Acromegaly: Growth Hormone Overproduction
Acromegaly is a rare endocrinal condition characterized by skin thickening, swelling and enlargement of bones and tissues. It is caused by an increase in the secretion of growth hormone by your pituitary gland. It is a gradual disorder that develops over years, and may not be even noticed until long time passes away. Many serious health problems and complication up to premature death are associated with Acromegaly. However, it is a treatable and controllable condition.
The signs and symptoms of Acromegaly are caused by increased growth of all body tissues. One of the most common symptoms of Acromegaly is the enlargement of your hands and feet. You may notice that you have to replace your shoes frequently with a large-sized one, or your ring is no longer fit to your fingers.
In most cases, Acromegaly is associated with back and joint pain. The slow progress of the features of Acromegaly may make it unnoticeable for many years, up to ten years. Sometimes, it is only noticed when you compare your old photos with your recent appearance.
The typical symptoms and signs of Acromegaly include:
Changes in body organs
- Enlargement of hands and feet.
- Barrel chest, due to increased chest size.
- Enlarged liver, spleen, heart, kidney and other viscera.
- Deepened and husky voice due to enlargement of vocal cords.
- Fatigue and muscle weakness.
Changes in face features
- Larger and coarser features of your face.
- Enlarged nose.
- Protrusion of the lower jaw.
- Underbite, which means that your lower teeth extend beyond the upper teeth.
- Thickened lips.
- Enlargement of the tongue.
Acromegaly photos:Click thumbnail to view full-size
Changes associated with sleep:
- Severe snoring.
- Frequent sleep apnea, which is a short stoppage of breathing during sleep due to swelling of the tissues of the upper airway.
Changes in sexual activity:
- Reduced sex drive.
- Failure to achieve or maintain erection in men.
- Irregularities of the menstrual cycle in women.
Changes in skin
- Thickened and oily skin.
- Excessive sweating and strong body odor.
- Skin tags, which are small skin outgrowths.
- Back pain.
- Joint pain and restricted joint movement.
- Impairment of vision.
Acromegaly is caused by excess production of growth hormone inside your body. Growth hormone is one of the essential hormones secreted in our bodies. The pituitary gland, which is a bean-shaped structure in the base of the brain, is the part of our body that produces the growth hormone along with many other hormones.
Growth hormone stimulates the liver to produce another hormone called Insulin-like Growth Factor-1 (IGF-1) which controls the growth and regeneration of our bones and other body tissues. The production of growth hormone from the pituitary gland is controlled by another part of your brain, called the Hypothalamus.
Acromegaly occurs when the growth hormone is secreted in a larger amount. In adults, this increase is usually caused by a tumor. In most cases, it is a tumor of the pituitary gland itself. While, in the other few cases, it is produced in other body tissues such as lungs, pancreas or adrenal gland.
Pituitary tumor or adenoma is the most common cause of Acromegaly in adults. Adenoma is a non-cancerous benign tumor that produces excess amount of pituitary hormones.
In addition, the increased size of the tumor may apply pressure on the surrounding structures and tissues resulting in the symptoms associated with Acromegaly such as headache and impaired vision.
In few cases, tumors of other body tissues may produce that excess growth hormone. Non-cancerous benign tumors of the lung, pancreas or the adrenal glands may produce the growth hormone itself, or another hormone, called growth-hormone releasing hormone (GH-RH). It is the hormone that stimulates the pituitary gland to produce more growth hormone.
Acromegaly, if left without treatment or diagnosed late, may progress into serious complications and health problems. These complications include:
- Hypertension or high blood pressure.
- Cardiomyopathy due to increased size of the heart,.
- Arthritis due to inflammation of joints.
- Precancerous colon polyps (outgrowths).
- Sleep apnea which is a frequent brief stoppage of breathing during sleeping.
- Loss of vision
- Spinal cord compression due to overgrowth of the spinal vertebrae.
- Uterine fibroids, which are a benign tumor of the uterus.
- Hypopituitarism, a condition of reduced hormonal output of other hormones of the pituitary gland.
- Carpal tunnel syndrome, a condition characterized by tingling or pain in your fingers caused by compression over your wrist nerves by the growing wrist tissues.
Your doctor will discuss with you your medical history and the signs and symptoms associated with your condition. Then, he/she will conduct complete physical examination. If your doctor suspects Acromegaly, other investigations may be required that include:
1. Blood tests:
When you have Acromegaly, your blood level of Insulin-like Growth Factor-1 (IGF-1) is usually elevated in response to the elevated level of growth hormone.
2. Glucose-suppressed Growth hormone level:
Your doctor may also recommend measuring your blood level of growth hormone. During this test, your blood level of growth hormone is measured, and then you are provided a preparation of sugar (glucose) to drink. Again, your growth hormone level is measured at certain times after that. The blood level of growth hormone normally decreases after glucose intake. But in case of Acromegaly, your growth hormone level will remain high.
After laboratory diagnosis of Acromegaly by the increased levels of IGF-1 and growth hormone, your doctor may recommend imaging tests to determine the size and the site of your tumor. MRI (Magnetic Resonance Imaging) or CT (Computerized Tomography) of your brain can detect pituitary tumors. In cases of non-pituitary tumors, your doctor may order another blood tests or imaging tests of your chest or abdomen.
Acromegaly causes irreversible changes in the different body tissues. Therefore, it should be treated as soon as possible to prevent the serious complications that may be associated with it. The treatment of Acromegaly includes three options that include surgery, medications and radiation.
For more information about the different treatment options for Acromegaly, you can refer to Acromegaly: Medical, surgical and Radiological Treatments.