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Acromegaly
Monday, February 19, 2007

We've talked briefly about what growth hormones are more about them in the introductory page of this blog. Now, we will be sharing with you, our blog reader, interesting and ethical facts about growth hormones.

Acromegaly

What is Acromegaly and what causes it?

Acromegaly is a hormonal disorder that results when the pituitary gland produces excess growth hormone (GH), which causes abnormal growth of the hands and feet. It most commonly affects middle-aged adults and can result in serious illness and premature death.


Who can get Acromegaly?

Acromegaly is rare. Scientists estimate that about 3 out of every million people develop acromegaly each year and that 40 to 60 out of every million people suffer from the disease at any time. However, because the clinical diagnosis of acromegaly often is missed, these numbers probably underestimate the frequency of the disease.

Signs and Symptoms of Acromegaly

Acromegaly literally means 'enlarged extremities' or 'enlarged hands and feet'. This is a typical feature, but there are many other symptoms which develop gradually.

1) Symptoms caused by excess growth hormones

  • The excess of growth hormone in your bloodstream can affect various tissues in your body which can make them 'thicken' or 'grow'.
  • Hands and feet become larger and broader. You may have to change your gloves/shoes size. You may not even be able to get a wedding ring off your finger.

  • The skin may thicken (particularly on the face) and become more greasy and sweaty.

  • Tickened lips and nose

  • Thickening of the scalp

  • Jaw becoming more protruding
  • Vocal cords thicken which may cause your voice to deepen.

  • Tongue may enlarge so you may often 'bite your tongue'.

  • Thickening of cartilage may cause arthritis in various joints.

  • Thickening of the nasal passages can make you snore loudly and may cause obstruction in airflow when you are asleep (sleep apnoea) - can make you have a poor nights sleep with daytime drowsiness.

  • 'Carpel tunnel syndrome' - When a nerve going through the wrist is squashed by thickened tissue. It can cause pain, tingling and weakness in parts of the hands.
  • Other symptoms include:
    - General tiredness and some muscle weakness.
    - About 1 in 5 people with acromegaly also develop diabetes as growth hormone counters the effects of insulin.
    - High blood pressure develops in about 1 in 3 cases.
    - Increase risk of heart disease and stroke, probably because of the increase risk of developing high blood pressure and diabetes.
    - Also, in about 1 in 3 cases, the adenoma also makes too much of another hormone called prolactin. This can cause sexual and menstrual problems, and a milky discharge from the nipple. Many men with acromegaly also develop erectile dysfunction (impotence).
Before After

2) Symptoms caused by the growing tumour
  • In many cases the tumour remains small and does not cause pressure symptoms. However, in some cases the tumour grows enough to cause pressure on the nearby tissues. This leads to:
    - Headaches
    - Vision problems - The tumour may press on the optic nerves (the nerves going from the eyes to the brain) which are just next to the pituitary.
    - Other normal cells in the pituitary may become squashed and damaged, causeing an underactive thyroid gland.

Treatments for Acromegaly

However, Acromegaly is treatable. As long as the growth hormones production has returned to normal levels, complications such as high blood pressure, diabetes, and high triglycerides can be reversed. There are 3 main types of treatment processes.

I. Surgery
To reduce GH production, doctors extract pituitary tumors through the nose to eliminate its pressure on the tissues surrounding the pituitary. Such surgery is known as the transsphenoidal surgery. More commonly, hormone levels may improve, but not return completely to normal.

II. Drug Therapy
3 common types of drugs used to lower or block the production of GH is as follows: - Synthetic hormones - Dopamine agonists - GH antagonists

III. Radiation Therapy
Radiation surgery is usually reserved for patients who still have tumor in their pituitary even after surgery. Radiation therapy is given in divided doses from four to six weeks. Radiation therapy cause a gradual loss of production of other pituitary hormones with time.


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