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What is Acromegaly?

Acromegaly is a rare but serious hormonal condition that develops because of an excess amount of growth hormone (GH) in your body. The extra amount of GH leads to excess growth in the bones and soft tissues of your body. Children with the condition might grow to abnormal heights along with an exaggerated bone structure. The arms, legs, and face are the parts mostly affected by acromegaly. Due to acromegaly being uncommon and the physical changes happening gradually over many years, the condition sometimes takes a long time to get diagnosed. If not treated, high levels of growth hormone can affect other parts of the body, in addition to your bones might be affected and cause serious — sometimes even fatal — health problems.

What are the Types of Acromegaly?

There are two types of acromegaly:

– Controlled acromegaly

In this type, the treatment can keep the GH and IGF-1 within normal levels.

– Active acromegaly

It occurs when someone has symptoms. The tumor might be too huge to remove, or medication might not be able to control GH and IGF-1.

What are the Symptoms of Acromegaly?

The symptoms of acromegaly are at times difficult to detect because they generally develop slowly over time. The most common symptom of acromegaly is enlarged hands and feet. For example, you might notice one day for many months that you have a ring that is feeling increasingly tight on your finger and it no longer fits anymore. If you have this condition, you might also find that you have to go up a size in shoes.

The symptoms of acromegaly usually include:

– Enlarged bones especially in the face, feet, and hands

– Unusual hair growth in women

– Enlarged jaw or tongue

– Prominent brow

– People who’ve had abnormal growth before adolescence might have excessive growth spurts

– Unintended weight gain

– Swollen and painful joints with limited movement

– Spaces in teeth

– Splayed toes and fingers

– Hoarse and deep voice

– Fatigue

– Sleeping problem

– Headaches

– Weakness in muscles

– Excessive sweating

– Body odour

– Large sebaceous glands, which are glands that produce oils in the skin

– Thick skin

– Skin tags with noncancerous growths

What are the Causes of Acromegaly?

Acromegaly happens when the pituitary gland starts producing excessive growth hormone (GH) over a long period. GH is part of a group of hormones whose function is to regulate the growth and development of the body. People with acromegaly contain a large amount of GH that accelerates bone growth and organ enlargement. Due to this growth stimulation, the bones and organs of people with acromegaly are much bigger as compared to other people’s organs and bones.

The brain’s pituitary gland makes GH and above 95 percent of people with acromegaly have a benign tumor that is affecting their pituitary. This tumor is known as adenoma which is common and affects about 17 percent of people. Usually, these tumours don’t cause excess GH, but when they do, can result in acromegaly.

What are the Risk Factors of Acromegaly?

Acromegaly can occur any time after puberty but it occurs mostly during the middle ages and most people aren’t always aware that they have some condition. Changes to the body may take place gradually over the course of many years.

Pituitary adenoma development is generally linked with the risk factors of acromegaly. Pituitary adenoma is the most common reason for acromegaly.

The risk factors of acromegaly include:

– Family history of pituitary adenoma

– MacCun Albright syndrome

– Lung cancers

– Adrenal tumours

– Females with early menopause

– Surgically induced menopause

– Young age females after their first childbirth

What are the Complications of Acromegaly?

If not treated, acromegaly can lead to major health problems. Complications of acromegaly might include:

– High blood pressure (hypertension)

– High cholesterol

– Heart problems, especially the enlargement of the heart (cardiomyopathy)

– Osteoarthritis

– Diabetes (type 2)

– Enlargement of the thyroid gland

– Sleep apnea

– Carpal tunnel syndrome

-The heightened risk of cancerous tumours

– Spinal cord compression or fractures

– Vision problems including vision loss

How Acromegaly is Diagnosed?

To diagnose acromegaly, your doctor might ask about your medical history and then carry out a physical exam. After that, your doctor might recommend some tests including:

-IGF-1 measurement

This test is done after fasting for a night where your blood sample will be taken by your doctor to measure the IGF-1 level in your blood. An elevated IGF-1 level might suggest acromegaly.

– Growth hormone suppression test

It is considered the best method for diagnosing acromegaly where your GH blood level is measured both before and after you drink a preparation of sugar (glucose) water. The glucose drink typically causes the GH level to fall among the people who don’t have acromegaly but if you have acromegaly, your GH level will become high.

– Imaging tests

An imaging test, like magnetic resonance imaging (MRI), might be prescribed by your doctor to help detect the location and size of a tumour you have on your pituitary gland. If no pituitary tumours are detected, your doctor might recommend some other imaging tests to detect non pituitary tumours.

What are the Treatment Options Available for Acromegaly?

The treatment options for acromegaly vary from person to person. To make your GH and IGF-1 levels low, treatment options usually include surgery or radiation to remove or decrease the size of the tumour that is causing your symptoms, and medication to make your hormone levels normal.

– Surgery for acromegaly

In many instances, surgery is very helpful to improve the symptoms of acromegaly or cure the condition totally. Surgeons mostly go for a type of surgery known as transsphenoidal surgery, where surgery is done through your nose and sphenoid sinus, a hollow space in your skull on the back of the nasal passages and under your brain, to carry out the surgery.

The specifics of the surgery will be based on the location and size of the tumour. Surgery aims to get rid of a tumour that is leading to the production of excessive growth hormone. If your surgeon is successful in removing a large portion of the tumor, you might not require further treatment. If your surgeon can remove only a part of a tumour, you might require medication or radiation therapy to manage and control your symptoms and decrease the growth hormone production.

– Medications for acromegaly

Your doctor might prescribe one medication or a combination of medications. Medications work variously to make your body’s growth hormone levels normal and manage your symptoms. In some instances, you might have to take medicines until the tumour has shrunk. This helps a surgeon to safely remove it through surgery. Some people might require to take medication long-term to effectively control and manage the levels of growth hormone and its symptoms.

Radiation for acromegaly

If the whole tumor cannot be removed during surgery, your doctor might prescribe radiation treatment. Radiation therapy helps to kill lingering tumour cells and gradually decreases GH levels. It might take a couple of years for this treatment to improve the symptoms of acromegaly.

Living with Acromegaly

The life expectancy of someone with acromegaly is based on the severity of the condition and other health conditions they have, generally because of untreated acromegaly. Acromegaly is a rare but serious condition that can cause many health-related complications but the good news is that it can be treated with surgery, radiation therapy, and/or medication.

Whom to Consult?

If you notice the signs and symptoms of acromegaly, then you shall contact your doctor for a diagnosis. Acromegaly generally develops slowly which makes it difficult to notice the physical changes that happen with this disorder at first. But getting a diagnosis early is vital as you can begin getting proper treatment and care. Acromegaly can cause serious health problems if it’s not treated properly and as soon as possible.

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