Acromegaly: Causes and Treatments

Image Credit: MGH Neuroendocrine and Pituitary Tumour Clinical Center 

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Article Authors: Gordon Slater| Tandose Sambo 

There are generative processes in the body that can lead to an overproduction of critical hormonal functions. Acromegaly, also known as “gigantism” in some instances,  is a rare disorder that occurs when the body generates too much growth hormone. The resultant effect is an accelerated growth of parts of the body, inclusive of bones and other critical tissues. The key visible sign of acromegaly is an enlargement of the hands and feet. 

Symptoms of Acromegaly 

The symptoms of acromegaly become more pronounced with age. The visible symptoms of acromegaly are an enlargement of the hands and feet. Non visible symptoms include fatigue or difficulty sleeping, changes in facial and dental construction, and numbness of the hands. If the onset of acromegaly occurs at an early age, there will often be an abnormality that leads to above average height. 

Hormonal balance is key to managing the general functions of the body. As the growth hormone secretions in the body are increased, there will be changes in the functions of the endocrine system. Sinus functions, and even the vocal chord operations will be affected. Reproductive function is often impacted in both men and women. Genetics can sometimes play a critical role in the development of acromegaly. 

Diagnosis of Acromegaly 

What causes the over performance of the pituitary gland as it produces the growth hormone? A benign tumour called an adenoma, often develops on the pituitary gland and causes the change in growth hormone production.

Acromegaly is best diagnosed via medical assessment. Blood tests are normally conducted in order to determine levels of insulin-like growth factor 1 (IGF-1). High levels of this hormone are indicators of acromegaly. Another test that is conducted is known as the glucose tolerance test. An MRI scan will show a clear picture of the state of the pituitary gland. 

A consultation with your orthopaedic specialist, as well as a series of critical function tests, will determine if you are diagnosed with acromegaly. 

How is Acromegaly Treated? 

The treatment of acromegaly is directly related to the severity of the condition. According to the aforementioned symptoms, treatment aims to reverse the root cause. With the overproduction of growth hormone being a key impactor to the condition, treatment aims to reduce growth hormone production to normal function. If there is pressure on the tissue being induced by the presence of the adenoma, treatment will be administered, until it can be removed via methods such as radiotherapy. 

Coupled with complementary treatments such as medicine (injections or tablets), the body’s hormonal function can be properly managed. After treatment, patients often start to see and feel physical results within a few days. 

Radiotherapy is usually the treatment path that is administered if the adenoma is not treatable by alternate methods. Treatment options for radiotherapy include stereotactic radiotherapy and conventional radiotherapy. Radiotherapy can be an invasive treatment that affects more than just the adenoma. It also can affect healthy surrounding cells. Stereotactic radiotherapy is often used, because it is less damaging to the surrounding tissue.Because of the nature of radiotherapy, long term incorporation of hormone replacement treatment is often administered.  

   Conclusion

Acromegaly is a condition that is caused by overproduction of growth hormone by the pituitary gland. It often causes an enlargement of parts of the body. Treatable by medicine or radiotherapy, there is a treatment plan that can be utilised for its management. Consultation with your orthopaedic surgeon will be key to diagnosis and treatment of this health condition. 

Reference Article: NHS Acromegaly 

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Dr. Gordon Slater

Dr. Slater is one of the first foot and ankle surgeons in Australia to adopt minimally invasive surgical techniques. He routinely uses MIS to treat a range of conditions, including bunions.

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Dr Gordon Slater is a highly-skilled surgeon specialising in foot and ankle conditions and sports injuries. Dr Slater is one of the first foot and ankle surgeons in Australia to adopt minimally invasive surgical techniques. He routinely uses MIS to treat a range of conditions, including bunions. MIS  has many advantages including shorter operating times, reduced post-operative pain, reduced risk of infection, minimal scarring and better cosmetic outcomes.

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