How to Test for an Adrenal Gland Problem

The adrenal glands produce hormones such as sex hormones and stress hormones such as cortisol. Adrenal gland problems occur when they make too much or not enough of a specific hormone, or when tumors, bleeding or infection is present. Adrenal gland problems can be fatal without proper diagnosis and treatment. There are a variety of tests health care professionals can do to diagnose adrenal gland problems. These include blood, urine or saliva tests, and four different imaging methods.

Instructions

How to Test for Adrenal Gland Problems with Blood, Urine or Saliva Tests

• 1

  An adrenocorticotropic hormone (ACTH) test should be ordered if your doctor suspects an adrenal gland problem due to abnormal levels of cortisol (stress hormone). Deficiencies in cortisol can cause Cushing's disease, in which there is a benign tumor on the pituitary gland; Addison's disease, in which too little cortisol is present due to adrenal gland damage or pituitary dysfunction; or hypopituitarism, in which little or no hormone is produced by the pituitary gland. Your doctor may also suggest a urine or saliva test if he suspects too much cortisol is being produced.

• 2

  An aldosterone and renin test should be ordered if your doctor suspects an abnormal amount of aldosterone. Aldosterone is hormone made by the cortex (outer lining) of the adrenal gland. It regulates the balance of water and salt in the body. These tests are also used to test for Conn's syndrome, in which the adrenal gland produces too much aldosterone, resulting in high blood pressure. Aldosterone levels can be detected via a blood test or 24-hour urine sample (urine is collected for 24 hours and tested). Renin is always tested using blood tests. Renin is an enzyme released by certain kidney cells when there is too little salt in your blood or blood volume is low. It also plays a role in the release of aldosterone.

• 3

  A dehydroepiandrosterone sulfate (DHEAS) test may be ordered to determine whether you have an adrenocortical tumor (a tumor on the cortex of the adrenal gland), adrenal cancer, or adrenal gland disorder. A DHEAS test is a blood test that can be done along with other hormone tests.

Imaging Methods to Test for Adrenal Gland Problems

• 4

  An ultrasound may be ordered to check for an adrenal tumor. Ultrasounds take only 30 minutes and can easily be done in a doctor's office; however, ultrasound is not the most accurate imaging method. Instead, your doctor may recommend a computed tomography (CT) scan, an hour-long test that is very accurate at finding tumors.

• 5

  A more expensive scan called an MRI (magnetic resonance imaging) may be ordered. MRI is highly accurate and similar to a CT scan, but the MRI uses magnetic fields to generate three-dimensional pictures of the adrenal gland.

• 6

  If your doctor believes you have a specific type of adrenal gland tumor that appears in nervous tissue, he will order a metaiodobenzylguanidine (MIBG) scan. For an MIBG scan you will be tested over a 3- or 4-day period for an hour each day. An MIBG scan uses a radioactive substance and a special scanner to detect adrenal gland tumors.