Acromegaly

Acromegaly is a rare hormonal disorder where the pituitary gland makes too much growth hormone after puberty. The excess growth hormone causes bones to get bigger. During childhood, this results in increased height, known as gigantism. However, when there’s an excess of growth hormone after puberty, as in the case of acromegaly, bone growth occurs in the hands, feet, and face. Organs and other tissues can increase in size, as well. For many people, the growth changes happen gradually. Some people may notice changes when comparing older photos with newer ones. Others only notice a difference when body changes become more prominent, such as a shoe size that continues to increase over several years. 

Acromegaly is most often diagnosed in adults in their 40s or 50s. If left untreated, it can lead to serious issues like arthritis, diabetes, heart problems, or other conditions. Early diagnosis and treatment can lower your chances of complications and improve your symptoms. 

Penn Medicine Endocrinology, Diabetes, and Metabolism specialists are among the leading providers in the greater Philadelphia, Lancaster, and Princeton areas who are experts in treating patients with rare hormonal disorders like acromegaly.

Acromegaly symptoms can vary for each individual but may include:

• Carpal tunnel syndrome
• Changes in vision, including loss of vision in severe cases
• Deeper voice
• Enlarged hands and feet
• Enlarged organs like the heart, liver, and spleen
• Facial changes, such as the forehead, jaw, lips, and nose becoming larger and more pronounced
• Fatigue
• Headaches
• Increased sweating
• Joint pain
• Numbness in your hands
• Sleep apnea
• Thickened, oily skin, particularly on the hands, feet, and face
• Wider space between your teeth

Acromegaly is mainly caused by the overproduction of growth hormone by the pituitary gland, a small gland at the base of the brain. When growth hormone enters the bloodstream, it causes the liver to produce a hormone called insulin-like growth factor 1 (IGF-1). IGF-1 is what causes bones, tissues, and organs to grow. Having elevated levels of IGF-1 also affects how the body processes blood sugar and fats, which can lead to heart disease, high blood pressure, and type 2 diabetes. 

In most cases, the overproduction of growth hormone is due to a tumor called a pituitary adenoma. These tumors usually aren’t cancerous, but they can still cause problems by pressing on nearby parts of the brain and disrupting normal hormone production. In rare cases, acromegaly can also be caused by tumors in other parts of the body that produce growth hormone-releasing hormone (GHRH), a substance that stimulates the pituitary gland to produce more growth hormone. 

Genetic factors may also play a role in some cases of acromegaly, but they’re less common. Overall, the exact cause of acromegaly is not always clear, but it usually involves some disruption in the normal regulation of growth hormone production and release.