Acromegaly

Acromegaly is an uncommon condition caused by excessive secretion of the growth hormone in adults.

Excess hormones result in abnormal growth of bones and soft tissues. Adults with this condition will have large hands and feet with prominent facial features.

This condition is commonly seen in middle-aged people. In children, excessive secretion of the growth hormone results in a condition called gigantism.

Changes due to acromegaly sets in slowly and hence, early detection is difficult.

If left untreated, an excess amount of growth hormones causes complications and leads to life-threatening situations.

Thus, treatment of acromegaly is important. Treatment usually has a good outcome and improves the symptoms considerably.

The characteristic symptoms of acromegaly are abnormal growth of the hands and feet. These are one of the earliest symptoms of the condition, often noticed with a change in shoe or ring size.

As the condition progresses, facial features also show changes.

Protrusion of the jaw bone and enlargement of the nasal bone are noticeable. The space between teeth increases and lips can thicken.

In addition, acromegaly have the following symptoms:

• Joint pain
• Rough and thick skin
• Tags on the skin
• Increased chest size
• Hoarseness in voice
• Excessive sweating
• Sleep apnea
• Headache
• Impaired vision
• Fatigue
• Irregularities in menstrual cycle in women
• Decreased libido
• Enlargement of internal organs like kidney, liver, and spleen

Excess production of the growth hormone in adults is the main cause of acromegaly.

Benign tumors increase the production of growth hormones from the pituitary gland.

Tumor types

Pituitary tumors are the most common cause of this disorder. Benign tumors of the pituitary gland stimulate excessive secretion of growth hormones.

Non-cancerous tumors found in other parts of the body like the lungs and pancreas may also result in this disorder.

These tumors produce the growth hormone-releasing hormone, which stimulates increased secretion of the original growth hormone.

Medical history, blood tests and physical examinations of the patient are used in making diagnosis of acromegaly.

Growth hormone suppression tests and imaging techniques are also used in the diagnosis of acromegaly.

Blood tests are done to measure the levels of the growth hormone and IGF-1, both of which would be elevated with acromegaly.

The growth hormone suppression test is the most conclusive test in the diagnosis of this disorder. In this test, the patient is asked to have glucose solution before and after the test.

In a normal person, GH levels go down after the ingestion of a glucose solution as glucose suppresses the release of the hormone.

In patients with acromegaly, the level of the hormone remains high.

Imaging methods like MRI are used to locate and assess the size of a tumor in and around pituitary glands.

If tumors are not present in the pituitary gland, a doctor may look out for tumors in other parts of the body as well.

Reducing the levels of the growth hormone is the focus of any treatment method for acromegaly. Surgery, radiation and medications are the most common methods used.

Surgical method removes pituitary tumors, which reduces the pressure on surrounding tissues.

If the whole tumor is not removed, it may result in high levels of GH after the surgery and require further treatment with medications or radiation.

Medications are used to block or reduce the production of the growth hormone from the gland. This includes somatostatin analogues, dopamine agonists, and growth hormone agonists.

Radiation is used to remove tumor cells that are present after surgery. In radiation therapy, radiation may be delivered daily for 4-6 weeks.

High beam radiation is delivered to the tumor in proton beam therapy.

In Gamma knife surgery, high dose radiation is delivered to the tumor without affecting the surrounding tissues.

Medical researchers have not yet found a way to prevent acromegaly.

If you have a history of pituitary tumors, periodic checkups will help in identifying any abnormal growth in the gland.

There are several alternative and homeopathic remedies used for the treatment of acromegaly.

Thyreoidinum, pitu-gl, Baryta carb, and Carcinosin are some of the medications suggested in homeopathy for the treatment of acromegaly.

Licorice tea, astralagus extract, and chaste-tree berry are some alternative herbal remedies suggested.

These remedies should be used with caution as their effectiveness is not scientifically proven yet.

Knowing about the disease and the different treatment options help in coping with acromegaly.

It also helps to make wise decisions regarding the choice of treatment.

If left untreated, acromegaly may lead to complications like:

• Arthritis
• Cardiomyopathy
• Diabetes
• Hypertension
• Loss of vision
• Sleep apnea
• Kidney failure
• Osteoarthritis