Acromegaly: Causes, Symptoms, Risk Factors, Diagnosis, Treatment and Complications

A hormonal disease called acromegaly happens when your pituitary gland overproduces growth hormone as an adult.

If you have an excess of growth hormone, your bones will grow. Gigantism is a condition that causes children to grow taller. However, there is no difference in height as an adult. The condition is known as acromegaly and affects just the bones in your hands, feet, and face.

Acromegaly is a rare disorder, and because the physical changes take place gradually over several years, it can sometimes take a while to diagnose. High levels of growth hormone can have effects on your bones in addition to other body parts if left untreated. Serious health issues may result, perhaps even life-threatening ones. However, treatment can significantly lessen your risk of complications and improve your symptoms, including the growth of your characteristics.

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What Causes Acromegaly?

Acromegaly happens when the pituitary gland continuously and excessively produces growth hormone (GH).

The pituitary gland is a little gland that is located behind the bridge of your nose at the base of your brain. It also produces GH and a number of other hormones. Your ability to govern your physical development depends on GH.

Your liver creates IGF-1, also known as insulin-like growth factor-I or IGF-I, in response to the pituitary gland secreting GH into your bloodstream. IGF-1 causes your bones and other tissues to grow. IGF-1 production is increased when GH levels are excessively high, which may result in the symptoms.

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Symptoms Of Acromegaly

Larger hands and feet are frequent characteristics of acromegaly. You might notice, for instance, that your shoe size has steadily increased and that previously fitting rings no longer fit.

Acromegaly can also cause subtle alterations in the way your face looks, like a protruding lower jaw and brow bone, a wider smile, thicker lips, and a broader nose.

Because acromegaly has a tendency to progress slowly, early signs may not be seen for years. Contrasting earlier and more recent photographs can often be the only way for people to notice physical changes.

Acromegaly generally manifests as any of the following signs and symptoms, which can vary from person to person:

• The hands and feet are bigger
• Enlarged features on the face, like lips, nose, tongue, and facial bones.
• Thickened, coarse, and greasy skin
• Sweating excessively and bad body odor
• Skin tags are tiny skin tissue growths.
• Joint or muscle weakness and exhaustion
• Limited joint motion and discomfort
• A voice that is thickened and husky due to enlarged sinuses and vocal cords
• Excessive snoring caused by an obstruction in the upper airway
• Vision issues
• Headaches that could be severe or chronic
• Women's irregular menstrual cycles
• Male erectile dysfunction
• Loss of sex enthusiasm

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Risk Factors Of Acromegaly

A tumor is the most prevalent cause of increased GH production in adults:

• Pituitary tumors. Acromegaly is primarily brought on by a pituitary adenoma, a noncancerous (benign) tumor. The tumor's excessive growth hormone production is what causes the majority of acromegaly's symptoms.

Acromegaly symptoms including headaches and vision problems are brought on by the tumor pressing on adjacent brain regions.

• Non-pituitary tumors. Acromegaly is occasionally brought on by tumors in other organs like the pancreas or the lungs. These tumors occasionally release GH. Other times, the pituitary gland receives a signal from the tumors to increase HGH production through the release of a hormone called growth hormone-releasing hormone (GH-RH).

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Diagnosis Of Acromegaly

Your doctor will ask you about your medical history and do a physical checkup. Then, he or she might suggest taking the following actions:

• Measurement of IGF-1. Your doctor will take a blood sample from you after you've fasted for the night in order to determine your blood's IGF-1 level. IGF-1 levels above normal point to acromegaly.
• Test for inhibition of growth hormone. The most reliable way to confirm an acromegaly diagnosis is using this test. In this test, the amount of GH in your blood is assessed both before and after you consume a sugar-containing preparation (glucose). The glucose drink usually lowers the GH level in patients without acromegaly. Acromegaly, however, causes your GH level to frequently remain high.
• Imaging. To determine the precise location and size of a tumor on your pituitary gland, your doctor could advise an imaging test, such as magnetic resonance imaging (MRI). Your doctor might schedule additional imaging exams to look for non pituitary tumors if no pituitary tumors are visible.

