Are your limbs and face gradually changing shape and getting bigger? Let's talk about Acromegaly.

Have you ever felt like your shoe size is getting bigger, or that the ring you used to wear is now stuck to your finger? Maybe your face shape looks a little different when you look at old photos? Many of these things happen over time, sometimes for years, so we don't pay much attention to them. But this could be a symptom of a rare condition called Acromegaly . Don't worry, we'll talk about everything in simple terms.

Simply put, what is Acromegaly?

Acromegaly is a condition caused by our body producing too much growth hormone, or Growth Hormone (GH) . This hormone helps us grow when we are young. However, if this hormone continues to be secreted after we have finished growing, that is, after we have become adults, some parts of our body, especially the bones of the arms, legs, and face, start to grow abnormally large.

This condition is usually seen most often in middle-aged people. But this does not mean that it does not occur in younger people. If growth hormone increases in this way at a young age, the condition is called gigantism. Then they grow unusually tall.

Why does acromegaly develop? What are the causes?

The main reason for this is a small gland the size of a pea at the base of our brain. We call it the Pituitary Gland . The most common cause of Acromegaly is a noncancerous (benign) tumor in this gland. This tumor is called a Pituitary Adenoma . This tumor stimulates the pituitary gland and produces too much growth hormone (GH).

This excess GH hormone accumulates in our blood and signals the liver to produce another hormone called IGF-1 (Insulin-like Growth Factor-1) . That IGF-1 hormone is what causes our bones and other organs to grow abnormally. It also affects the way our body controls sugar and fat, increasing the risk of developing other diseases.

Very rarely, this condition can also be caused by tumors that develop in other parts of the pancreas, liver, or brain. Research has found that some genetic factors may also play a role.

What are the symptoms of acromegaly?

These symptoms often appear gradually, so it may take a while for you to notice the difference.

How to diagnose this disease?

It's important to recognize this condition as soon as possible. When you see a doctor because of these symptoms, he or she will ask you questions like:

• What changes do you see?
• When did you first notice these changes?
• How are you feeling now?

Then, several tests are performed to confirm the diagnosis.

Main tests

• Blood tests: A blood test is done to see if your IGF-1 hormone levels are elevated for your age.
• Glucose Tolerance Test: Here, you are given a sugary drink and your blood sugar and GH hormone levels are measured for two hours. Normally, GH levels should drop after drinking sugar. If they don't, and remain high, it's a sign of acromegaly.

Other tests

• MRI or CT scan: These scans help to detect a pituitary tumor.
• X-ray tests: Check for bone thickening.
• Echocardiogram: An ultrasound test of the heart to see if the heart has been affected.
• Colonoscopy: Check the health of the colon.
• Sleep Study: See if you have Sleep Apnea.

What are the treatments?

Your doctor will determine the most appropriate treatment plan for you based on your age, health condition, and the severity of your condition. There are three main treatment options.

1. Surgery:

Often, the first treatment is surgery to remove the pituitary tumor. This is especially important if the tumor is pressing on the nerves that affect vision. The surgeon removes the tumor through a small incision through the nose or inside the upper lip. Symptoms may begin to improve within a few days after surgery.

2. Medication:

If there are any remaining tumor fragments after surgery or if you need more help controlling your hormone levels, your doctor will prescribe medications. These medications either lower your GH levels or block its effects on the body.

• Somatostatin analogs (e.g. lanreotide, octreotide)
• Growth hormone receptor antagonists (e.g. pegvisomant)
• Dopamine agonists (e.g. cabergoline)

3. Radiation Therapy:

If there are still parts of the tumor remaining after surgery and medication, or if GH levels need to be further reduced, radiation therapy is used. This stops the tumor from growing and reduces GH production. Modern techniques such as stereotactic radiosurgery can deliver high doses of radiation to the tumor without damaging healthy tissue.

Complications that may occur if left untreated

Acromegaly can cause serious health problems if not treated properly, so don't ignore this condition.

• Cardiovascular disease
• Diabetes
• High blood pressure
• Arthritis (Osteoarthritis)
• Carpal Tunnel Syndrome
• Sleep Apnea
• Loss of vision
• Increased risk of colon cancer
• Spinal nerve compression

Acromegaly, Growth Hormone, Pituitary Gland, Enlargement of limbs, Facial changes, Hormonal problems