Acromegaly: Complete Guide to Symptoms, Causes, Diagnosis, and Treatment
Updated: 2 days ago
Medically reviewed by Dr. Baraa Alnahhal, MD · Last reviewed: September 2026
Quick Answer: What Is Acromegaly?
Acromegaly is a rare hormonal condition in adults in which a benign (noncancerous) pituitary tumor causes the brain to produce too much growth hormone (GH), which raises IGF-1 levels and makes the bones of the hands, feet, and face — plus some organs and tissues — grow bigger over many years. It is usually curable only with early surgery, but surgery, medicines, and radiation therapy can control the disease, and with treatment, life expectancy is close to that of people without acromegaly.
TL;DR
What it is: A rare hormonal condition in adults where bones, organs, and tissues grow bigger due to too much growth hormone.
The cause: Almost always a benign pituitary tumor (adenoma); rarely, a lung or pancreas tumor.
The earliest clue: A slow change in ring or shoe size, followed by enlarged hands and feet, jaw and brow changes, gaps between teeth, thicker lips and nose.
Why it's sneaky: Changes build over many years, so diagnosis is often delayed — but early treatment prevents serious complications.
The risks if untreated: Heart disease, high blood pressure, type 2 diabetes, sleep apnea, colon polyps, higher risk of several cancers.
The good news: Surgery, medicines, or radiation can control hormone levels — and with treatment, life expectancy is close to normal.
Acromegaly at a Glance
Topic | Quick Summary |
What it is | A rare hormonal condition causing bones, organs, and tissues to grow bigger |
How rare | Fewer than 15 per 100,000; about 3 to 5 new cases per million people each year |
The cause | Usually a benign pituitary tumor (adenoma); rarely lung or pancreas tumors |
The mechanism | Excess GH triggers the liver to make too much IGF-1, which drives tissue growth |
Earliest sign | Ring or shoe size changing; enlarged hands and feet |
Facial changes | Bigger jaw and brow, broader nose, thicker ears and lips, gaps between teeth, enlarged tongue |
Other symptoms | Headaches, vision troubles, extra sweating, fatigue, joint pain, sleep apnea, deeper voice |
Key difference | Gigantism happens in children before puberty; acromegaly happens in adults after growth plates close |
Diagnosis | IGF-1 blood test, oral glucose tolerance test (OGTT), MRI of the pituitary |
Treatment | Transsphenoidal surgery, somatostatin analogues, dopamine agonists, pegvisomant, radiation |
Outlook | Life expectancy with treatment is close to normal; bone enlargement usually can't be reversed |
What Is Acromegaly?
Acromegaly is a rare hormonal condition in adults that causes some bones, organs, and other tissues to grow bigger. A small gland in the brain called the pituitary gland drives these changes by making too much growth hormone (GH). High GH levels increase another hormone called insulin-like growth factor-1 (IGF-1). This usually happens due to a benign (noncancerous) pituitary tumor.
When the body has too much growth hormone, bones get bigger. In childhood, this leads to increased height as part of a condition called gigantism. In adults with acromegaly, a change in height doesn't happen. Instead, bones in the hands, feet, and face become bigger. Other changes may include joint pain, thickened skin, and facial changes such as a bigger jaw or nose.
These changes happen slowly over many years. So people with acromegaly and their loved ones may not notice the symptoms right away. Healthcare professionals may also have a hard time finding and treating the condition early on.
Acromegaly affects fewer than 15 people per 100,000, and about 3 to 5 people per million are diagnosed each year. Because the condition develops slowly and diagnosis is often delayed, the true number of cases may be slightly higher.
Without treatment, acromegaly can lead to serious and sometimes life-threatening complications. But treatments — surgery, medicine, and radiation — can lower the risk of complications and improve many symptoms. With treatment, many people with acromegaly live a healthy life with a life expectancy close to that of people without acromegaly.
Acromegaly vs. Gigantism
It helps to know the difference, because the same hormone is behind both:
Gigantism happens when too much growth hormone is produced before puberty, while the bones are still growing. Children with gigantism grow unusually tall, with very long arms and legs.
Acromegaly develops after puberty, when the growth plates are closed. It causes changes in the hands, feet, and facial bones — but not extreme height.
