Acromegaly

Overview

Acromegaly is a hormonal disorder that develops when your pituitary gland produces too much growth hormone during adulthood. This excess growth hormone leads to an increase in bone size, specifically in the bones of your hands, feet, and face, a condition known as acromegaly. This disorder is uncommon and its physical changes occur slowly over many years, making it sometimes difficult to recognize. If left untreated, high levels of growth hormone can affect other parts of the body, leading to serious, sometimes even life-threatening health problems. However, treatment can reduce the risk of complications and significantly improve symptoms, including the enlargement of features.

Symptoms

Common Signs

A common sign of acromegaly is enlarged hands and feet. For instance, you may find that rings that used to fit are now too small, and that your shoe size has progressively increased. Acromegaly may also cause gradual changes in the shape of your face, such as a protruding lower jaw and brow bone, an enlarged nose, thickened lips, and wider spacing between your teeth.

Progression

Because acromegaly progresses slowly, early signs may not be obvious for years. Sometimes, people notice the physical changes only by comparing old photos with newer ones.

Varied Symptoms

Overall, acromegaly signs and symptoms tend to vary from one person to another, and may include any of the following:

• Enlarged hands and feet.
• Enlarged facial features, including the facial bones, lips, nose, and tongue.
• Coarse, oily, thickened skin.
• Excessive sweating and body odor.
• Small outgrowths of skin tissue (skin tags).
• Fatigue and joint or muscle weakness.
• Pain and limited joint mobility.
• A deepened, husky voice due to enlarged vocal cords and sinuses.
• Severe snoring due to obstruction of the upper airway.
• Vision problems.
• Persistent or severe headaches.
• Menstrual cycle irregularities in women.
• Erectile dysfunction in men.
• Loss of interest in sex.

When to See a Doctor

If you have signs and symptoms associated with acromegaly, contact your doctor for an exam. Acromegaly usually develops slowly, and even your family members may not notice the gradual physical changes that occur with this disorder at first. However, early diagnosis is important so that you can start receiving proper care. Acromegaly can lead to serious health problems if it’s not treated.

Causes

Growth Hormone Production

Acromegaly occurs when the pituitary gland produces too much growth hormone (GH) over a long period of time. The pituitary gland, a small gland at the base of your brain, produces GH and several other hormones. GH plays a crucial role in managing your physical growth. When the pituitary gland releases GH into your bloodstream, it triggers your liver to produce a hormone called insulin-like growth factor-1 (IGF-1). IGF-1 is what causes your bones and other tissues to grow. Too much GH leads to too much IGF-1, which can cause acromegaly signs, symptoms, and complications.

Pituitary Tumors

In adults, a tumor is the most common cause of excessive GH production. Most acromegaly cases are caused by a noncancerous (benign) tumor (adenoma) of the pituitary gland. The tumor produces excessive amounts of growth hormone, causing many of the signs and symptoms of acromegaly. Some of the symptoms of acromegaly, such as headaches and impaired vision, are due to the tumor pressing on nearby brain tissues.