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Overview
What Is Acromegaly?
Acromegaly is a rare hormone disorder in which the body produces too much growth hormone. In most cases, the excess hormone comes from a benign tumor in the pituitary gland. Acromegaly develops after the growth plates have closed, so it causes bones and other tissues to grow wider or thicker rather than making a person taller. This acromegaly definition explains why changes may appear gradually in adults.
Symptoms
Acromegaly Symptoms
Acromegaly symptoms often develop slowly, so they may not be obvious at first. A person may notice changes in appearance, shoe or ring size, energy, sleep, or body function over several years. Comparing current features with older photographs can sometimes make these changes easier to recognize.
- Enlarged hands or feet, including a gradual increase in ring or shoe size
- Coarsened or more prominent facial features
- Enlargement of the jaw (prognathism)
- Wider spaces between the teeth
- Thickened, oily, or rough skin
- Excessive sweating
- Joint pain or stiffness
- Persistent headaches
- Vision changes, especially loss of side vision
- Loud snoring or pauses in breathing during sleep (sleep apnea)
- Numbness or tingling in the hands (carpal tunnel syndrome)
- Irregular or absent menstrual periods
- Reduced sexual function or interest
- Fatigue or reduced energy
When symptoms are subtle
Changes can develop gradually
Older photographs may help show gradual changes in the face, hands, or feet, but they cannot diagnose acromegaly. Arrange a medical assessment rather than relying on appearance or self-diagnosis.
Causes
Causes of Acromegaly
Growth hormone normally signals the liver and other tissues to produce insulin-like growth factor 1 (IGF-1). IGF-1 helps promote growth and changes in tissues and bones. When growth hormone and IGF-1 remain too high after normal height growth has ended, bones and soft tissues can gradually become enlarged, causing acromegaly.
PITUITARY CAUSES
Most cases are caused by a benign growth hormone-producing pituitary adenoma. The tumor can also press on nearby structures, contributing to headaches or vision problems.
RARE NONPITUITARY CAUSES
Rarely, a tumor elsewhere in the body produces growth hormone or a hormone that stimulates the pituitary to release it. These nonpituitary causes require targeted testing to identify the source.
Risk Factors
Acromegaly Risk Factors
Acromegaly can affect adults of any sex and is most often diagnosed in middle age. It is usually not preventable and is not caused by diet, exercise, or another modifiable behavior. Most people have no clear risk factor beyond the development of a pituitary tumor.
- Middle age is the typical period when acromegaly is diagnosed, although it can occur earlier or later; this is a nonmodifiable factor.
- A family history of pituitary tumors may be relevant and should be shared with a clinician; family history is nonmodifiable.
- Rare inherited endocrine tumor syndromes, such as multiple endocrine neoplasia type 1, can increase risk; these genetic factors are nonmodifiable.
- A personal history of certain inherited hormone-related conditions may increase the likelihood of pituitary tumors; this factor is nonmodifiable.
Complications
Acromegaly Complications
Complications of acromegaly may develop gradually when growth hormone and IGF-1 remain elevated. Effective treatment and regular monitoring can reduce future health risks and help identify problems early.
- High blood pressure
- Heart disease or enlargement of the heart
- Diabetes or impaired blood glucose control
- Sleep apnea
- Arthritis and other joint problems
- Carpal tunnel syndrome
- Vision loss caused by pressure from a pituitary tumor
- Colon polyps
- Reduced quality of life
Diagnosis
How Acromegaly Is Diagnosed
Clinicians diagnose acromegaly by combining physical findings, hormone tests, and imaging. Appearance alone is not enough because similar changes can have other causes, and symptoms may be subtle or develop slowly.
Blood tests for growth hormone excess
- An IGF-1 blood test is usually the initial test because IGF-1 levels are more stable than growth hormone levels.
- Growth hormone may be measured during an oral glucose tolerance test, because glucose normally lowers growth hormone but may not do so in acromegaly.
- Results are interpreted using the person’s age, symptoms, examination findings, and other medical information.
Treatment & Management
Acromegaly Treatment and Management
Acromegaly treatment is individualized according to tumor size, hormone levels, symptoms, vision effects, overall health, and response to earlier treatment. The goals are to lower growth hormone and IGF-1, control tumor growth, protect vision, and manage complications. Treatment may control the disease without reversing every physical change.
| Treatment | Main role | Important considerations |
|---|---|---|
| Transsphenoidal pituitary surgery | Removes the pituitary tumor through the nose and may rapidly lower hormone levels. | Often considered when a tumor can be safely removed; hormone levels may remain high if the tumor cannot be completely removed. |
| Medicines | Lower growth hormone production or block the effects of growth hormone. | May be used when surgery is not suitable, when disease persists, or as additional treatment; ongoing doses and monitoring may be needed. |
| Radiation therapy | Reduces hormone production from remaining tumor tissue when other treatments do not control the disease. | Its effects can take time, and long-term follow-up is needed because other pituitary hormone problems may occur. |
- Repeat IGF-1 and growth hormone testing helps assess whether treatment is controlling hormone excess.
- Pituitary imaging is repeated when indicated to monitor remaining or returning tumor tissue.
- Vision assessment is used when a tumor affects or may affect the optic nerves.
- Cardiovascular and metabolic complications are screened for and treated as needed.
- Sleep apnea is evaluated and treated to improve breathing and reduce related health risks.
- Joint pain, stiffness, and other musculoskeletal problems are managed with appropriate care.
Outlook and Prognosis
Outlook and Prognosis for Acromegaly
Acromegaly is usually manageable, but one treatment does not reliably cure every case. Outcomes are generally better when the condition is recognized early and growth hormone, IGF-1, and related complications are controlled.
Many people need lifelong or extended follow-up with an endocrinology team. Care may include repeat hormone testing, imaging when appropriate, and monitoring for tumor recurrence or persistent complications.
When Should You See a Doctor
When Should You See a Doctor?
- Arrange an appointment if your ring or shoe size steadily increases without another clear explanation.
- Ask for medical advice about noticeable changes in facial features or jaw shape.
- Discuss persistent or recurring headaches with a clinician.
- Seek evaluation for excessive sweating that is new or difficult to explain.
- Arrange an assessment for menstrual changes or reduced sexual function.
- Discuss ongoing joint pain, stiffness, or swelling.
- Ask about evaluation if loud snoring, pauses in breathing, or severe daytime sleepiness suggest sleep apnea.
Seek urgent care
Some symptoms need prompt attention
Seek urgent medical care for sudden vision loss, a severe sudden headache, fainting, chest pain, or severe breathing difficulty. These symptoms can have causes other than acromegaly, but they should be assessed promptly.
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Acromegaly
Endocrinology & Metabolic Diseases
Tests & Procedure
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Acromegaly
Hormone Therapy
Symptoms
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