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Acromegaly can change your physical structure drastically over the years. It is the problem occurring due to the hormonal disorder. Your pituitary glands produce the growth hormone required while you grow up. The normal levels of the hormone ensure proper bone growth. But, too much of the growth hormone can result in growth issues. Your bones may increase in size that makes you look abnormal. It mostly occurs in the hands, feet, as well as the face. It is a condition that you can detect only during middle age. The condition even affects the children of small age. It can lead to increased growth and the condition known as gigantism. Such children have an abnormal increase in height and exaggerated bone growth. It is important to detect the issue at the early stages to get proper treatment. Else, it may mar your visual appeal. Therefore, you need to know in detail about the problem to get proper treatment.
What Is Acromegaly?
It is a rare disorder triggered due to the excess production of growth hormone in your body. The pituitary gland produces a hormone known as growth hormone (GH). It influences your growth and development. The tumors developing the pituitary glands can result in the overproduction of GH. Irrespective of the benign nature of the tumor, its presence can affect the hormonal levels in your body. The tumor can expand beyond the normal confines of the gland and expand. In some rare cases, the tumor located elsewhere in the body can trigger acromegaly.
Due to abnormal growth hormone production, you can see physical changes in your body. But, the changes may appear only after a long duration of time. Therefore, you may take a long time to recognize the presence of the problem in your body. By the time, it may affect your health adversely and even have fatal complications. Therefore, when you suspect the issue, get treatment immediately. It may cure the problem completely. But, it reduces the several complications associated with the disease. Proper treatment also helps improve the characteristics of the condition. So, you can manage the enlargement of the physical features.
Symptoms Associated With Acromegaly
The hormonal problem progresses gradually with time. So, you may see the signs only after some duration of time. It tends to progress slowly. You may ignore the early signs as it may not appear abruptly. Only when you compare the old and new photos of the affected person, you can spot the difference. Therefore, the common signs associated with the issue are:
Most people spot the difference in the hands and feet structure. The enlarged size of your feet, as well as hands, can make you puzzled. So, it becomes difficult to put on the rings that earlier fit you perfectly. The problem becomes noticeable when your shoe size increases progressively after your growth stops.
Facial shape change that appears gradually can also indicate the excess growth hormone. You can see your lower jaw as well as brow protruding from earlier photos. Acromegaly can also thicken your lips, enlarge the nose, and increase the spacing between the teeth.
It also triggers several other signs and symptoms. You may not experience all the signs as it varies from one person to another.
- Enlarged feet as well as hands
- Thickened, coarse, and oily skin
- Enlarged and coarsened facial features
- Profuse sweating along with bad body odor
- Muscle weakness and exhaustion
- Skin Tags(small outgrowths of your skin tissue)
- Husky and deepened voice triggered by enlarged sinuses and vocal cords
- Impaired vision
- Obstruction of the upper airway leading to snoring
- Impaired vision
- Enlarged tongue
- Limited mobility in joints
- Pain and limited joint mobility
- Experience pain in the joints
- Loss of sex drive
- Erectile dysfunction (men)
- Enlarged vital organs (for example heart)
- Irregular menstrual cycles (women)
The problem usually develops slowly. So, the affected person or their loved ones never notice the signs at first. You may ignore the gradual physical changes occurring with the disorder. But, observing the signs can help with early detection. Getting proper medical care as soon as possible can prevent complications associated with the disease.
Causes Of Acromegaly
Acromegaly is a problem triggered by hormonal issues. So, your pituitary gland and the hypothalamus influence it. The pituitary gland is the gland situated at the base of your brain. It is placed behind your nose bridge. The small gland can secrete several hormones that control the overall functioning of your body. Growth hormone is one of the main hormones secreted by the gland. It is important for your physical growth. The growth hormone can trigger your liver to produce an important hormone known as IGF-1 (Insulin-like Growth Factor-1). IGF-1 stimulates the growth of your bone as well as the other tissue in your body.
