoms that can come from a lot of different things, either hormonal or not. If you're not feeling well, tell your doctor everything that's not going well,” urges Dr. Behzadpour. “As a medical professional, they can tease out what's related to hormones and what's not, and they'll make sure they get the testing you need. But, it's up to you to advocate for yourself and tell your doctor what you feel is wrong so they can order the right test.”

To learn more about Riverside Endocrinology Specialists, visit myrhc.net/endocrinology or call 815-963-6515.