Acromegaly

Acromegaly is a rare condition. It is caused when the pituitary gland makes too much GH. The pituitary gland is a small endocrine gland attached to the bottom of the brain. It controls, makes, and releases several hormones, including GH.

Usually, a noncancerous (benign) tumor of the pituitary gland releases too much GH. In rare cases, pituitary tumors can be inherited.

In children, too much GH causes gigantism rather than acromegaly.

Your health care provider will perform a physical exam and ask about your symptoms.

The following tests may be ordered to confirm the diagnosis of acromegaly and check for complications:

• Blood glucose
• Growth hormone
• Insulin-like growth factor 1 (IGF-1)
• Prolactin
• Spine x-ray
• MRI of the brain, including the pituitary gland
• Echocardiogram
• Colonoscopy
• Sleep study

Other tests may be ordered to check whether the rest of the pituitary gland is working normally.

Often a GH suppression test is needed. This involves drawing blood from a vein 4 or 5 times over 2 hours before and after drinking a specific amount of a sugar solution. Glucose and GH are measured in the blood.

Surgery to remove the pituitary tumor that is causing this condition often corrects the abnormal GH. Sometimes, the tumor is too large to be removed completely and acromegaly is not cured. In this case, medicines and radiation (radiotherapy) may be used to treat acromegaly.

Some people with tumors that are too complicated to remove by surgery are treated with medicines instead of surgery. These medicines may block the production of GH from the pituitary gland or prevent the action of GH in other parts of the body.

After treatment, you will need to see your provider regularly to make sure that the pituitary gland is working normally and that acromegaly does not come back. Yearly evaluations are usually recommended.

More information and support for people with acromegaly and their families can be found at:

• National Institute of Diabetes and Digestive and Kidney Diseases -- www.niddk.nih.gov/health-information/endocrine-diseases/acromegaly
• National Organization for Rare Disorders -- rarediseases.org/rare-diseases/acromegaly/

Pituitary surgery is successful in most people, depending on the size of the tumor and the experience of the neurosurgeon with pituitary tumors.

Without treatment, the symptoms will get worse. Conditions such as high blood pressure, diabetes, and heart disease may result.

Contact your provider if:

• You have symptoms of acromegaly
• Your symptoms do not improve with treatment

Acromegaly cannot be prevented. Early treatment may prevent the disease from getting worse and help to avoid complications.

Somatotroph adenoma; Growth hormone excess; Growth hormone secreting pituitary adenoma; Pituitary giant (in childhood)

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Katznelson L, Laws ER Jr, Melmed S, et al. Acromegaly: an endocrine society clinical practice guideline. J Clin Endocrinol Metab. 2014;99(11):3933-3951. PMID: 25356808 pubmed.ncbi.nlm.nih.gov/25356808/.

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Updated by: Sandeep K. Dhaliwal, MD, board-certified in Diabetes, Endocrinology, and Metabolism, Springfield, VA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.