Symptoms: The Early Signs Most People Miss
Acromegaly symptoms can change the way some body parts look. Common visible changes include:
Thick ears and lips
A broad nose
Enlarged hands and feet
A jutting brow or jaw
Gaps between teeth
An enlarged tongue
An expanded rib cage that may make the chest round-shaped
Skin changes may include acne, skin tags, thickened or oily skin, and swelling under the skin. Most people with acromegaly don't have every possible change — and because the changes come on so slowly, they may take years to notice.
Beyond the Visible: How Acromegaly Affects the Body
Too much GH and IGF-1 affect many organs and systems:
Dental health. Acromegaly can cause an unusually large jaw and spacing between the teeth. People may notice gaps forming, bite changes, or teeth that don't line up correctly. An enlarged tongue can lead to speech and breathing problems — regular dental care matters.
Reproductive and sexual health. Excess growth hormone can cause erectile dysfunction, reduced libido, and low testosterone in men. Sexual issues are usually due to hormonal imbalance rather than physical enlargement.
Voice changes. Thickening of tissues in the vocal cords and throat can make the voice deeper or hoarser over time. Some people notice snoring or speech changes.
Early symptoms can be subtle — such as changes in ring or shoe size. As the condition progresses, other common symptoms include:
Vision troubles, including loss of side vision
More sweating and body odor than usual
Fatigue and low energy
Headaches
Joint pain
Sleep problems, including sleep apnea
When to See a Doctor
Get a healthcare checkup if you think you have symptoms of acromegaly. The condition develops slowly, and even family members may take a long time to notice the physical changes. But it's important for a healthcare professional to find the condition as early as possible — treatment can help prevent the serious health conditions that can develop alongside acromegaly.
Causes: The Pituitary's Role
The pituitary gland sits at the base of the brain, behind the bridge of the nose. It makes growth hormone and other hormones that manage many of the body's essential functions.
The most common cause of acromegaly is a noncancerous tumor in the pituitary gland, called an adenoma. An adenoma makes too much growth hormone over a long period. Some symptoms — such as headaches and impaired vision — come from the tumor pressing on nearby brain tissues.
Here is the chain of events: the pituitary releases growth hormone into the bloodstream → this triggers the liver to make IGF-1 → IGF-1 is what causes bones and other tissues to grow → too much GH means too much IGF-1 → acromegaly symptoms and complications follow.
Tumors that grow from the pituitary's somatotroph cells (the cells that make GH) are called GH-secreting adenomas — and only these cause acromegaly. Other pituitary adenomas come from different hormone-producing cells and cause different conditions, such as Cushing disease or hyperthyroidism.
Rarely, tumors in other parts of the body — such as the lung or pancreas — cause acromegaly. These tumors either release growth hormone directly or make growth hormone-releasing hormone, which signals the pituitary to make more.
Risk Factors
The main known risk factor is multiple endocrine neoplasia type 1 (MEN1), a rare inherited condition in which tumors can form in the parathyroid glands, pancreas, and pituitary gland. If a pituitary tumor in MEN1 makes excess growth hormone, acromegaly can result.
Very rarely, acromegaly can also run in families through familial isolated pituitary adenoma (FIPA), which increases the chance of pituitary tumors. Outside these rare inherited syndromes, most people with acromegaly have no known risk factors.
Complications: Why Early Treatment Matters
Without treatment, acromegaly can lead to serious complications:
System | Complications |
Heart and blood vessels | High blood pressure; narrowed arteries raising heart attack and stroke risk; cardiomyopathy (stiff or enlarged heart muscle) that may lead to heart failure |
Cancer risk | Higher risk of prostate, breast, colon, thyroid, and stomach cancers; colon polyps that can lead to colon cancer without treatment |
Reproductive and sexual health | Irregular or missed periods; erectile dysfunction and reduced desire; infertility; pregnancy may need special monitoring (gestational diabetes risk) |
Metabolic | Insulin resistance and type 2 diabetes; high cholesterol and other blood fat changes |
Bone, joint, and nerve | Osteoarthritis (joint pain and stiffness); carpal tunnel syndrome (numbness and tingling in hands); spinal cord compression or fractures |
Other | Sleep apnea; goiter (thyroid changes); vision loss if the tumor presses on optic nerves; depression, fatigue, and reduced quality of life |
Without treatment, acromegaly and its complications can shorten life expectancy. Early treatment can prevent these complications or keep them from becoming worse.
