Have you ever noticed that the shape of your arms, legs, or face is changing? Maybe a ring you wear often feels tight, or your shoe size has changed? These are not just random things, they could be symptoms of a rare but potentially serious condition called acromegaly . Don't worry, we'll talk about this in detail and simply today.
What is Acromegaly? Simply put...
Acromegaly is a condition caused by high levels of a chemical called Growth Hormone (GH) in your body. Normally, this growth hormone (GH) is produced by the pituitary gland , a pea-sized gland at the base of our brain. However, in acromegaly, this hormone is produced in excess due to a tumor in the pituitary gland or elsewhere in the body.
Did you know that the pituitary gland is a small but very important gland. It releases eight hormones, one of which is growth hormone (GH).
What is growth hormone (GH) for us?
Growth Hormone, also known as Human Growth Hormone (hGH) or Somatotropin , is a natural hormone. It is important for the growth of various parts of our body and for height during childhood. However, as we grow older, after the epiphyses of our bones have closed, our bodies still need this GH. Do you know why? It helps maintain the healthy structure of our bones, cartilage, and internal organs, and helps with metabolism, especially keeping our blood glucose levels at the right levels.
So, if the body's growth hormone (GH) increases too much after adulthood, problems such as bone deformity, organ enlargement, and increased blood sugar levels (hyperglycemia) can occur.
What is the difference between Acromegaly and Gigantism?
Both are caused by an increase in growth hormone (GH). However, the difference lies in who the condition affects. Adults develop acromegaly. Children develop gigantism .
If growth hormone (GH) levels increase in children before the growth plates in their bones close (i.e., before puberty is complete), they will grow abnormally tall. This is called gigantism. It is rarer than acromegaly. Some doctors also call it "pediatric acromegaly."
However, if your growth hormone (GH) levels increase after your growth plates have closed, you won't grow taller. However, that excess hormone can affect the shape of your bones, the size of your organs, and other health factors. That condition is called acromegaly.
Who is most likely to develop acromegaly?
It can develop at any age after puberty. However, doctors most often diagnose it in people between the ages of 40 and 50, that is, in middle age.
How common is this?
Acromegaly is actually a rare disease . Only about 31 out of 100,000 people have been diagnosed with this disease. So don't be unnecessarily scared, but it's important to be aware of the symptoms.
How does acromegaly affect my body?
When an adult develops acromegaly, that is, when there is an increase in growth hormone (GH), the bones, cartilage, organs of the body, and other tissues begin to enlarge in size. There are obvious changes in appearance . For example:
- Enlargement of hands and feet.
- Enlargement of ears, lips, and nose.
- Protruding jaw, enlarged forehead.
Growth hormone (GH) signals our liver to produce another hormone called Insulin-like Growth Factor 1 (IGF-1) . This hormone, called IGF-1, actually helps our bones and body tissues grow, and also affects the way our body controls blood sugar (glucose) and fats (lipids). So, when GH levels increase, IGF-1 levels also increase. This can lead to conditions like Type 2 Diabetes , High Blood Pressure (Hypertension) , and Heart Disease .
Just think, just like a faucet that is left running too long wastes water, these hormones, when they become too high, have various effects on the body.
What are the causes of acromegaly?
The most common cause of acromegaly is a tumor in the pituitary gland. This is called a pituitary adenoma . This tumor causes the pituitary gland to release too much growth hormone (GH).
A little more about Pituitary Adenoma...
These pituitary adenomas are often benign. That is, they are not cancerous. Most of the tumors that cause acromegaly grow very slowly. So, you may not notice any symptoms of this excess GH for years.
Depending on the size and location of the tumor, it can press on other parts of the pituitary gland and affect other hormones produced by the pituitary gland. If the tumor is large, it can also press on nearby parts of the brain, causing headaches and vision problems .
What are the symptoms of Acromegaly?
When an adult develops acromegaly, it affects the body's bones and tissues, causing them to grow abnormally. This can cause the following symptoms:
- Enlarged hands or feet: Maybe your rings start to get tight, and your shoe size, especially the width, increases.
- Changes in facial shape: Protrusion or enlargement of the jaw area and/or forehead.
- Enlargement of the lips, nose, and/or tongue.
- Excessive sweating or oily skin.
- Voice deepening and hoarseness.
Other symptoms:
- Headaches
- Joint pain
- Vision changes
- Increased occurrence of small skin tags
- Numbness in hands
- Sleep apnea (sleep apnea)
- Carpal tunnel syndrome or spinal problems.
Acromegaly symptoms often develop very slowly , sometimes over years. So they can be difficult to recognize at first. Some people only notice that their hands have become larger when a ring they wear becomes tight or their shoe size changes.
Imagine, there is a person named Nilanthi. She has been feeling like her wedding ring is tight for a while now. Her shoes are not as tight as they used to be, they are a little tight. She thought she had just grown bigger. But at the same time, her friends are saying that her face is a little different than before, and her chin is a little bigger. These are the little things that are noticed first.
