Acromegaly is a rare disorder that develops when your body produces too much growth hormone (GH). This hormone normally helps children grow and develop. But in adults, having excess GH leads to abnormal growth, usually starting in the hands and feet. Most people with acromegaly are diagnosed in middle age.
A similar condition called gigantism can occur in children if they have GH overproduction before puberty ends and their growth plates fuse. Every case of acromegaly is unique, and symptoms may take years to become noticeable. Fortunately, there are treatments available to manage this condition.
The most common cause of acromegaly is a non-cancerous tumor in the pituitary gland called a pituitary adenoma. The pituitary gland, located at the base of the brain, regulates growth hormone. A tumor in this gland can cause it to release too much GH.
In rare cases, tumors in other parts of the body like the pancreas, liver or brain can also trigger excess GH production. These tumors produce high levels of insulin-like growth factor 1 (IGF-1), another hormone that can cause acromegaly symptoms.
Acromegaly symptoms usually develop slowly over several years. Some of the most common signs include:
Enlarged hands and feet (need for bigger rings or shoe sizes)
Coarsened, broader facial features (thickening of the lips, nose, tongue and jaw)
Wider spacing between teeth
Protruding brow and lower jaw
Aching joints and arthritis
Thickened, oily skin with skin tags
Excessive sweating and body odor
Deepened, hoarse voice
Headaches
Sleep apnea and snoring
Fatigue and muscle weakness
Tingling or pain in fingers from carpal tunnel syndrome
Vision problems
Menstrual cycle changes and breast discharge in women
Lower libido and erectile dysfunction in men
Early diagnosis of acromegaly is important for the best treatment outcome. Your doctor will ask about your symptoms and any changes you've noticed. Several tests are used to confirm an acromegaly diagnosis:
Blood test to check IGF-1 hormone level
Oral glucose tolerance test to measure GH response
Prolactin level test
Echocardiogram to assess heart health
Colonoscopy to evaluate the colon
Sleep study to check for sleep apnea
X-rays to look for bone thickening
MRI or CT scans to locate tumors
Your doctor may also review photos of you over time to identify any gradual physical changes associated with acromegaly. Feel free to ask your doctor questions so you fully understand the condition and next steps.
Treatment for acromegaly aims to reduce GH production, relieve symptoms, and prevent complications. There are three main treatment approaches:
Surgery - to remove the pituitary tumor, especially if it's large or pressing on the optic nerve. This is often the first treatment. Medication may be given before surgery to shrink the tumor.
Medication - drugs like somatostatin analogs, growth hormone receptor antagonists, and dopamine agonists can help lower GH levels or block its effects.
Radiation therapy - can help if parts of the tumor remain after surgery or if medications aren't effective enough. Options include conventional radiation, proton beam therapy, and stereotactic radiosurgery.
With proper treatment, many people with acromegaly can manage the condition well and avoid complications. However, without treatment, acromegaly can lead to serious health issues like:
Cardiovascular disease
Carpal tunnel syndrome
Diabetes
Enlarged thyroid (goiter)
High blood pressure
Osteoarthritis
Colon polyps
Sleep apnea
Spinal cord compression
Vision loss
Untreated acromegaly can be life-threatening, so following the treatment plan from your doctor is essential. Connecting with others who have acromegaly through support groups can be very helpful. Organizations like the Pituitary Network Association provide resources and ways to connect with other patients and families dealing with this rare condition.
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