Acromegaly is a hormonal disorder that occurs when there is too much production of growth hormone from the pituitary gland. The symptoms may only manifest at an early stage of adulthood, but the development of acromegaly may start during childhood.
This hormonal disorder often tends to relate to gigantism. In acromegaly, the attack of growth hormone is only limited to the bones in hands, feet, and face.
The progression of acromegaly in the body is slow. The changes may be difficult to recognize at an early phase. It commonly develops when a person reaches adulthood. If left untreated, this can lead to life-threatening health problems.
Causes
The location of the pituitary gland is at the base of the brain, behind the nose. Its function is to signal the liver to release insulin-like growth factors (IGF-1), which make the tissues and bones in the body grow. Too much growth hormone triggers the development of acromegaly.
These are the two types of tumors that trigger the pituitary gland in releasing excessive growth hormone:
- Pituitary Tumor. This is a tumor that develops in the pituitary gland, pressuring the brain tissues. This tumor tends to stimulate excessive growth hormone and manifest symptoms, such as headaches and damaged vision. The development of this tumor is usually hereditary.
- Non-Pituitary Tumor. Lung and pancreas tumors may cause acromegaly in some people. These tumors produce growth hormone-releasing hormone (GH-RH) that triggers the pituitary gland to make more growth hormones.
- Genetic Syndromes. For some people with acromegaly, it may occur with other genetic syndromes. These include multiple neoplasia type 1 (MEN1), Carney complex, and McCune-Albright syndrome.
Signs and Symptoms
The symptoms of acromegaly may vary depending on the person. These include the following:
- Enlarged hands, feet, face, lips, tongue, and jaw
- Thick, oily skin from excessive sweating, strong body odor
- Joint pains, joint swelling
- Voice hoarseness, deep voice
- Severe snoring when asleep
- Vision impairment
- Severe headaches
- Irregular menstrual cycle
- Erectile dysfunction
- Bad bite
Risk Factors and Complications
The primary risk factor is a family or personal history of having a pituitary tumor.
Acromegaly is manageable, but it may lead to other health complications if left untreated. These include:
- Hypertension
- High cholesterol
- Cardiomyopathy, an enlargement of the heart
- Osteoarthritis
- Type 2 diabetes
- Goiter
- Precancerous polyps
- Carpal tunnel syndrome
- Development of cancerous tumors
- Loss of vision
- Sleep apnea, a disorder that stops and starts breathing while asleep
- Premature death
Diagnosis of acromegaly
The signs and symptoms of acromegaly are hard to diagnose at an early stage. Aside from taking the patient’s history and physical examination, physicians order tests to confirm the diagnosis.
These include:
- Blood Tests. The examination for the blood sample will measure the IGF-1 level. If the result shows a high level of IGF-1, it may suggest a diagnosis of acromegaly.
- Growth Hormone Suppression Test. This is the best way to confirm that the patient has acromegaly. This test monitors the body’s growth hormone level through a blood test before and after drinking glucose. People with acromegaly will show a high level of growth hormone after consuming glucose.
- Imaging Tests. Magnetic resonance imaging (MRI) locates and measures the size of the tumor in the pituitary gland. If no pituitary tumors are found, a computed tomography scan (CT scan) is another option. It creates x-ray images of the body organs and internal parts.
Treatments
The suggested treatment varies depending on the location and size of the tumor, symptoms, and current health condition.
Treatment options include the following:
Surgery
Transsphenoidal surgery is the procedure for removing pituitary tumors through the nose. In most cases, if the tumor size is small, the growth hormone level returns to normal after the surgery. It also helps in relieving the signs and symptoms, such as headaches and vision problems.
Medications
Some medications will reduce the size of the tumor and limits the production of growth hormone. These medications may be used before or after surgery.
Radiation
Radiation therapy kills the tumor cells. This is done if surgery is not possible due to health conditions, and if medicines are not as effective.
Key Takeaway
Acromegaly is a rare condition related to the excessive production of growth hormone during adulthood. This is most commonly caused by a pituitary tumor that triggers the pituitary gland into stimulating more growth hormone. There are treatment options that can remove and manage the tumors. If these tumors are left untreated, it increases the risk of developing other life-threatening health complications.
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