Acromegaly is a condition that happens when the pituitary gland produces excess growth hormone that affect many parts of your body. The onset of this condition is slow and can be challenging to diagnose early. Though acromegaly can cause life-threatening complications, it can be managed.
What is Acromegaly?
Your pituitary gland sits at the base of your brain and is responsible for releasing the growth hormone. When the gland releases too much of this hormone in adults, it can cause the body to have enlarged bones, cartilage, organs, and other tissues.
In about 90% of all cases of acromegaly, the excessive release of growth hormone is caused by the presence of a benign tumor on the pituitary gland. This type of tumor is known as a pituitary adenoma.
What are the symptoms of Acromegaly?
Most of the symptoms of acromegaly are visually apparent. However, these symptoms can vary from person to person. Some of the more common visual acromegaly symptoms include:
● Thick, coarse, and oily skin
● Deeper voice
● A more prominent nose, lips, and tongue
● Hands and feet become bigger.
● Increased body odor and sweating
● More extensive and darker skin tags
● Brow bone or jaw may jut out.
● Increased spacing between the teeth
● muscle weakness and fatigue
● Severe snoring issues due to obstruction of upper airway
● Impaired vision
● Pain & limited joint mobility
● Menstrual cycle irregularities in women
● Erectile dysfunction in men
● Enlarged organs like the heart
● Loss of interest in sex
Non-visual acromegaly symptoms include:
● Joint aches
● Vision problems
What are the complications of Acromegaly?
In most cases, acromegaly can be treated. However, since the condition develops slowly, you could experience further complications before your condition is diagnosed. These complications can be life-threatening. Some of these complications include:
● High blood pressure
● Carpal tunnel syndrome
● Sleep apnoea
● Compression of the spinal cord
● Pre-cancerous growths on the colon
As you can see, some of the complications of acromegaly are dangerous to your health. This is why it is essential to get a diagnosis at the earliest and manage the condition before these complications can manifest.
Diagnosis of Acromegaly
Your doctor may ask about your medical history and conduct a physical examination. The following investigations are also performed :
● GH and IGF-I measurement: Elevated levels of these hormones suggest acromegaly.
● Growth hormone suppression test: GH blood levels are measured before and after you drink a preparation of sugar (glucose). Generally, glucose ingestion depresses the levels of GH. If you have acromegaly, the GH level in your body will tend to stay high.
● Imaging: Your doctor will suggest that you undergo an imaging procedure like MRI (magnetic resonance imaging), to help locate the exact location and size of a tumour of your pituitary gland. If no pituitary tumors are seen, your doctor may look for nonpituitary tumors as the cause of your high GH levels.
What are the treatments for Acromegaly?
One of the first lines of treatment will be to address the underlying reason for the increased growth hormone. Other treatments will center around reducing the adverse effects of the condition. You might need a combination of these different types of treatments.
Your doctor might recommend a treatment known as transsphenoidal surgery. It involves removing the tumorous growth on your pituitary gland through the nose. In some cases, the surgeon might even be able to remove the entire tumor. However, growth hormone levels can still be elevated after surgery. In this case, medications and radiation treatments will be required.
The most important step to treat acromegaly is to control the growth hormone. Medicines can be prescribed to do precisely this. There are three types of medications that can limit the effects of growth hormone.
● Medicines to reduce the production of growth hormone: These drugs will be injected into the gluteal muscle once a month to limit the excessive secretion of growth hormone by the pituitary gland.
● Medicines to reduce the production of hormones: These are oral medications that are effective in some people.
● Treatments to stop the effects of growth hormone: This drug has to be used daily to block the effects of growth hormone. These are called Growth Hormone Antagonists .
You might require radiation therapy after surgery. This is done to destroy any remaining tumor cells and to reduce the growth hormone. There are three types of radiation therapy.
● Conventional radiation therapy: This treatment cycle lasts 4-6 weeks, where you will be given regular doses of radiation. However, the effects of this treatment might be felt only years later.
● Stereotactic radiosurgery: This treatment subjects only the tumor cells to a single dose of radiation. You will feel the full effects of this therapy within five years.
● Proton beam therapy: A targeted treatment, proton beam therapy is given over several doses. The effects of this therapy appear sooner than the other two treatments.
How can Acromegaly be prevented?
Unfortunately, scientists and medical professionals have not been able to determine the cause of tumors on the pituitary gland. This means that acromegaly cannot be prevented. However, an early diagnosis can help you avoid the onset of further complications.
Frequently Asked Articles (FAQs)
1. What is the difference between gigantism and acromegaly?
Acromegaly and gigantism are closely related. The former affects middle-aged adults, whereas gigantism is seen when excess growth hormones are secreted in children.
2. What is the prognosis of acromegaly?
The prognosis of acromegaly depends on when the condition is treated. If the right treatment is given, a person with acromegaly can expect average life expectancy. However, if left untreated, especially with the related complications, life expectancy can reduce by ten years.
3. What organs are affected by acromegaly?
The most noticeable organ effects are in the heart, kidneys, and vocal cords, though other organs can be affected too.
4. Is acromegaly reversible?
Some features of the condition cannot be reversed, particularly those affecting the bones. If you have developed other complications like high blood pressure and diabetes, then you will have to regulate those conditions for your entire life.
5. What is the life expectancy of an individual with acromegaly?
The life expectancy of someone with acromegaly after treatment is the same as the general population. However, if you do not get the right treatment, it can be a life-threatening condition. This is why it is essential to consult with a doctor at the earliest sign of acromegaly.