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Treatment Of Acromegaly

Treatment for acromegaly depends on the patient. The location and size of your tumor, the intensity of your symptoms, your age, and your general health will all likely have an impact on your treatment options.

Treatment options often involve surgery or radiation to remove or reduce the size of the tumor that is causing your symptoms, as well as medicines to help normalize your hormone levels, in order to help lower your GH and IGF-1 levels.

Your doctor can suggest additional therapies if you have acromegaly-related health issues in order to assist you in managing your challenges.

Surgery

Transsphenoidal surgery is a technique that doctors can use to remove the majority of pituitary tumors. Your surgeon will do this operation while accessing your pituitary gland through your nose. Your doctor will advise another sort of surgery to remove the tumor if it is not on your pituitary gland and is the cause of your symptoms.

When a tumor is removed, your GH levels usually return to normal, especially if your tumor is small. Removing the tumor may also assist with headaches and vision disturbances if the tumor is placing pressure on the tissues surrounding your pituitary gland.

Your surgeon might not always be able to remove the entire tumor. If so, even after surgery, your GH levels can remain excessive. Your doctor might advise more surgery, medication, or radiation therapy.

Medications

To assist your hormone levels in returning to normal, your doctor may advise one of the following medications or a combination of medications:

• Drugs (somatostatin analogs) that lower the generation of growth hormone. Your doctor will ask you about your medical history and do a physical checkup.
• Drug that acts as a growth hormone antagonist. Pegvisomant (Somavert), a medicine, prevents GH from impacting bodily tissues.

For those who haven't had great success with conventional treatments, pegvisomant may be very beneficial. This drug, which is administered as a daily injection, doesn't affect GH levels or tumor size, but it can help lower IGF-1 levels and relieve symptoms.

Radiation 

Your doctor might advise radiation therapy if your surgeon wasn't able to completely remove the tumor during surgery. Radiation therapy gradually reduces GH levels and gets rid of any tumor cells that are still alive. Before this treatment noticeably alters the symptoms of acromegaly, years may pass.

In addition to GH, radiation therapy frequently reduces the levels of other pituitary hormones. If you receive radiation therapy, you'll probably need to see your doctor on a frequent basis to ensure that your pituitary gland is functioning properly and to monitor your hormone levels.

Your lifetime may be occupied by this aftercare.

Radiation therapy comes in various forms, such as:

• Radiation therapy as usual. Over the course of four to six weeks, this kind of radiation therapy is often administered every weekday. For ten or more years following treatment, you might not fully experience the effects of traditional radiation therapy.
• Radiosurgery using Stereotactic Techniques. Stereotactic radiosurgery uses 3D imaging to deliver a high dosage of radiation to the tumor cells while reducing the quantity of radiation to healthy surrounding tissues. It can often be administered in a single dose. Within five to ten years, this kind of radiation might return GH levels to normal.

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Complications Of Acromegaly

Untreated acromegaly can cause serious health issues. Possible complications include:

• Hypertension, or high blood pressure
• High triglycerides
• Cardiovascular diseases, especially cardiomyopathy, which causes the heart to enlarge
• Osteoarthritis
• Diabetes type 2
• Goitre, an enlargement of the thyroid gland
• Polyps, which are malignant growths, on the colon's lining
• Breathing regularly stops and begins during sleeping, or sleep apnea
• Carpal tunnel syndrome
• Increased risk of malignant tumors
• Fractures or compression of the spinal cord
• Eyesight changes or loss of vision.

Acromegaly can be treated early to stop the onset or worsening of these problems. Acromegaly and its complications might cause early death if left untreated.

Frequently Asked Questions

Q: Which famous people have acromegaly?

Answer: The great khali (Dalip Singh Rana) and Big show (Paul Wight)

Q: What hormone causes Acromegaly?

Answer: excessive of growth hormone in adults causes acromegaly.

Q: What is the most common cause of Acromegaly?

Answer: pitutary gland tumor

Q: Can surgery be done for acromegaly?

Answer: Yes, surgery can be done for acromegaly by excision the pitutary gland.

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