Some issues can urge your pituitary gland to produce an excess amount of growth hormone. It, in turn, produces more amount of IGF-1. So, you can experience abnormal growth of the bones and soft tissues. The unusual skeletal growth can result in gigantism. You can also experience other signs that can change your physical appearance. Hormone production in adults occurs due to tumor development. In the majority of the cases, the adenoma can cause excess GH production. Therefore, the tumors in the following region can affect the growth hormone production:
In the majority of the cases, the excess hormone secretion happens due to the presence of noncancerous tumors (adenoma) in your pituitary gland. The tumor urges the pituitary gland to secrete an excess amount of growth hormone. So, it can cause several issues in your body. The pressure in the pituitary glands due to the benign tumors can cause impaired vision and headaches. It is due to the tumor mass pressing your brain tissues nearby.
In some cases, tumors in other parts of the body can lead to excess growth hormone production. Such tumors also are known as non-pituitary tumors can result in acromegaly. The tumors in the pancreas or lungs can result in the disorder. The tumors can either secrete the growth hormone or produce GH-RH. GH-RH, growth hormone-releasing hormone can stimulate your pituitary gland to produce more GH.
Complications Due To Acromegaly
You need to understand that hormonal problems can trigger major health problems. So, the progression of acromegaly can result in other issues like:
- Cardiovascular disease (for example heart enlargement known as cardiomyopathy)
- Hypertension (High blood pressure)
- Vision loss
- Diabetes mellitus
- Spinal cord compression
- Sleep apnea (the condition leading to breathing problems while you sleep)
- Polyps or the precancerous growth on the colon lining
- Carpal tunnel syndrome
- Vision loss
It is important to identify the issue as soon as possible to get the necessary treatment. So, with early detection and treatment, you can prevent complications. At the least, you can stop the issue from getting worse. Acromegaly is a serious health condition. Therefore, leaving it untreated can result in fatal complications. You can even face death by ignoring the problem.
Diagnosis Of Acromegaly
Once you suspect the problem yourself or in your children, you need to get an appointment with your doctor immediately. It is necessary to come to a conclusive decision before starting the treatment. So, your doctor can use the following diagnostic methods to detect the issue.
It is the first step assessment by your doctor to understand the severity of the symptoms. So, the doctor can ask you about medical history. It is to eliminate the possibility of other issues that trigger the symptoms. The medical professional also check the hands, legs, and facial structure in detail to detect the problem. Mostly the comparison of your facial features with old photos and the present state can reveal the changes. If your doctor detects the problem, then you need to undergo further tests.
Two key blood tests can shed light on the presence of acromegaly. If you suffer from the condition, then the levels of the certain hormone may vary. So, measuring the specific hormone levels can help your doctor confirm the issue. Measuring the growth hormone levels directly cannot help your doctor come to a proper conclusion. It is due to the fact that it fluctuates every day. So, a normal person can show fluctuations in the hormone levels. Therefore, it becomes difficult to come to a proper conclusion. Checking the Insulin-like Growth Factor 1 (IGF1) and oral glucose tolerance test can help determine the issue.
Your doctor can detect the presence of the problem without measuring the growth hormone by measuring the IGF-1 the Insulin-like growth factor-1 is the hormone linked directly to the growth hormone. GH commands your body to make the IGF-1. IGF-1 stimulates tissue growth in your body. People without acromegaly, the high levels of IGF-1 signals the body to stop producing the growth hormone. But, people affected by the issue continue to produce growth hormone (GH) even with high IGF-1 levels.
Oral Glucose Tolerance Test (OGTT)
Your growth hormone levels are directly linked to the glucose levels in your blood. In normal cases, the high blood glucose levels can stop the production of growth hormone in your body. So, your doctor conducts the OGTT to raise the blood glucose levels in your body. It helps to monitor the growth hormone levels and detect the problem. It is known as the growth hormone suppression test. Your doctor measures your GH levels after you drink glucose water. The glucose ingestion suppresses the GH levels in normal people. So, the high GH levels after drinking the sugar preparation indicate the hormonal problem. Therefore, your doctor can use the definitive method to diagnose the issue and develop a treatment plan.
Pituitary tumors are the main cause of the majority of acromegaly cases (95%). Therefore, your doctor can use sophisticated imaging techniques to detect the tumor. Tests like MRI (Magnetic Resonance Imaging) help detect the size and exact location of the tumor triggering the issue. If the doctor cannot find the presence of a tumor in the pituitary gland, then you suffer from the excess growth hormone due to the tumor presence in other areas of the body. Therefore, your doctor uses other imaging techniques like CT scan to detect the presence of tumor elsewhere in your body.
