Acromegaly: What to watch for and what to expect

Do your hands or feet seem bigger, or has your jaw slowly changed shape? Those slow, steady changes can be from acromegaly — a rare condition caused by too much growth hormone, usually from a small pituitary tumor. It develops over years, so many people don’t notice right away. Knowing the common signs and the tests doctors use can speed up diagnosis and protect your health.

Signs, causes, and health risks

Typical signs include enlarged hands and feet, coarser facial features, gaps between teeth, and thicker skin. You might also have persistent joint pain, excessive sweating, snoring or sleep apnea, and new or harder-to-control diabetes. Most cases (over 90%) come from a benign pituitary adenoma that pumps out excess growth hormone. Left untreated, acromegaly raises the risk of heart disease, stroke, sleep apnea, arthritis, and blood sugar problems.

How doctors diagnose acromegaly

If a doctor suspects acromegaly they will usually start with a blood test for IGF-1 (insulin-like growth factor 1). IGF-1 stays high when growth hormone is elevated over time, so it’s a good first screen. If IGF-1 is high, the next step is an oral glucose tolerance test to see whether growth hormone drops normally after drinking glucose — if it doesn’t, that supports the diagnosis. Imaging follows: a pituitary MRI checks for a tumor and helps plan treatment.

Treatment options are straightforward and effective in most people. The first-line choice is often transsphenoidal surgery to remove the pituitary tumor. Many people improve quickly after surgery, though some will still need medications. Common drugs include somatostatin analogs (octreotide, lanreotide), which lower hormone output; pegvisomant, a growth hormone receptor blocker; and dopamine agonists like cabergoline for mild cases. Radiation is used less often but can be helpful when surgery and meds don’t fully control the disease.

Living with acromegaly means more than treating the tumor. Regular follow-up with an endocrinologist is essential: IGF-1 levels are checked periodically, MRI scans may be repeated, and other problems (diabetes, high blood pressure, sleep apnea) need active management. Dental exams, joint care, and sleep studies can greatly improve quality of life. If you snore loudly or feel very tired during the day, ask about a sleep study — treating sleep apnea makes a big difference.

Wondering what to do next? If you notice persistent changes in your face, hands, or feet, or you have new joint pain and worsening sleep or blood sugar control, talk to your primary doctor and ask for an endocrine referral. Early detection makes treatment simpler and lowers long-term risks. You don’t have to figure it out alone — an endocrine team will guide testing and build a clear plan that fits your life.