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​Acromegaly Causes, Symptoms, and Treatment Options

Acromegaly is when high levels of growth hormone cause bones and soft tissues to grow more than they should.

Learn about the treatment options for Acromegaly at the UPMC Pituitary Center of Excellence.

Contact the UPMC Department of Neurosurgery

To make an appointment or learn more:

What Is Acromegaly?

Acromegaly is a disorder starts when a tumor in your pituitary gland makes too much growth hormone during adulthood. This leads to an increase in bone size, specifically of the hands, feet, and face.

Since symptoms can occur over time, and not all at once, acromegaly is often misdiagnosed.

Gigantism vs. Acromegaly

Both gigantism and acromegaly are serious health issues.

Gigantism is when growth hormone hypersecretion begins in childhood or adolescence, before growth plates close in the long bones (arms and legs). People with gigantism may be tall or obese, and their hands and feet may grow in a way that isn't normal. They may also have coarse facial features.

In acromegaly, the secretion of too much growth hormone occurs in adulthood. It happens most often between ages 20 and 50, after the bony growth plates close. People with acromegaly may notice growth in their face or hands, even though changes are throughout the body.

Without treatment, gigantism and acromegaly can cause major health problems like:

  • High blood pressure.
  • Diabetes.
  • Sleep apnea.
  • Arthritis.
  • Thickening of the heart.
  • Colon polyps.
  • Cancer.

Both gigantism and acromegaly can also shorten how long you live if not treated.

Treatment for gigantism and acromegaly may include:

  • Medicine.
  • Surgery.
  • Radiation therapy.

Causes of Acromegaly

Acromegaly happens most often when a tumor forms in the pituitary gland. But an injection of growth hormone can also cause acromegaly.

Who Is at Risk for Acromegaly?

Middle-aged adults are most at risk for getting acromegaly, but it can form at any age.

When tumors that over-produce growth hormone form in children or adolescents, before their growth plates close, they have gigantism, not acromegaly. The hormone causes them to grow much taller than normal.

What Are the Complications of Acromegaly?

Complications of acromegaly may include:

  • Sleep apnea.
  • Diabetes.
  • High blood pressure.
  • Heart disease.
  • Arthritis.
  • Carpel tunnel syndrome.
  • Colon polyps.
  • Irregular periods (in women).
  • Erectile dysfunction (in men).

Some acromegaly complications can also be life-threatening, such as:

  • Cardiomyopathy.
  • Heart rhythm disorders and valve diseases.
  • Vascular endothelial dysfunction.
  • Cancerous colon polyps.

What Are the Signs and Symptoms of Acromegaly?

Signs and symptoms of acromegaly may include:

  • Growth of the hands and feet (your rings or shoes may no longer fit).
  • Severe acne, skin tags, and thickening skin.
  • Deepening voice and enlarged tongue.
  • Protrusion of forehead and jaw.
  • Separation of teeth.
  • Excessive sweating.
  • Fatigue.

    It's crucial to talk with your doctor about your symptoms so they can decide the best treatment plan for you.

    How Do UPMC Experts Diagnose Acromegaly?

    Since the symptoms of acromegaly can advance over time, people may not know they have it for years. The average age people learn they have acromegaly is around 40 or 45.

    To diagnose acromegaly, your doctor will:

    • Ask about your symptoms and medical history.
    • Do a physical exam.
    • Order blood and imaging tests.

    Lab and imaging tests for diagnosing acromegaly

    Blood tests will measure the hormones the pituitary gland makes, such as growth hormone (GH), insulin-like growth factor (IGF-I), and other pituitary hormones.

    Your doctor might also order:

    • A glucose tolerance test to see if the level of growth hormone drops. If you have acromegaly, the hormone will not drop.
    • An MRI or CT scan of your head to look for a tumor in your pituitary gland.

    Acromegaly Treatments

    At UPMC, our expert team treats acromegaly at the Pituitary Center of Excellence.

    The goal of treatment is to:

    • Remove or reduce the size of your pituitary tumor.
    • Reduce how much growth hormone your body makes so it's at a normal level.
    • Stop and reverse symptoms from having too much growth hormone.
    • Correct any issues with your thyroid, adrenal gland, and sex organs.
    • Screen for complications, such as with a colonoscopy or cardiac echo.

    Based on your symptoms, UPMC's neurosurgical team may suggest both surgical and non-surgical treatments.

    Without treatment, acromegaly can cause serious health problems and may be fatal.

    Minimally invasive surgery

    For most cases of acromegaly, the best treatment is to remove the pituitary tumor (adenoma) causing the high levels of growth hormone.

    The best surgical treatment for acromegaly is the Endoscopic Endonasal Approach (EEA) to remove the pituitary tumor. This state-of-the-art, minimally invasive approach lets surgeons access the pituitary tumor through your nose, without making an incision. Surgeons also remove the pituitary tumor through the nose and nasal cavities.

    Surgeons will leave and explore the normal pituitary gland and structures around it, like the arteries, veins, and nerve. They'll also check for other lesions and remove any tissue that isn't normal.

    Pros of EEA include:

    • No incisions to heal.
    • No disfigurement.
    • Faster recovery time.
    • More access to invasive or previously incurable tumors pituitary tumors.

    Other needed treatments, such as radiosurgery or medicine, can begin soon after EEA surgery.

    Gamma Knife® radiosurgery for acromegaly

    Gamma Knife radiosurgery is a technique that uses highly focused radiation beams to target tumors and lesions in the brain. There's no incision or pain involved.

    For acromegaly, our neurosurgeons use the Gamma Knife for:

    • Tumor left after surgery.
    • Elevated growth hormone levels, even after surgery, treatment, and health management.

    As the nation's leading provider of Gamma Knife techniques, UPMC has treated more than 12,000 patients with tumors, vascular malformations, pain, and other functional problems.

    Medicine for managing acromegaly

    Our neuroendocrinologists, who specialize in diagnosing and treating pituitary tumors, may prescribe medicine to:

    • Reduce how much growth hormone your pituitary gland makes.
    • Stop the growth hormone from being active in your body.
    • Manage your issue if surgery isn't successful or is too high risk with your other health problems.

    People with acromegaly should follow up on a regular basis with a neuroendocrinologist. Your doctor will screen you for side effects from the excess growth hormone and to make sure your symptoms don't recur.