Are your limbs and face changing shape? Let's talk about Acromegaly!

Have you ever felt that the ring you always wear is now stuck to your finger? Or that your shoe size, especially the width, has become larger than usual? With such small changes, do you feel that the shape of your face is also gradually changing? You may not pay much attention to these. But these can be symptoms of a rare but concerning condition called Acromegaly. Let's talk about this simply today.

Simply put, what is Acromegaly?

Acromegaly is a rare but serious condition that occurs when your body has too much growth hormone (GH) . This hormone is normally produced by the pituitary gland, a pea-sized gland located at the base of your brain. However, in acromegaly, this hormone is produced too much because of a tumor in the pituitary gland or elsewhere in the body.

Growth Hormone is essential for children to grow tall and develop. But once we become adults, after the growth plates in our bones close, this hormone no longer increases our height. But our adult bodies also need this hormone. It is to maintain the healthy structure of our bones, cartilage, and organs, to carry out metabolism properly, and to keep blood sugar levels at the right level.

However, if the growth hormone in an adult's body increases too much, many problems can occur, such as irregular changes in the shape of the bones, enlargement of organs, and increased blood sugar (hyperglycemia).

What is the difference between Acromegaly and Gigantism?

Both of these conditions are caused by an increase in Growth Hormone (GH). The difference lies in the age group affected.

• Gigantism: This occurs in children. This means that if the GH hormone increases before puberty, before the growth plates of the bones close, those children grow abnormally tall. This is a condition that is even rarer than acromegaly.
• Acromegaly: This occurs in adults. As mentioned earlier, after the growth plates close, GH increases, but instead the shape of the bones in the hands, feet, and face changes and becomes larger.

Who gets acromegaly? How common is it?

Acromegaly is a very rare disease. According to statistics, between 3 and 14 people out of 100,000 have been diagnosed with this disease. Although it can develop at any age after puberty, the disease is most often diagnosed in middle age, that is, between the ages of 40 and 50.

How does this condition affect the body?

When Growth Hormone (GH) increases, it signals our liver to produce another hormone. It is called `Insulin-like Growth Factor 1 (IGF-1)`. This hormone called IGF-1 actually makes our bones and tissues grow, and also controls blood sugar and lipids. So, when GH increases, IGF-1 also increases a lot. As a result, serious conditions like Type 2 Diabetes, High Blood Pressure, and Heart Disease can occur.

What are the symptoms of acromegaly?

The symptoms of acromegaly appear very slowly, over many years. So they can be a little difficult to recognize in the early stages. You may only be able to spot changes in your face if you look at an old photo of yourself.

The table below clearly shows what these symptoms are.

If you have one or more of these symptoms, it is very important to see your doctor immediately and talk about this.

How is acromegaly diagnosed?

When you see a doctor, he or she will carefully listen to your symptoms, perform a physical examination, and then order several tests to confirm the diagnosis.

• Blood tests: This is the most important one. They measure the levels of GH and IGF-1 in your blood.
• Imaging Tests: If blood tests confirm that GH levels are high, an MRI scan may be ordered to check for a pituitary tumor.

If the disease is confirmed, further tests can be done to see if it has affected other parts of the body.

• An echocardiogram to check the functioning of the heart.
• A sleep study to see if you are suffocating while sleeping.
• Colonoscopy to check the health of the colon.
• An X-ray or DEXA scan to check bone health.

What are the treatments for acromegaly?

There are several treatment options for acromegaly. Your doctor will determine which treatment is best for you based on your condition, the size and location of the tumor.

1. Surgery: This is the main treatment for most people. The most common procedure is called Transsphenoidal Surgery . This involves removing the pituitary gland tumor through the nose. If the tumor is completely removed, there is a good chance that the disease will be completely cured.

2. Medication: If surgery cannot completely remove the tumor, or if it is necessary to shrink the tumor before surgery, medications are used. These medications control the body's GH levels. Some people may need to take the medication long-term.

3. Radiation Therapy: This treatment is used to destroy any remaining parts of the tumor when surgery and medication cannot control the disease.

What complications can occur if left untreated?

If left untreated, acromegaly can lead to serious health problems over time. This is the most dangerous aspect of the disease.

• Type 2 Diabetes
• High blood pressure (Hypertension)
• Heart disease, especially cardiomyopathy
• Arthritis
• Colon polyps - These can later turn into cancer.
• Organ Failure

Therefore, it is very important to see a doctor as soon as possible if you have symptoms and to follow the prescribed treatment if the disease is diagnosed. If GH levels are controlled with treatment, the risk of these complications can be greatly reduced.

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