The Main Cause of Acromegaly
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Acromegaly Symptoms: Acromegaly can cause a wide range of symptoms that tend to develop slowly over time. Typical symptoms include:
- joint pain
- Big hands and feet
- Carpal tunnel syndrome (compression of the nerve in the wrist, causing numbness and weakness in the hands)
- Thick, thick and oily skin
- skin tags
- Enlarged lips, tongue and nose
- A protruding jaw and eyebrow
- Widely spaced teeth
- Voice deepening due to enlarged sinuses and vocal cords
- Sleep apnea (breaks in breathing during sleep due to airway obstruction)
- excessive sweat
- fatigue and weakness
- Headaches
- impaired vision
- loss of sexual desire
- In women, abnormal periods
- In men, erectile dysfunction
- In children and adolescents, excessive height (gigantism)
Some of the above symptoms are the result of the tumor compressing nearby tissues – for example, headaches and vision problems can occur if the tumor crushes nearby nerves. If you think you have acromegaly, see your GP right away. Acromegaly can usually be successfully treated with surgery and medication on the brain, but early diagnosis and treatment are important to prevent symptoms from getting worse and to reduce your chances of experiencing complications.
Diagnosis of Acromegaly: If acromegaly is suspected, your doctor will do a blood test to check your IGF-1 level. Elevated levels of IGF-1 could mean that your GH levels are also high. Another way to diagnose acromegaly is with an oral glucose tolerance test.
In this test, blood GH levels are measured after drinking sugary water. Normally, sugary water will cause the pituitary gland to stop producing GH and blood levels to drop. However, a GH-producing pituitary tumor will not stop producing GH, so blood GH levels will not change.
Acromegaly Treatments: Acromegaly requires specialized care. Too much GH and IGF-1 in your blood decreases your quality of life and how long you can live. The main goal of treatment is to bring GH and IGF-1 levels back to normal. Treatment may be surgery, pituitary irradiation (radiotherapy to the pituitary gland), medication, or a combination of these options.
If the cause of acromegaly is a pituitary tumor, surgery to remove the tumor is the first treatment. Complete removal of some tumors is difficult and other types of therapy are often necessary to achieve normal levels of GH and IGF-1. If your GH level is not normal after surgery, or if you are not a candidate for surgery, pituitary irradiation and medication are also options.
Irradiation can take a long time to bring GH levels back to normal. It can take ten to 20 years to be fully effective. Once the objective is reached, the effects of irradiation are permanent. Drugs are also available to treat acromegaly, but they are not a cure. If surgery or radiation doesn’t lower your GH levels, you’ll likely have to take medication for the rest of your life.
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(Rarely, when medications are stopped, disease control continues.) The most effective drugs for acromegaly are somatostatin analogues and a GH receptor antagonist. Another type of medication (dopamine agonists) works for some but not most patients. Some patients may benefit from a combination of these drugs.