Growth hormone excess · Pituitary adenoma · IGF-1

Acromegaly, recognized early and treated well.

Acromegaly is caused by a pituitary tumor that releases too much growth hormone in adulthood. The changes are slow: rings and shoes that no longer fit, a jaw and brow that broaden, joints that ache. On average it takes 7 to 10 years to be diagnosed, and much of the harm to the heart, joints and metabolism is preventable with earlier treatment. Dr. Hasan is experienced in diagnosing acromegaly and managing it long-term with pituitary surgeons.

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What to look for

Signs of growth hormone excess

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  1. 1Broader nose, thicker lips, enlarged jaw and brow; teeth spreading apart
  2. 2Enlarged tongue; snoring and sleep apnea; deeper voice
  3. 3Larger hands and feet: rings and shoes no longer fit; carpal tunnel
  4. 4Oily, thickened skin; excess sweating; skin tags
  5. 5High blood pressure; enlarged heart; heart failure if untreated
  6. 6Joint pain and early arthritis
  7. 7Insulin resistance and diabetes; colon polyps
  8. 8Headache; peripheral vision loss from a large tumor
On testing↑ IGF-1 (age-adjusted)GH not suppressed after glucose↑ Prolactin (often co-secreted)Pituitary MRI↑ Glucose, A1c

IGF-1 is the screening test. A random growth hormone level is not useful because GH is released in pulses.

Treatment

Treatment aims to normalize IGF-1, shrink or remove the tumor, preserve normal pituitary function and reverse the metabolic and cardiovascular effects. Most people need more than one modality over time.

SurgeryTranssphenoidal removal by a pituitary neurosurgeon; cures 60 to 80% of smaller tumors
MedicationSomatostatin analogs (octreotide, lanreotide, pasireotide), cabergoline, or pegvisomant for residual disease
RadiationStereotactic radiosurgery for tumors that persist despite surgery and medication
Lifelong careIGF-1 monitoring, pituitary hormone replacement, sleep, heart, joint and colon screening

Oral octreotide is now available for people controlled on injections who prefer a tablet.

Illustration of the pituitary gland at the base of the brain
Growth hormone-secreting adenomas arise in the anterior pituitary. Most are macroadenomas (over 1 cm) by the time of diagnosis.

Dr. Hasan is experienced in diagnosing acromegaly, coordinating pituitary surgery, managing somatostatin analog and pegvisomant therapy, and the long-term follow-up of cardiovascular, metabolic and skeletal complications.

Common questions

Will my features go back to normal?

Soft-tissue swelling, sweating, headaches and carpal tunnel improve within weeks to months of control. Bone changes to the jaw, brow, hands and feet are permanent, which is why early diagnosis matters.

Is acromegaly hereditary?

Usually not. A small minority occur in familial syndromes (MEN1, AIP mutations, familial isolated pituitary adenoma). Genetic testing is considered for young onset or a family history.

How often do I need IGF-1 checked?

Every 3 to 6 months while treatment is being adjusted, then at least yearly for life, along with a pituitary MRI schedule set by tumor size and treatment.

Does acromegaly shorten life?

Untreated, yes, mainly through heart disease and sleep apnea. With IGF-1 normalized, life expectancy returns to that of the general population.

Related conditions

Pituitary disordersPituitary adenomaHyperprolactinemiaType 2 diabetesInsulin resistanceBone health

In Wexford or by telehealth in PA and OH

If your hands, feet or face have changed, get tested.

Book an Appointment →Call (412) 485-0311