Adrenal Disorder
Specialist Houston
The adrenal glands sit above your kidneys and produce hormones essential for life — including cortisol, aldosterone, and adrenaline. When they produce too much or too little, the effects touch every system in your body. Our board-certified endocrinologists are Houston's specialists in diagnosing and managing the full spectrum of adrenal disease.
Adrenal Disease by the Numbers
Expert Care for All Adrenal Disorders
The adrenal glands are small but mighty — and disorders that affect them are frequently missed or misattributed to stress, anxiety, or other causes. Our endocrinologists have the specialized training and in-office testing capabilities to properly evaluate adrenal function and provide a precise diagnosis.
Cushing's Syndrome
Caused by excess cortisol — from a pituitary tumor, adrenal tumor, or prolonged steroid use. Symptoms include weight gain around the abdomen, a "moon face," easy bruising, stretch marks, and high blood pressure. Diagnosis requires specialized testing including dexamethasone suppression testing and 24-hour urine collection.
Learn more →Adrenal Insufficiency
The adrenal glands don't produce enough cortisol — and in primary adrenal insufficiency (Addison's disease), also insufficient aldosterone. Symptoms include profound fatigue, weight loss, low blood pressure, and salt cravings. This condition requires careful hormone replacement and patient education about sick-day rules and adrenal crisis prevention.
Learn more →Pheochromocytoma
A rare tumor of the adrenal gland that secretes adrenaline-like hormones (catecholamines), causing episodic high blood pressure, palpitations, sweating, and headaches. Requires biochemical testing and imaging for diagnosis, followed by careful pre-surgical preparation. Our team coordinates with surgery when needed.
Learn more →Hyperaldosteronism
Excess aldosterone — often from a benign adrenal adenoma or bilateral adrenal hyperplasia — is a leading cause of treatment-resistant high blood pressure. It's far more common than historically recognized. We test for this in appropriate patients and guide treatment including targeted medical therapy or referral for adrenalectomy.
Learn more →Adrenal Nodules & Incidentalomas
With widespread use of CT and MRI imaging, adrenal masses are discovered incidentally in up to 10% of adults. The vast majority are benign, but all newly found adrenal nodules warrant evaluation for hormonal activity and malignancy risk. We follow established guidelines to characterize each nodule and determine the appropriate follow-up plan.
Learn more →Congenital Adrenal Hyperplasia
A group of inherited disorders affecting cortisol synthesis, often leading to androgen excess. CAH can present in childhood or be detected in adulthood — especially in women with irregular periods, excess hair growth, or fertility challenges. We provide both diagnostic evaluation and long-term hormonal management.
Learn more →Symptoms That May Point to an Adrenal Disorder
Adrenal disorders are among the most under-recognized in medicine. Their symptoms often overlap with anxiety, depression, fibromyalgia, or simply "getting older." If you experience multiple symptoms below — especially alongside difficult-to-control blood pressure or unusual weight changes — an adrenal evaluation may be warranted.
🌀 Too Much Cortisol (Cushing's)
- Weight gain, especially in abdomen and face ("moon face")
- Easy bruising or thin, fragile skin
- Purple stretch marks on abdomen or thighs
- High blood pressure resistant to medication
- High blood sugar or new diabetes
- Muscle weakness, especially in hips and thighs
- Bone loss or vertebral fractures
- Irregular or absent periods in women
⚠️ Too Little Cortisol (Adrenal Insufficiency)
- Profound, unrelenting fatigue
- Unintentional weight loss
- Low blood pressure — lightheadedness on standing
- Salt cravings
- Nausea, vomiting, abdominal pain
- Darkening of skin (in primary adrenal insufficiency)
- Adrenal crisis — medical emergency during illness or stress
- Depression, cognitive changes
How We Evaluate Adrenal Function
Comprehensive History & Symptom Review
Many adrenal disorders have subtle presentations. We take time to understand your complete symptom picture, medication history (including steroid use), family history, and prior lab results before ordering targeted testing.
Specialized In-Office & Lab Testing
We use a range of tests depending on the suspected diagnosis: overnight or low-dose dexamethasone suppression testing for Cushing's, ACTH stimulation testing for adrenal insufficiency, plasma aldosterone and renin for hyperaldosteronism, and plasma or urine metanephrines for pheochromocytoma. Many of these can be coordinated through our clinic.
Imaging Interpretation
For adrenal nodules or when biochemical testing suggests a structural cause, we review CT or MRI imaging using established criteria. We use adrenal mass characteristics (size, density, washout) to guide further workup and follow-up intervals.
Individualized Treatment & Long-Term Management
Treatment varies widely: hormone replacement for adrenal insufficiency, medications to control excess cortisol or aldosterone, or coordination with experienced surgeons for adrenalectomy. We provide long-term follow-up and patient education — including adrenal crisis prevention planning for patients on cortisol replacement.
Houston's Adrenal Specialists
Former Asst. Professor, Baylor COM
Adrenal Education Library
Adrenal Disorder FAQ
I was told I have an adrenal nodule on a CT scan. Should I be worried?
Most adrenal nodules found incidentally — called adrenal incidentalomas — are benign and non-functioning. However, all newly discovered adrenal masses should be evaluated by an endocrinologist to rule out hormonal activity (even if you feel fine) and assess the risk of malignancy based on imaging characteristics. We follow published endocrine society guidelines for this evaluation.
My blood pressure won't respond to multiple medications. Could this be hormonal?
Yes — endocrine causes of hypertension are significantly underdiagnosed. Primary hyperaldosteronism (excess aldosterone) alone accounts for an estimated 5–12% of all hypertension cases, and pheochromocytoma, Cushing's syndrome, and thyroid disorders can also drive resistant high blood pressure. If you have difficult-to-control hypertension, an endocrinology evaluation is appropriate.
I was on steroids for a long time and my doctor says my adrenals might be "suppressed." What does that mean?
Prolonged steroid use (prednisone, dexamethasone, inhaled or topical steroids at high doses, etc.) can suppress the body's natural cortisol production through feedback on the pituitary and hypothalamus. When steroids are stopped, the adrenal glands may not "wake up" quickly enough, leading to adrenal insufficiency symptoms. We can test adrenal reserve and guide safe steroid tapering or replacement.
What is an adrenal crisis and how do I prevent one?
An adrenal crisis is a life-threatening medical emergency that can occur in patients with adrenal insufficiency during illness, surgery, or significant physical stress. The body can't produce the extra cortisol needed to respond to physiologic stress. We educate all patients with adrenal insufficiency on sick-day rules, stress dosing of hydrocortisone, and carry emergency injection kits.
Can Cushing's syndrome go undiagnosed for years?
Absolutely — and it often does. The symptoms of Cushing's syndrome (weight gain, fatigue, hypertension, high blood sugar, emotional changes) are non-specific and overlap with many common conditions. Studies suggest average time from symptom onset to diagnosis is 3–6 years. If you have multiple features of Cushing's, especially with difficult-to-control metabolic problems, we recommend screening.