Acromegaly
Also known as: Growth hormone excess, Gigantism (when it begins in childhood)
Acromegaly is a hormonal disorder in which the body produces too much growth hormone, almost always because of a noncancerous tumor in the pituitary gland. In adults, whose growth plates have closed, the excess hormone does not make you taller but gradually enlarges the bones of the hands, feet, and face and thickens soft tissues. Because the changes happen over years, acromegaly is often diagnosed late, sometimes only after someone notices that rings or shoes no longer fit or that their facial features have changed in old photographs. Left untreated, it raises the risk of diabetes, high blood pressure, heart disease, sleep apnea, and joint problems. Treatment can control hormone levels and reverse many of the soft-tissue changes.
At a Glance
- Common symptoms
- Enlarged hands and feet, with rings and shoes becoming tight, Coarsened facial features, including a larger nose, lips, jaw, and brow, Widely spaced teeth and a protruding lower jaw
- Main treatments
- Surgery to remove the pituitary tumor through the nose (transsphenoidal surgery), which is the first-line treatment for most people, Somatostatin analog injections (such as octreotide or lanreotide) to lower growth hormone production, Growth hormone receptor blockers (pegvisomant) or dopamine agonists when other options are insufficient
- Category
- Endocrine · Rare; most often diagnosed in middle-aged adults after years of gradual changes
- See a doctor if
- Your hands, feet, or facial features have gradually enlarged
Symptoms
Causes
- A benign pituitary tumor (adenoma) that secretes growth hormone, responsible for the vast majority of cases
- Rarely, tumors elsewhere in the body (lungs, pancreas) that produce growth hormone or the hormone that stimulates it
- Rare inherited syndromes such as multiple endocrine neoplasia type 1 or familial isolated pituitary adenoma
Risk Factors
- Middle age, when the condition is most often diagnosed
- A family history of pituitary tumors or related genetic syndromes
- No clear lifestyle risk factors are known; most cases arise sporadically
- Long-standing untreated symptoms increase the risk of complications
Diagnosis
- Blood test for IGF-1, which is reliably elevated in active acromegaly
- Oral glucose tolerance test with growth hormone measurement, since growth hormone normally falls after sugar but does not in acromegaly
- MRI of the pituitary gland to locate and measure the tumor
- Vision field testing if the tumor is large
- Screening for complications such as diabetes, high blood pressure, sleep apnea, and colon polyps
Treatment
- Surgery to remove the pituitary tumor through the nose (transsphenoidal surgery), which is the first-line treatment for most people
- Somatostatin analog injections (such as octreotide or lanreotide) to lower growth hormone production
- Growth hormone receptor blockers (pegvisomant) or dopamine agonists when other options are insufficient
- Radiation therapy for tumors that cannot be fully removed or do not respond to medication
- Management of complications, including blood pressure, blood sugar, sleep apnea, and joint pain
- Supportive: regular physical activity and a heart-healthy diet to reduce cardiovascular and metabolic risk
- Supportive: dental and orthopedic care for jaw, bite, and joint changes
Prevention
- Acromegaly cannot be prevented, but early diagnosis limits permanent changes
- Pay attention to gradual changes in hand, foot, or facial size
- Seek evaluation for unexplained joint pain, sweating, and sleep apnea occurring together
- People with a family history of pituitary tumors may benefit from genetic counseling
- Keep up with follow-up appointments after treatment, since tumors can recur
When to See a Doctor
- Your hands, feet, or facial features have gradually enlarged
- You develop persistent headaches with vision changes
- New diabetes, high blood pressure, or sleep apnea alongside physical changes
- Sudden severe headache, vision loss, or collapse in someone with a known pituitary tumor (emergency)
Frequently Asked Questions
Related Conditions
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