Acromegaly
Acromegaly is a rare hormonal condition caused by the body producing too much growth hormone.
Overview
Acromegaly is a rare hormonal condition caused by the body producing too much growth hormone. This usually happens because of a non-cancerous tumour of the pituitary gland (a small gland at the base of the brain that controls hormone production). Excess growth hormone leads to increased production of another hormone called insulin-like growth factor 1 (IGF-1). Over time, this causes enlargement of certain parts of the body and can affect many organs, including the heart, jaw, teeth, joints and metabolism. Acromegaly usually develops slowly, and symptoms may not be recognised for several years.
Causes and Genetics
In most cases, acromegaly is caused by a benign pituitary tumour (adenoma) that produces excess growth hormone. The condition is usually not inherited and occurs sporadically. Rarely, it may be associated with inherited conditions that affect endocrine glands (such as Multiple Endocrine Neoplasia Type 1 and a mutation called the AIP mutation). The tumour itself is typically non-cancerous, but it can cause symptoms both by producing excess hormone and by pressing on nearby structures.
Symptoms and Features
Symptoms develop gradually and may go unnoticed at first.
Characteristic Symptoms and Features
- Enlargement of hands and feet: rings may no longer fit and shoe size may increase
- Changes in facial features: broadening of the nose, thickening of lips, enlargement of the jaw and widening of the spaces between teeth
- Joint pain and stiffness
- Excessive sweating
- Headaches
Other Associated Symptoms and Features
- Vision problems: if the pituitary tumour presses on nearby nerves, it may cause visual disturbance, particularly loss of side vision
- Heart enlargement and high blood pressure: long-term excess growth hormone can affect heart structure and function
- Sleep apnoea: breathing pauses during sleep are common
- Diabetes: growth hormone excess can affect blood sugar control
- Carpal tunnel syndrome: tingling or numbness in the hands
In children or adolescents who have not completed growth, excess growth hormone causes a different condition called gigantism which is associated with increased height.
Treatment
Regular monitoring of hormone levels, heart health and metabolic function is essential. Patients are usually managed through specialist endocrine services.
Research and Future Directions
Ongoing research is focused on improving medical treatments that better control growth hormone levels and reduce side effects. New long-acting medications and more targeted therapies are being developed. Researchers are also studying ways to diagnose acromegaly earlier to reduce complications and improve quality of life. Advances in treatment have significantly improved outcomes compared to previous decades.