Acromegaly is a rare hormonal disorder that develops when the pituitary gland produces excessive amounts of growth hormone (GH) after the growth plates of the bones have closed. The excess growth hormone increases the production of insulin-like growth factor-1 (IGF-1), which causes bones, tissues, and certain organs to enlarge. Acromegaly usually develops gradually, so changes in appearance and other symptoms may go unnoticed for years. Early diagnosis and treatment are important because untreated acromegaly can lead to cardiovascular disease, diabetes, sleep apnea, joint problems, and other serious complications. Although acromegaly can occur at any age in adults, it is most commonly diagnosed in middle-aged adults.
The most common cause of acromegaly is a benign (noncancerous) tumor of the pituitary gland, known as a pituitary adenoma. These tumors can cause the pituitary gland to release excessive amounts of growth hormone. Large pituitary tumors may also press on nearby structures and cause headaches or vision problems.
Rarely, tumors located outside the pituitary gland can produce growth hormone or substances that stimulate the pituitary gland to release excessive growth hormone. Such tumors may occur in organs such as the pancreas or lungs.
Most cases of acromegaly are not caused by an identifiable lifestyle-related risk factor. In rare cases, acromegaly may occur as part of certain inherited genetic conditions that predispose a person to pituitary tumors.
Without appropriate treatment, prolonged exposure to excessive growth hormone and IGF-1 can affect many organs and systems. Possible complications include:
High blood pressure (hypertension)
Heart disease and enlargement of the heart
Abnormal heart rhythm and other cardiovascular problems
Arthritis and chronic joint pain
Type 2 diabetes
Sleep apnea
Carpal tunnel syndrome
Goiter and other thyroid abnormalities
Hypopituitarism, in which the pituitary gland does not produce enough other hormones
Uterine fibroids
Spinal cord or nerve compression
Vision problems or vision loss
Colon or bowel polyps
Increased risk of other health problems related to long-term hormonal changes
Early diagnosis and treatment can significantly reduce the risk of many of these complications.
Doctors usually diagnose acromegaly using a combination of medical history, physical examination, blood tests, and imaging studies.
Common tests may include:
An IGF-1 test is commonly used to screen for acromegaly because IGF-1 levels remain relatively stable throughout the day and reflect the effects of growth hormone.
During this test, the patient drinks a glucose-containing solution and blood samples are taken at specific intervals. Normally, glucose suppresses growth hormone production. In people with acromegaly, growth hormone may remain abnormally elevated.
A magnetic resonance imaging (MRI) scan may be performed to identify a pituitary tumor and determine its size and location. Additional tests may be recommended to evaluate complications involving the heart, thyroid gland, blood sugar, vision, or other organs.
Treatment aims to reduce excessive growth hormone production, normalize IGF-1 levels, relieve symptoms, and prevent or manage complications.
Depending on the cause and severity, treatment may include:
If a pituitary tumor is responsible, surgery may be recommended to remove the tumor. Transsphenoidal surgery, performed through the nose, is commonly used for suitable pituitary tumors.
Radiation therapy may occasionally be recommended when surgery and medicines do not adequately control growth hormone production or when residual tumor tissue remains.
Consult a healthcare professional if you notice progressive enlargement of your hands, feet, facial features, or tongue, persistent headaches, excessive sweating, unexplained joint problems, changes in vision, or other symptoms suggestive of hormonal abnormalities. Because acromegaly often develops slowly, recognizing gradual physical changes can help with earlier diagnosis.
Can acromegaly be cured?
In some people, treatment can eliminate the underlying pituitary tumor or bring growth hormone and IGF-1 levels back to normal. Others may require long-term medication or additional treatment to control the condition.
Is acromegaly the same as gigantism?
No. Both conditions involve excessive growth hormone. Acromegaly occurs after the growth plates have closed, while gigantism occurs when excessive growth hormone is produced during childhood before the growth plates close.
Is acromegaly hereditary?
Most cases are not inherited. However, rare genetic conditions can increase the risk of developing pituitary tumors and acromegaly.
Can acromegaly affect life expectancy?
Untreated acromegaly can increase the risk of serious cardiovascular, metabolic, respiratory, and other complications. Appropriate treatment and regular monitoring can substantially reduce these risks.
Can the physical changes caused by acromegaly be reversed?
Treatment can improve many symptoms and prevent further progression. However, some changes to bones and soft tissues may not completely reverse after hormone levels are controlled.
Medical Disclaimer:This information is provided for general educational purposes and should not be used as a substitute for professional medical advice, diagnosis, or treatment. If you have symptoms or concerns about acromegaly, consult a qualified healthcare professional.
