Acromegaly – Symptoms and Causes
Overview
Acromegaly is a rare disorder. It happens when the pituitary gland produces too much growth hormone. This small gland in the brain usually develops a non-cancerous tumor that causes this excess hormone production.
The extra growth hormone leads to enlarged bones and tissues in adults.
The condition affects adults differently than children. When excess growth hormone occurs in children, it causes gigantism with increased height. In adults, however, the bones in the hands, feet, and face grow larger while height stays the same.
Acromegaly progresses very slowly. Changes happen over many years, making it difficult for patients and doctors to notice symptoms early. This slow progression often delays diagnosis and treatment.
Without proper medical care, acromegaly can cause serious health complications that may be life-threatening. Treatment options include:
- Surgery to remove the pituitary tumor
- Medication to regulate hormone levels
- Radiation therapy
Healthcare providers use these treatments to bring growth hormone levels back to normal and stop the progression of the condition.
Physical Changes and Symptoms
People with acromegaly experience gradual bodily changes that often go unnoticed for years. These changes affect facial features, skin, and body parts in several ways.
Facial changes include thickened ears and lips, a wider nose, and a more prominent jaw or brow. Teeth may develop gaps between them, while the tongue grows larger. The rib cage may expand, giving the chest a rounded appearance.
Skin problems are common with acromegaly:
- Acne outbreaks
- Skin tags (small, harmless growths)
- Thicker, oilier skin
- Swelling under the skin
Because these changes happen slowly, many people don’t notice them right away. Often, it’s only when jewelry no longer fits or shoe sizes increase that someone becomes aware. Comparing old photos with new ones sometimes reveals these gradual changes.
Other symptoms include:
- Vision problems (including loss of peripheral vision)
- Increased sweating and body odor
- Extreme fatigue
- Headaches
- Joint pain
- Deeper voice
When to See a Doctor
Visit a healthcare provider if you notice these symptoms. Since acromegaly develops gradually, even family members might take time to notice physical changes.
Regular checkups help healthcare providers spot subtle signs you might miss.
What Causes Acromegaly
Acromegaly most commonly results from a pituitary gland tumor. This non-cancerous growth, called an adenoma, produces excessive growth hormone over time.
The pituitary gland sits at the brain’s base behind the nose and normally controls physical growth by releasing proper amounts of growth hormone.
When a pituitary tumor develops, it can cause problems in two ways:
- Excess Hormone Production: The tumor makes too much growth hormone.
- Physical Pressure: The tumor can press on nearby brain tissues, causing headaches and vision problems.
The excess growth hormone triggers the liver to produce insulin-like growth factor-1 (IGF-1). It’s actually this IGF-1 that stimulates bone and tissue growth throughout the body, leading to the characteristic symptoms of acromegaly.
In rare cases, other factors can cause acromegaly:
| Rare Causes | How They Lead to Acromegaly |
|---|---|
| Lung tumors | May directly produce growth hormone |
| Pancreatic tumors | May produce growth hormone |
| Other tumors | May release growth hormone-releasing hormone (GHRH) |
These rare tumors either make growth hormone themselves or produce GHRH, which signals the pituitary to release more growth hormone. The end result is the same – too much growth hormone in the blood, leading to excess IGF-1 and the symptoms of acromegaly.
Risk Factors
People with a rare genetic condition called multiple endocrine neoplasia, type 1 (MEN 1) face a higher risk of developing acromegaly. In MEN 1, several glands may develop tumors:
- Parathyroid glands – can release excess hormone leading to bone thinning and kidney stones.
- Pancreas – tumors may produce too much insulin, causing low blood sugar.
- Pituitary gland – tumors may overproduce growth hormone, resulting in acromegaly.
Although extremely rare, acromegaly can sometimes run in families. This genetic connection highlights the importance of knowing your family medical history when assessing personal risk factors.
Complications
Acromegaly, when left untreated, can cause several serious health problems throughout the body, affecting different systems and organs.
Heart and Blood Vessel Problems
- High blood pressure
- Narrowed arteries that increase the risk of heart attack and stroke
- Cardiomyopathy (heart muscle disease)
Cancer Risks
- Higher chance of developing certain cancers
- Colon polyps that may develop into colon cancer if not addressed
Sexual and Reproductive Issues
- Irregular or missed menstrual periods
- Erectile dysfunction in men
- Decreased sexual interest
Other Serious Conditions
Untreated acromegaly can also lead to:
| Condition | Description |
|---|---|
| Osteoarthritis | Joint pain and stiffness |
| Type 2 Diabetes | Blood sugar regulation problems |
| Goiter | Abnormal thyroid gland growth |
| Sleep Apnea | Breathing repeatedly stops during sleep |
| Carpal Tunnel Syndrome | Hand numbness, tingling, and weakness |
| Spinal Problems | Compression or fractures of the spine |
| Vision Changes | Including possible vision loss |
Getting treatment early is key to preventing these complications or stopping them from getting worse. Without proper treatment, acromegaly and its complications can shorten life expectancy.
