The adrenal medulla is the core of the adrenal gland, and is surrounded by the adrenal cortex. Secretion of hormones from the medulla is controlled by the sympathetic nervous system. The cells of the medulla are the body’s main source of the hormones adrenaline (epinephrine) and noradrenaline (norepinephrine). These hormones are part of the response initiated by the sympathetic nervous system. The hormone boosts the supply of oxygen and glucose to the brain and muscles, while suppressing other non-emergency bodily processes, such as digestion.

The adrenal cortex is the site of steroid hormone synthesis. Some cells make cortisol, while other cells make androgens such as testosterone. Other cells of the cortex regulate water and electrolyte concentrations by secreting aldosterone, which helps to regulate blood pressure. In contrast to the medulla that is controlled directly by the nervous system, the cortex is regulated by hormones secreted by the pituitary gland and hypothalamus.

Cortisol is an important steroid hormone that is often called the ”stress hormone” as it is involved in the response to stress, and is involved in restoring homeostasis after a stressful event, such as the (good) stress caused by running around a soccer field. Cortisol increases blood pressure, blood sugar levels and has an immunosuppressive action. Long-term stress causes prolonged cortisol secretion, hyperglycemia, and weakening of the immune system. Excess levels of cortisol in the blood result in Cushing’s syndrome, symptoms of which include rapid weight gain, a round face, excess sweating, and thinning of the skin and mucous membranes.

Epinephrine, also called adrenaline, is a “fight or flight” hormone which is released from the adrenal medulla when stimulated by the sympathetic nervous system. Epinephrine plays a central role in the short-term stress reaction—the body’s response to threatening, exciting, or environmental stressors such as high noise levels or bright light. When secreted into the bloodstream, it binds to multiple receptors and has many effects throughout the body. Epinephrine increases heart rate, dilates the pupils, and constricts blood vessels in the skin and gut while dilating arterioles in leg muscles. It increases the blood sugar level, and at the same time begins the breakdown of lipids in fat cells. It also “turns down” non-emergency bodily processes such as digestion. Similar to other stress hormones, such as cortisol, epinephrine depresses the immune system.

Stress also releases norepinephrine in the brain. Norepinephrine has similar actions in the body as adrenaline, such as increasing blood pressure. Norepinephrine is also psychoactive because it affects alertness.

Hormones of the Adrenal Glands