Acromegaly is a medical condition arising from the excess production of growth hormone (GH) by the pituitary gland. The extra amount of GH causes excess growth in the bones and soft tissues of the body.
People who suffer from this disorder usually experience a sudden weight gain, an extraordinary enlargement of their bones and soft tissues, especially around their hand, leg, and face regions. This increase is due to the excess growth hormone produced in their bodies. Acromegaly is a rare condition and usually affects middle-aged adults.
About three to four out of every 1 million people develop acromegaly every year and around 60 out of every 1 million people have the condition per time. These statistics may be underestimated since most cases of acromegaly are often undiagnosed.
Types of Acromegaly
There are no types of acromegaly. However, acromegaly is a type of disorder resulting from the excess production of growth hormone in adults (people who have passed the age of growing in height). In children, however, the excess production of GH rather causes an abnormal increase in height which is referred to as gigantism.
When a doctor suspects a person has acromegaly, he may order for one or more of the following for proper diagnosis:
- Blood Tests: Blood tests are used to discover if a patient has too much GH. However, they can sometimes be inaccurate because GH levels fluctuate throughout the day.
- Glucose Tolerance Test: This reveals if a person’s body can suppress GH levels or not. This test requires the person to be tested drinks around 75 to 100 grams of glucose before the test GH levels are tested. If the person’s body is secreting normal levels of GH, excess glucose will cause the body to suppress your GH levels, if not it will still show high GH levels, which indicates acromegaly.
- Insulin-Like Growth Factor 1 (IGF-1: IGF- A test for a protein called insulin-like growth factor 1 (IGF-1). This testing is usually conducted to determine levels of IGF-1 and show if there is an abnormal growth in the body. It is also used to monitor the progress of other hormone treatments.
- Imaging Studies: X-rays, MRI, and CT scans are often used to check the internal components of the body. For patients with acromegaly, doctors look out for pituitary or nonpituitary tumors capable of causing the release of excess growth hormone. MRI and CT scans help find the pituitary tumor and determine its size. Where there is none, the doctor also looks for tumors in the abdominal, chest, or pelvic region capable of causing excess GH production.
Treatments for acromegaly are aimed at returning GH production levels to normal, maintaining the normal pituitary function, relieving the pressure around growing tumors, and treating hormonal deficiencies associated with the disorder.
They include the following:
Surgery is a quick and effective way to reduce growth hormone levels and is recommended to people with acromegaly. It involves the removal of the tumor causing excess GH, thus, resulting in relief of acromegaly symptoms in the patient.
However, where complication arises, the pituitary tissues surrounding the tumor could be damaged. This will eventually require lifelong pituitary hormone replacement treatment. On rare occasions, cerebrospinal fluid leaks and meningitis emerge which can be life-threatening and require an urgent medical response.
Medication can either be used to shrink large tumors before surgery or treat the condition, where the surgery to reduce GH levels is unsuccessful. These medications serve as GH production blockers or regulators.
- GH receptor antagonists
- Somatostatin analogs
- Dopamine agonists
- Osteoarthritis, a condition that causes joints to become painful and stiff.
- Hypertension (high blood pressure), where a person’s blood pressure becomes higher than normal.
- Cardiomyopathy, a cardiovascular disease that results in the enlargement of the heart.
- Diabetes mellitus, where the body can’t use glucose (a type of sugar) normally.
- Goiter, a condition in which the thyroid gland grows larger.
- Precancerous growths (polyps) on the lining of the colon.
- Hypopituitarism, which causes a reduction in the release of pituitary hormones, which is called.
- Sleep apnea, a condition in which breathing repeatedly stops and starts during sleep.
- Carpal tunnel syndrome, a common condition that causes pain, numbness, and tingling in the hand and arm.
For most people with acromegaly, detection usually takes longer due to the slow unfolding nature of the sickness. In most cases, the enlargement of their affected body parts happens slowly while other symptoms become obvious after a long time. However, these are signs to look out for:
- Enlargement of face, feet, and hands
- Weight gain
- Spaced dentition
- Hair growing excessively in women
- Enlargement of jaw or tongue
- Headaches and fatigue
- Brow becoming more prominent
- Splaying fingers and toes
- Developing body odor
- Increase in sweating
- Growth spurts becoming excessive
- Voice becoming deeper and hoarse
- Insomnia or inability to sleep
- Swelling and pain in joints
- Weakening muscles
- Enlarged pores in the skin
- Thickened skin
Acromegaly is caused by the overproduction of growth hormone (GH) by the pituitary gland.
The pituitary gland is a small gland located in the brain which produces some hormones. The major function of the growth hormone is to manage and regulate physical growth.
When much GH is produced, excessive amounts of a hormone called insulin-like growth factor-I (IGF-I) is produced by the liver, which in turn stimulates the growth of bones and other tissues and results in acromegaly and gigantism.
The causes of acromegaly are mostly the presence of benign (noncancerous) tumours in the brain or other parts of the body. These tumours may be pituitary or non-pituitary hormones.
- Pituitary tumors: In pituitary tumours or adenoma, the tumour mass presses nearby brain tissues, resulting in the secretion of excessive amounts of growth hormone, and leading to acromegaly.
- Nonpituitary tumors: In a few people with acromegaly, tumours in other parts of the body, such as the lungs or pancreas, cause the disorder. Sometimes, these tumours secrete excess GH. In other cases, the tumours produce a hormone called growth hormone-releasing hormone (GH-RH), which stimulates the pituitary gland to make more.
- What is the difference between acromegaly and gigantism?
Though both acromegaly and gigantism are growth disorders resulting from the excess production of growth hormone (GH), acromegaly only occurs in adults (people who have passed the age of growing in height) and results in the enlargement of the bones and tissues of some parts of their body, while gigantism occurs in children and majorly results in the excessive increase in height and some parts of the body.
- How does acromegaly affect the heart?
Acromegaly, chronic excess of growth hormones (GH) with insulin-like growth factor -1 (IGF-1) leads to the development of acromegalic cardiomyopathy resulting in systolic dysfunction and congestive heart failure.
- What happens if acromegaly goes untreated?
If untreated, it may lead to various complications. The most complications include joint problems, pituitary hormone deficiency, and respiratory problems, among others.
- Is acromegaly a chronic condition?
Acromegaly is an uncommon chronic disease characterized by hypersecretion of pituitary growth hormone (GH) by somatotroph adenomas, along with increased levels of insulin-like growth factor -1 (IGF-1)
- What is the life expectancy of someone with acromegaly?
Life expectancy may be reduced by approximately 10 years, especially when the growth hormone levels are uncontrolled and diabetics and heart disease are present.