Treatment Options For Acromegaly
Treatment focuses on lowering your production of GH, as well as reducing the negative effects of the tumor on the pituitary gland and surrounding tissues. You may need more than one type of treatment.
Endoscopic Transnasal Transsphenoidal Surgery
It is the common invasive surgical option chosen by your doctor to remove the tumors in your pituitary gland. Your surgeon removes the tumor through the nose using transsphenoidal surgery. The pressure on the pituitary glands eases after the removal of the tumor. So, it can prevent the excess production of the growth hormone. It can ease the symptoms of acromegaly. The tumor location is significant while extracting it. In some cases, your surgeon finds it difficult to remove the tumor completely or cannot perform the surgery due to the sensitive location. In such cases, to reduce the GH levels, you need further treatments.
Drug therapy or taking medication can become the initial line of treatment without the surgery. In some cases, your doctor chooses it after surgery to bring the excess growth hormone levels. The surgery may not extract the whole tumor, which cannot improve the acromegaly. So, your doctor has three types of medication options to lower the GH production or block it completely.
It is the drugs that can lower the hormone levels. Your doctor may opt for it as the first line of medical therapy to decrease the tumor size. You can take the medications orally to reduce the GH levels. So, your doctor gives you the lowest dose first and slowly increase the dose. It not only improves the results, but also avoids the side effects like compulsive behaviors and health issues like dizziness. It may not work well for all. So, your doctor can suggest other treatment options.
Your doctor can prescribe it when the dopamine agonists fail to provide the desired effects. Both dopamine agonists and somatostatin analogs reduce the growth hormone secretion. But, they act in different methods. Your doctor can opt from the two types of somatostatin analogs. It interferes with your pituitary gland’s growth hormone production. So, you can see a rapid decline in the growth hormone levels, which can ease the symptoms. It is available in the form of an injection that a healthcare professional injects into the muscles of your buttocks. Therefore, by injecting the medication once a month can show you results.
Growth Hormone Antagonist
Unlike the other medications, it does not prevent the pituitary glands from producing the growth hormone. But, it stops the hormone from affecting your body. The medication available in injection form can offer effective results for people with fewer success rates using other drugs. You can take the injection yourself without the help of doctors. So, taking it daily can normalize your IGF-1 levels. Remember, it only lowers the growth hormone levels and does not reduce the tumor size. So, it can ease the other signs associated with acromegaly except for headaches.
The radiation therapy suggested by your doctor can kill the tumor cells remaining after the surgery. It is also ideal for tumors that have high removal risks with invasive surgery. Radiation therapy uses high-intensity beams to destroy lingering tumor cells. So, it can slowly reduce GH levels. But, the treatment can show a visible result after a long duration. Therefore, you need to wait for years to see a noticeable improvement in the symptoms. The different types of therapies available are:
Conventional Radiation Therapy
The type of therapy takes a long time to see the effect. So, you have to wait at least ten or more years to see the full effect of the treatment. The therapy is given to affected people every weekday. So, you need to continue it for a period of four to six weeks.
Proton Beam Therapy
It targets the tumor in particular and leaves the normal tissues. So, the high-intensity proton beam can shrink the tumor without exposing your normal tissue to radiation. The therapy is offered in a fraction over a period of time. But, compared to conventional radiation therapy, it takes less time to show visible results.
Stereotactic radiosurgery is the short-acting therapy among the lot. So, with just one single high dose of radiation, it shrinks the tumor cells. So, it limits the exposure of the normal tissue to the radiation. It can show results in five years. Therefore, you can see the GH levels returning back to normal after a short duration of time.
You need to understand that the problem may not cure completely. So, you need to monitor the functioning of the pituitary gland periodically. Your doctor can check the functioning of the gland to ensure it works properly. Therefore, periodic checking can help you avoid complications. Remember, you need follow-up care for the rest of your life.
Acromegaly is the condition that can reduce your life expectancy considerably. With proper treatment, you can control the growth hormone production and ensure it reaches the normal limits. So, it can avoid other complications like heart problems and diabetes. The successful treatment and monitoring of the problem can prevent fatal complications associated with the disorder.View Article Sources