Acromegaly: Causes, Symptoms, Diagnosis and Treatment

What is Acromegaly?

Acromegaly is a rare condition that affects three to four out of every million people per year.

As a condition, acromegaly was first identified in 1886. Acromegaly is a condition that affects the growth of bone and skeletal muscles, the way the body uses proteins, fats, carbohydrates, and the growth of skin cells. Acromegaly is defined as an “acquired” condition because it is generally not hereditary, it develops sometime after birth.

Acromegaly is a condition that progresses slowly, so slowly that it often is not diagnosed until many years after it starts. Without treatment, acromegaly can affect your long-term health. Fortunately, acromegaly can be treated successfully to protect your health and quality of life. However, to receive the full benefits of therapy, you should receive treatment as soon as possible.

What Caused Acromegaly?

Insulin like growth factor 1 (IGF-1) and Acromegaly

Acromegaly is caused by high levels of growth hormone in the bloodstream. Typically, acromegaly occurs after the normal growth of the skeleton and other organs of the body is complete. The extra growth hormone also stimulates the liver to produce higher-than-normal amounts of a substance called insulin like growth factor-1 (IGF-1). Together, these two chemicals in the bloodstream cause the symptoms of acromegaly.

What causes high levels of growth hormone?

In the vast majority (95%) of cases of acromegaly, the high levels of growth hormone are caused by a benign tumor on the pituitary gland. The pituitary gland is located just below the brain. It controls the production and release of growth hormone and several other hormones. High levels of growth hormone can also be caused by the tumor itself producing excess growth hormone.

Long-term effects of acromegaly

Even though these tumors are generally not cancerous, they cause harm by causing the symptoms of acromegaly. If left untreated, the symptoms may reduce the life expectancy of a person with acromegaly by up to 10 years.

What are Symptoms of Acromegaly?

As with most conditions, there are visible acromegaly symptoms that are observable to the naked eye, while other acromegaly symptoms are not so apparent.

Visible symptoms of acromegaly include:

  • Enlarged hands
  • Enlarged feet
  • Widened fingers or toes due to skin overgrowth with swelling, redness, pain
  • Enlarged jaw (prognathism) and tongue
  • Enlarged facial bones
  • Thickening of the skin, skin tags
  • Enlarged sebaceous glands
  • Excessive sweating
  • Widely spaced teeth
  • Swelling of the bony areas around a joint
  • Weight gain (unintentional)
  • Hair, excessive on females

Acromegaly symptoms that are not so visible include:

  • Headache
  • Easy fatigue
  • Decreased muscle strength (weakness)
  • Limited joint mobility
  • Joint pain
  • Carpal tunnel syndrome

Over the course of time, acromegaly can cause a higher-than-normal risk of other conditions, some of which can be life-threatening:

  • Cardiovascular disease
  • Diabetes
  • Cancer
  • Sleep difficulties
  • Respiratory issues
  • Joint problems
  • Goiter
  • Excessive sweating

Making an Acromegaly Diagnosis

Before making a correct acromegaly diagnosis, a health care professional must:

  • Recognize the symptoms of acromegaly
  • Run certain tests and images
  • Possibly consult a specialist in endocrinology (the study of hormones and their roles in the body)

Arriving at a correct acromegaly diagnosis as early as possible is important. The longer acromegaly goes untreated, the higher the risk of complications. The average case of acromegaly is diagnosed nine years into its course.

Who makes the acromegaly diagnosis?

In most cases (52%), an acromegaly diagnosis is made by a general practitioner or family physician. Other types of healthcare professionals who may diagnose acromegaly are neurologist (15%), endocrinologists (13%), rheumatologists, cardiologists, lung/ear/nose/throat specialists, and ophthalmologists.

Talk to a health care professional if you think you have one or more symptoms of acromegaly.

Tests and Images for an Acromegaly Diagnosis

Tests and images that will help a healthcare professional make an accurate diagnosis of acromegaly include:

  • A blood test for the level of growth hormone
  • A blood test for the level of insulin-like growth factor-1
  • An X-ray of the spine to check for abnormal bone growth
  • A cranial magnetic resonance image (MRI) or computed tomography (CT) scan to check for a pituitary tumor
  • An echocardiogram to check for leaky mitral or aortic valves

How Acromegaly can be treated?

The goals of acromegaly treatment are to:

  • Eliminate the tumor on the pituitary gland and prevent the tumor from growing back
  • Restore normal function of the pituitary gland
  • Normalize the levels of growth hormone and insulin like growth factor to reduce the symptoms of acromegaly

While changes to bones caused by acromegaly cannot be reversed, appropriate treatment may reverse changes to organs and other tissues.

Three main acromegaly treatment categories

Acromegaly treatment options fall into three main categories:

  • Surgical removal of the tumor – Microsurgery is done to remove the tumor on the pituitary gland. This may lower growth hormone levels, assuming patients can tolerate general anesthesia and are good candidates.
    Good candidates for surgery have:

    • Small tumors that secrete GH
    • Tumors pressing on nerves, like the optic nerve
    • Well-defined, noninvasive tumors
  • Less than 50% of patients are cured of acromegaly by surgery.
  • Medication – Medication may control excess growth hormone. Medication may also be used before surgery to reduce the size of a tumor if surgery is unavailable, or if the tumor is too large to be removed safely.
  • Radiation therapy – Radiation of the pituitary is used for treatment when there is little or no response to surgery, but the reduction in growth hormone levels is very slow.

By lowering levels of growth hormone and insulin-like growth factor, it’s possible to reduce symptoms and the risk of premature mortality for people with acromegaly.


Disclaimer: This content including advice provides generic information only. It is in no way a substitute for qualified medical opinion. Always consult a specialist or your own doctor for more information. NDTV does not claim responsibility for this information.

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