Acromegaly

Acromegaly is a rare hormonal disorder prevalent in about 3-14% out of 100000 people. The disease occurs when your pituitary gland makes more than the average growth hormone due to a tumor growing in the gland.

Typically, the condition is diagnosed in middle-aged adults. However, it may also occur in childhood. When it happens in childhood, the situation is termed gigantism. Gigantism occurs before the end of puberty when your growth plates are about to fuse. There are approximately 2,000 Canadians affected by acromegaly and still more waiting to be diagnosed.

Let us discuss the symptoms and treatment of acromegaly.

Symptoms of acromegaly:

Acromegaly is marked by noticeable physical changes that occur gradually over the years. Hence, early signs are not visible. The common symptoms of this condition are as follows:

• Enlarged feet and hands.

• Enlarged lips, nose, and tongue.

• Widening of space between the teeth.

• Thick, coarse, and oily skin.

• Excessive sweating.

• Development of skin outgrowths.

• Fatigue.

• Muscle and joint weakness.

• Hoarse voice.

• Vision problems.

• Persistent headache.

• Menstrual problems in women.

• Erectile dysfunction in men.

Complications in acromegaly:

Untreated acromegaly can sometimes result in life-threatening complications. These are as follows:

• Heart problems.

• High blood pressure.

• Diabetes.

• High cholesterol.

• Sleep apnea (Breathing stops and often starts during sleep).

• Enlarged thyroid.

• Compression of the spinal cord.

• Fractures.

• Polyps in colon.

• Changes in vision or loss of vision.

• Increased risk of cancerous growths.

Treatment of acromegaly:

Growth hormone triggers insulin-like growth factor (IGF-1) that plays an essential role in physical growth. The goal of the treatment includes getting the growth hormone and IGF-1 levels back to normal. The following treatment options are available:

• Surgery: Surgery involves the removal of the tumors growing on the pituitary gland. The surgery is done using a tiny endoscope or microscope inserted through the nose and sinuses to reach the skull. The surgery helps relieve pressure put by the tumor on the gland and drops the levels of growth hormone.

• Medicines: Doctors may prescribe the medication in combination. However, they do not offer a complete cure. The following drugs are available.

  • Somatostatin analogs: Intramuscular injections of somatostatin analogs octreotide and lanreotide reduce the secretion of growth hormone and reduce the pituitary tumor size.

  • Dopamine agonists: They also reduce growth hormone levels. But aren’t as effective as somatostatin analogs. Cabergoline (Dostinex) and bromocriptine (Parlodel) are prescribed as oral tablets.

  • Growth hormone receptor antagonist: A daily injection of this drug (pegvisomant) will stop the synthesis of growth hormone.

• Radiation therapy: If it is impossible to remove tumors from the pituitary gland, radiation therapy may help destroy the tumors.

Early detection and successful removal of tumors from the pituitary glands help in treating acromegaly. Talk to your doctor regarding the treatment options and their side ects.