If you have these symptoms, it is very important to talk to a doctor.
How is Acromegaly diagnosed?
Because the symptoms appear very slowly, over many years, it can be a little difficult to diagnose.
Your doctor may refer you to an endocrinologist , a doctor who specializes in hormone-related diseases. He or she will make a diagnosis based on your medical history, clinical examination, and specialized tests (such as blood tests and imaging tests).
What are the diagnostic tests?
If you are diagnosed with acromegaly, your doctor may order further tests to see if the condition has affected other parts of your body. These may include:
- An echocardiogram test to check for heart problems.
- Sleep study tests to see if you are suffocating during sleep.
- Colonoscopy to check the health of the colon.
- Check bone health with an X-ray or DEXA scan .
How is Acromegaly treated?
There are several treatment options for acromegaly. Depending on your symptoms and condition, your doctor will suggest the treatment that is right for you.
The most commonly used treatments are:
- Surgery
- Medication
- Radiation therapy
Surgery for Acromegaly
In many cases, surgery can significantly reduce or completely cure the symptoms of acromegaly. Surgeons most often use a technique called transsphenoidal surgery , which involves performing the surgery through the nose and through the sphenoid sinus (a hollow space behind the nasal passages, below the brain).
The details of the surgery depend on the size and location of the tumor. The primary goal of surgery is to completely remove the tumor that is causing the excess growth hormone (GH) production. If the surgeon is able to remove a large portion of the tumor, you may not need any further treatment. However, if only part of the tumor is removed, you may need medication or radiation therapy to control symptoms and reduce growth hormone (GH) production.
Medications for Acromegaly
Your doctor may prescribe one medication or a combination of medications. The medications work in different ways to normalize your body's growth hormone (GH) levels and reduce symptoms. In some cases, the medication is given until the tumor shrinks, so a surgeon can safely remove it. Other people may need to take medication long-term to control growth hormone (GH) levels and symptoms.
Can acromegaly be completely cured?
Acromegaly can sometimes be cured, but not always. When a pituitary tumor causing acromegaly is surgically removed, the cure rate is about 85% for small tumors . For larger tumors, it is between 40% and 50%.
Medications cannot completely cure acromegaly, but they can provide long-term, safe treatment .
Can acromegaly be prevented?
Unfortunately, there is nothing you can do to prevent acromegaly. Scientists are still not sure what causes the pituitary tumors that cause acromegaly. However, they believe that some genetic factors may play a role.
What is the prognosis of acromegaly?
The outlook for this depends on the severity of the disease and how well the symptoms are controlled with treatment. Many people see a significant reduction in symptoms after treatment.
If left untreated, acromegaly can significantly change your appearance and the shape of your bones. These symptoms can have a significant impact on your self-esteem and quality of life. Support groups help some people cope with the challenges of acromegaly.
Acromegaly can also cause health complications, such as heart disease or type 2 diabetes, which can reduce quality of life and shorten life expectancy. Therefore, it is important to see a doctor if you have symptoms and, if diagnosed, to follow a treatment plan closely.
What complications can occur if left untreated?
If left untreated, acromegaly can lead to complications such as:
- Type 2 diabetes
- High blood pressure (Hypertension)
- Heart disease
- Heart muscle disease (Cardiomyopathy)
- Arthritis
- Colon polyps - These can become cancerous if left untreated.
- Organ failure
What is the life expectancy of someone with acromegaly?
This depends on the severity of the disease and whether there are other health conditions, which are often caused by untreated acromegaly.
If your growth hormone (GH) levels are not properly controlled and you have other conditions like heart disease and diabetes, your lifespan can be reduced by about 10 years.
However, if you have acromegaly, are treated properly, and have normal growth hormone (GH) and IGF-1 levels, you are likely to live a normal life span.
When should I see a doctor about acromegaly?
If you have symptoms of acromegaly, it is very important to talk to a doctor.
If you have been diagnosed with acromegaly, you will need to see your doctor regularly to make sure your treatment is working properly.
Acromegaly is a rare but serious condition. The good news is that it can be treated with surgery, medication, and/or radiation therapy. If you've noticed that your hands, feet, and/or facial features are getting bigger, talk to your doctor. He or she can run a few simple tests to see if your growth hormone (GH) levels are the cause of your symptoms.
Finally, take-home message
- Acromegaly is a rare condition in adults caused by increased growth hormone (GH).
- Symptoms may include swelling of the limbs and face, excessive sweating, and a change in voice . These may appear slowly, so you may not notice them.
- The main cause of this is a tumor, often non-cancerous, that develops in the pituitary gland.
- Early detection and treatment can prevent many complications and improve quality of life.
- If you have these symptoms, don't hesitate to seek medical advice. That's the wisest thing to do.
Please remember, this information is for informational purposes only. It should never be used as a substitute for medical advice. If you have any health concerns, please consult a qualified medical professional.
` Acromegaly, Growth Hormone, Pituitary Gland, Gigantism, IGF-1, Hormonal disorder, Endocrine
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