Acromegaly is a rare but serious hormonal disorder that develops when the body produces too much growth hormone (GH) in adulthood. The condition usually results from a noncancerous tumor in the pituitary gland (pituitary adenoma) that causes excessive hormone secretion.
Unlike gigantism, which occurs in children before bone growth plates close, acromegaly develops in adults and leads to enlargement of the hands, feet, facial features, and internal organs. Because symptoms appear gradually and may take years to become noticeable, acromegaly often goes undiagnosed for a long time.
If left untreated, acromegaly can cause life-threatening complications, including heart disease, diabetes, high blood pressure, and increased risk of certain cancers. Early detection and treatment are essential to prevent long-term damage.
What Causes Acromegaly?
The main cause of acromegaly is excess growth hormone production, most commonly due to a pituitary adenoma.
1. Pituitary Tumors
About 95% of acromegaly cases are caused by benign pituitary tumors.
These tumors press on nearby structures and overstimulate GH production.
2. Non-Pituitary Tumors
In rare cases, tumors in the lungs, pancreas, or adrenal glands can produce growth hormone-releasing hormone (GHRH), which stimulates the pituitary gland.
Signs and Symptoms of Acromegaly
The symptoms of acromegaly develop slowly, often making it difficult to recognize early. The infographic from Sparsh Diagnostic Centre highlights key signs and symptoms:
1. Changes in Appearance
Enlarged hands and feet (rings and shoes may no longer fit)
Facial changes – broad nose, protruding brow, enlarged lips and tongue, and gaps between teeth
Thickened, oily, or sweaty skin
Skin tags
2. Head and Neurological Symptoms
Cognitive changes
Deepening of the voice
Soft tissue swelling in the throat
Snoring and sleep apnea
Enlarged jaw (prognathism)
3. Eye Problems
Decreased vision due to pressure from large pituitary tumors
4. Musculoskeletal Symptoms
Joint pain, stiffness, and arthritis
Weakness
5. Cardiovascular and Respiratory Issues
Heart valve problems (leaky valves)
Thickening of the left ventricle (reduced pumping efficiency)
Rib cage changes that restrict breathing
6. Metabolic and Hormonal Issues
Increased production of glucose and insulin-like growth factor 1 (IGF-1)
Insulin resistance leading to diabetes
Low testosterone, irregular menstrual cycles, and reduced sexual function
7. Gastrointestinal Changes
Development of precancerous colon polyps
8. Kidney and Blood Pressure Issues
Imbalance of sodium and water, leading to high blood pressure
Complications of Acromegaly
If untreated, acromegaly can lead to severe health problems:
Type 2 Diabetes Mellitus due to insulin resistance
Cardiovascular disease (heart failure, hypertension, arrhythmias)
Arthritis and joint degeneration
Vision loss from optic nerve compression
Increased cancer risk (especially colon cancer)
Reduced quality of life and shortened life expectancy
How is Acromegaly Diagnosed?
Since symptoms progress slowly, diagnosis often occurs years after onset. Doctors use the following methods:
1. Blood Tests
IGF-1 Test: High levels of insulin-like growth factor 1 confirm excess GH.
Oral Glucose Tolerance Test (OGTT): In healthy individuals, glucose suppresses GH levels. In acromegaly, GH remains elevated.
2. Imaging
MRI of the pituitary gland is performed to detect tumors.
3. Other Tests
Colonoscopy to check for polyps
Echocardiogram to evaluate heart changes
Sleep studies for sleep apnea
Treatment Options for Acromegaly
The goal of treatment is to reduce growth hormone production, relieve pressure from tumors, and manage complications.
1. Surgery
Transsphenoidal surgery is the most common treatment to remove pituitary adenomas.
Success rates depend on tumor size and location.
2. Medications
Somatostatin analogs (Octreotide, Lanreotide) – reduce GH secretion.
Dopamine agonists (Cabergoline, Bromocriptine) – effective in some patients.
GH receptor antagonists (Pegvisomant) – block GH action on tissues.
3. Radiation Therapy
Used when surgery and medication are not fully effective.
Stereotactic radiosurgery (Gamma Knife) offers precise treatment.
Living with Acromegaly
With proper treatment, many people live normal, healthy lives. However, lifelong monitoring is required:
Regular blood tests to monitor GH and IGF-1
MRI scans to check for tumor regrowth
Screening for diabetes, heart disease, and colon polyps
Healthy lifestyle choices: balanced diet, regular exercise, and quitting smoking
Prevention and Early Detection
While acromegaly cannot be prevented, early diagnosis is key to reducing complications. People should consult a doctor if they notice:
Rapid changes in hand or foot size
Altered facial appearance
Worsening headaches or vision problems
Unexplained joint pain or fatigue
Frequently Asked Questions (FAQ)
1. What is the difference between acromegaly and gigantism?
Acromegaly occurs in adults after bone growth plates close, leading to tissue and organ enlargement.
Gigantism occurs in children before growth plate closure, causing excessive height.
2. Is acromegaly a type of cancer?
No, acromegaly is usually caused by a benign (noncancerous) pituitary tumor, though it can still lead to serious complications.
3. Can acromegaly be cured?
Surgery can cure some cases, especially if the tumor is small and fully removed. However, many patients require lifelong medication or radiation.
4. How rare is acromegaly?
It affects about 50–70 people per million, with around 3–4 new cases per million each year.
5. What happens if acromegaly is not treated?
Untreated acromegaly can cause diabetes, heart disease, sleep apnea, arthritis, and premature death.
6. Can acromegaly affect fertility?
Yes, it can cause low testosterone in men, irregular menstrual cycles in women, and infertility.
7. What is the life expectancy of someone with acromegaly?
With early diagnosis and treatment, many patients live normal lifespans. Without treatment, life expectancy may be reduced by up to 10 years due to complications.
Acromegaly is a rare but serious condition caused by excess growth hormone, usually due to a pituitary adenoma. Symptoms develop gradually, making early detection challenging. Recognizing key signs—such as enlarged hands, feet, facial changes, headaches, and joint pain—is crucial for timely diagnosis.
Effective treatment through surgery, medication, and radiation can control the condition, prevent complications, and improve quality of life. Regular monitoring and lifestyle changes also play an important role in long-term management.
If you or someone you know is experiencing symptoms of acromegaly, consult a healthcare provider promptly for evaluation and treatment.
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