Acromegaly

When to seek medical advice

If you have some of the signs and symptoms associated with acromegaly, contact your doctor for an evaluation. Acromegaly usually develops slowly, and even your family members may not initially notice the gradual physical changes that occur with the disorder. Early diagnosis is important so that the disease can be treated properly. Your primary care doctor may refer you to an endocrinologist, a specialist who will be more familiar with recognizing and treating this disorder.

On average, the diagnosis of acromegaly is delayed by 5 to 10 years after signs and symptoms first appear. To begin the diagnostic process, your doctor will take a complete medical history and conduct a physical exam. Then he or she may recommend the following steps:

• GH and IGF-I measurement. After you've fasted overnight, your doctor will take a blood sample to measure your levels of GH and IGF-I. Elevated levels of these hormones suggest acromegaly.

• Glucose tolerance test. Your doctor may perform another test called the glucose tolerance test, the definitive method for verifying acromegaly. In this test, your blood levels of GH are measured before and after you drink a preparation of glucose (sugar). Normally, glucose ingestion depresses levels of GH. If you have acromegaly, your GH level will tend to stay high.

• Imaging. Your doctor may recommend that you have imaging or radiologic procedures — such as computerized tomography (CT) scans or magnetic resonance imaging (MRI) scans — that can pinpoint the location and size of a tumor of your pituitary gland. Even if radiologists see no tumor of your pituitary, they may look for non-pituitary tumors that might be responsible for high levels of GH.

Progression of acromegaly can result in major health ramifications. Complications may include:

• High blood pressure (hypertension)

• Coronary artery disease

• An enlarged heart, which may lead to heart failure

• Arthritis of the large joints: hips, knees and shoulders

• Diabetes mellitus

• Pre-cancerous growths (polyps) on the lining of your colon

• Sleep apnea, a condition in which breathing repeatedly stops and starts during sleep

Early treatment of acromegaly can prevent these complications from developing or becoming worse. If untreated, acromegaly and its complications can lead to premature death.

 

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