Acromegaly – The ABCs

What is acromegaly?

Before we talk about acromegaly, it is quite important that you know that your body produces different kinds of hormones for it body to function normally. When these hormones are not properly produced, overproduced or are lacking in sufficient quantities, the body will cease to work properly based on the function of the hormone in question. Body functioning processes can even get out of hand.

When a special type of hormone called growth hormone is produced in unusually massive amounts in the body, acromegaly surfaces. Although it not very common, when it does happen, the affected person experiences excess tissues and bone growth. If a child is affected, he can attain an abnormally tall stature and an extremely huge bone structure, especially in the legs, arms, and face.

 

What are the symptoms of acromegaly?

The symptoms show up with time – it’s progressive. That is why it could be quite difficult to detect on time. For instance, you may observe in months that you have got a ring that feels somewhat tight on your finger. Then one day, you wake up to the reality that ‘hey’, it doesn’t fit any longer. Also, your leg could grow to the extent that you just realize one day that your shoe has become undersized.

But you can always watch out for these common symptoms:

  • Your face, hands and feet bones will become enlarged bones.
  • If you are a woman, you will experience an excessive growth of hair.
  • Your tongue and perhaps jaw becomes enlarged
  • You should expect to have a prominent brow
  • You will also experience excessive growth spurts. This is quite common in those who have had abnormal in their pre-adolescence years.
  • More weight will be gained.
  • Joints will become painful and swollen. This can limit movements.
  • You will have spaces between your teeth
  • Your toes and fingers will be splayed.
  • Your voice will become hoarse and deep.
  • An unexplained weakness of the muscles and body.
  • Headaches
  • Sleeplessness
  • Sweating excessively.
  • Unpleasant body odor
  • Increased sebaceous glands. Sebaceous glands manufacture sebum, skin oil.
  • Your skin will become thickened.
  • Non-cancerous growths called skin tags will appear on your skin.

Seeing your doctor is no option when you notice any of these symptoms.

 

Acromegaly

Photo Credit: Mayo Clinic

 

So what can cause acromegaly?

Your body’s growth and development is largely dependent on your growth hormone (GH). It is produced in a gland located in your brain. It is called the pituitary. The slightest tumor in this gland can trigger its unreasonable activity in GH manufacturing. When its production is more than the required amount, your bones, tissues, and organs begin to grow more than is necessary, too; more than what the average growth range is. That’s acromegaly. At least, 95% of cases of this condition were associated with a tumor in the pituitary. This percentage was a submission of the National Institutes of Health.  This tumor is a benign tumor and is often referred to as an adenoma. But not all adenomas will cause an acromegaly.

 

Who could be at risk for an acromegaly?

Post-pubertal and mid-age adults are at a risk. The body changes happen progressively that you might even not be aware you are beginning to develop the condition.

 

How to diagnose an acromegaly

Often, people who are affected are not aware that an acromegaly due to the fact that it doesn’t occur suddenly. But your doctor can always diagnose you of it if he suspects you might have it. It is easy to diagnose in mid-age adults although the symptoms can manifest at any point in time.

Blood Tests

Blood tests can be conducted on you to determine if you have excess GH in your blood. Because throughout the day, GH levels are always changing in the body, doing a GH test might hence give a false result.

Glucose tolerant test

That is why your doctor might order for a glucose tolerance test. In this test, you will be required to consume about 75 – 100 grams of glucose. After this, your glucose level will be tested for. If your body is producing normal amounts of GH, too much glucose will make your body suppress your GH concentrations. But if you have an acromegaly, your GH levels will remain high.

Insulin-Like Growth Factor 1 (IGF-1) test

In this test, your doctor tests for a protein – insulin-like growth factor 1 (IGF-1). IGF-1 levels will show if an abnormal growth exists in your body. IGF-1 is also adopted in testing and monitoring the progress of various hormonal treatments.

Imaging Studies

Imaging tests such as an MRI scan and X-rays can also be used in diagnosing this condition. These tests reveal internal organs as they are in size and the condition diagnosed. That a tumor is not found in the pituitary gland doesn’t certify that you don’t have an acromegaly. Tumors could have grown in the organs of the body such as the pelvis, chest, and abdomen. Tumors in these organs can raise GH production. This means that your doctor will not only scan your pituitary gland, he will also check those other organs.

Your doctor might as well do a physical examination on you.

A sonogram may also be used to view the size of your internal organs. In every 1 million people, 4 are likely to have an acromegaly. This was one of the reports submitted by NIH although this might not always be true as most cases could go undiagnosed on time in the early stage.

 

Treatment for acromegaly

The goals of every acromegaly treatment are to;

Return GH production amounts to normal

  • Eliminate pressure around any pituitary tumors that are growing.
  • Maintain normal functions of the pituitary.
  • Treat hormone deficiencies that present as well as improve acromegaly symptoms.

Various treatment options exist but they are determined by your overall health and age.

Surgery

It is often the first recommended options by doctors to get rid of the tumors. It has been proven to be very successful in reducing GH levels to normal levels and improving symptoms. Besides, it is very quick. One minus to a surgical option is a likely damage to the tissues surrounding the pituitary gland and sometimes meningitis and a cerebrospinal fluid leak. Damage to the pituitary tissues will mean that you will be placed on a lifelong pituitary hormone replacement.

Medication

It is an option when surgery has failed in putting GH levels under control. It is also used to shrink enlarged tumors prior to the time of surgery. These medication types are used in regulating or block GH release; dopamine agonists, somatostatin analogs and GH receptor antagonists.

Radiation

Radiation is a long-term therapy for getting rid of tumors. This is because it has to be given in multiple sessions and a session lasts for about 4 -6 weeks.

Radiation is used to shrink large tumors or parts of a tumor that a surgery could not get rid. It could as well be used in combination with medications when the use of just medications is not fruitful. This combination method is a slow process of tumor destruction.

Radiation has its accompanying side effects. For instance, it can impair your reproductive functions, cause brain damage, loss of vision and sometimes secondary tumors.

 

What are the complications associated with acromegaly?

Acromegaly has its intrinsic complications that could be serious if left unattended to on time. Some of these complications are;

  • Loss of vision
  • Spinal cord compression
  • Noncancerous fibroids of the uterus if a woman is affected
  • A deceased pituitary hormone release. This is referred to as hypopituitarism.
  • A syndrome called carpal tunnel.
  • Sporadic breathing pattern while asleep – sleep apnea
  • Pre-cancerous growths (polyps) on the lining of the intestine.
  • Enlargement of the thyroid gland. That’s goiter. It is expressed in the swelling of the neck.
  • Type 2 diabetes
  • Joint paints – arthritis
  • Enlargement of the heart
  • High blood pressure

 

The outlook for acromegaly

It is quite a good one if and only if the condition is diagnosed very early.  The pituitary tumors will be removed successfully. Treatment may also help keep acromegaly from having long-term effects.

It could be quite challenging coping with acromegaly symptoms and its treatments. Joining a support group would be very helpful for you. You could find out some of these support groups on the web.

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