Acromegaly

What is acromegaly?

Acromegaly is a hormonal disorder. It develops when your pituitary gland, located deep in the brain, produces too much growth hormone (GH). Growth hormone affects growth of all tissues of the body, especially bone. Too much of this hormone can cause:

• abnormal growth of the head, face, hands, or feet
• diabetes
• coronary artery disease
• high blood pressure
• enlarged heart, kidneys, liver, spleen and other organs.

How does it occur?

Acromegaly is nearly always caused by a benign (noncancerous) tumor of the pituitary gland called an adenoma. The tumor produces too much growth hormone. The cause of these tumors is not known. In some cases, tumors in other parts of the body cause an excess of growth hormone.

What are the symptoms?

The most common symptoms of acromegaly are enlarged hands and feet. In addition to enlarged hands and feet, acromegaly may also cause:

• enlargement of bones and features of the face, including the tongue
• deep husky voice
• heavy sweating
• headaches
• vision problems
• loss of sex drive
• irregular menstrual periods
• erectile dysfunction.

Acromegaly usually develops very slowly. The gradual physical changes may not be noticed for several years.

How is it diagnosed?

Your healthcare provider will ask about your symptoms and examine you. You may have one or more of these tests:

• blood tests to measure growth hormone levels or insulin growth factor 1 (IGF-1)
• blood tests to measure blood sugar levels (glucose tolerance test)
• computerized tomography (CT) scans or magnetic resonance imaging (MRI) scans.

How is it treated?

The goals of treatment are to:

• Reduce the amount of growth hormone your body produces
• Relieve the pressure of the growing pituitary tumor on other parts of the brain
• Keep the pituitary gland working normally.
• Reduce the symptoms.

Current treatment choices are surgery, medicine, and radiation. You may need more than one type of treatment.

Surgical removal of the tumor is often the first treatment option. Most pituitary tumors can be removed, at least partially. This relieves pressure on the brain and reduces growth hormone levels. The facial appearance and soft tissue swelling start to improve within a few days after successful surgery. It can also bring high blood pressure back to a normal level.

Medicines used to control or block growth hormone are octreotide (Sandostatin), cabergoline (Dostinex), bromocriptine (Parlodel), and pegvisomant (Somavert). Sometimes medicines are used to shrink the tumor before surgery. Radiation therapy of the pituitary gland is another possible treatment to reduce the levels of growth hormone.

How long will the effects last?

Usually, hormone levels may improve but not return completely to normal after surgery. You may always need to take medicines to keep the growth hormone levels low. Or you may need to take medicines to keep the tumor from getting bigger. You will need to be checked regularly by your healthcare provider for increasing growth hormone levels or a return of the tumor.

How can I take care of myself?

• It is very important that you keep your follow-up appointments with your healthcare provider.
• If you are taking medicine, take it exactly as prescribed.
• If you notice new or returning symptoms, see your healthcare provider promptly.
• Follow your healthcare provider's advice about diet and exercise.