How Acromegaly Is Diagnosed
Diagnosis begins with a health history and physical exam, followed by specific tests:
IGF-1 measurement. A blood test measures the level of IGF-1 in your blood. A high level can mean growth hormone is also high — an important marker for acromegaly. But IGF-1 can also be elevated by diabetes, liver or kidney disease, or pregnancy, so confirmation is needed.
Oral glucose tolerance test (OGTT). GH is measured before and after you drink a glucose (sugar water) solution. In people without acromegaly, the glucose drink typically causes GH to fall. If you have acromegaly, GH tends to stay high.
MRI and other imaging. An MRI of the pituitary gland is the main imaging test — it shows the location and size of a pituitary tumor. If no pituitary tumor is found, other scans look for tumors elsewhere in the body. X-rays of the hands and feet may check for bone growth changes.
Treatment Options
Acromegaly is not always curable, but treatment can often control the disease. The goals are to improve symptoms, prevent complications, and bring GH and IGF-1 levels back to healthy ranges. Keeping these hormone levels under control improves quality of life and lowers long-term health risks.
Your plan depends on the tumor's size and location, symptom severity, your age, and overall health — and some people need a combination of treatments:
Pituitary tumor surgery to remove the tumor causing symptoms — often the first treatment.
Medicines that lower GH or block its effects — used if surgery doesn't bring hormone levels into the healthy range.
Radiation therapy to target the tumor and reduce hormone production — recommended if surgery isn't possible, can't remove the whole tumor, or if medicines don't help enough.
Treatment can improve soft tissue swelling and skin changes, but bone enlargement usually cannot be reversed. If you also have diabetes, sleep apnea, or heart disease related to acromegaly, additional treatments may be needed for those.
Surgery
The main surgical treatment is transsphenoidal surgery. A neurosurgeon removes the pituitary tumor through the nose and a hollow space behind the nasal passages called the sphenoid sinus. This approach avoids opening the skull and is the most common way surgeons treat acromegaly.
Surgery often returns growth hormone to the right level, especially if the tumor is small. If the tumor was pressing on nearby tissues, removing it can also relieve headaches and vision changes. Sometimes the whole tumor can't be removed — especially if it has grown close to important nerves or blood vessels — and additional surgery, medicines, or radiation may be needed.
Medicines
Medicine Type | Examples | How It Works | Key Points |
Somatostatin analogues | Octreotide (Mycapssa, Sandostatin), lanreotide (Somatuline Depot), paltusotine (Palsonify) | Mimics somatostatin, a natural brain hormone that limits GH production; lowers GH and IGF-1; may shrink the tumor | First-line if surgery doesn't improve symptoms; Mycapssa is a twice-daily capsule, lanreotide is monthly injections; paltusotine (FDA-approved 2025) is a once-daily capsule |
Dopamine agonists | Cabergoline, bromocriptine | Taken by mouth; may lower GH and IGF-1, especially when levels are only slightly high; may shrink the tumor | Higher doses often needed; side effects include nausea, tiredness, dizziness, sleep problems, mood changes |
Growth hormone receptor antagonist | Pegvisomant (Somavert) | Blocks GH's effect on tissues, lowering IGF-1 | Given as a daily shot; does not shrink tumors or reduce GH levels; requires regular blood tests to monitor the liver |
Radiation Therapy
Radiation is usually used after surgery to destroy leftover tumor cells. It gradually lowers growth hormone levels, but improvement may take months or even years. Because radiation can also lower other pituitary hormones, you'll need lifelong follow-up to monitor hormone levels and pituitary function.
Stereotactic radiosurgery — uses 3D imaging to deliver a precise high dose to the tumor while limiting exposure to healthy tissue, usually in a single dose. GH may return to a healthy range within several years. The most common technique is Gamma Knife (no surgical knife involved).
Proton beam radiation — uses tiny protons to target the tumor; may cause less damage to the pituitary and surrounding tissue than conventional radiation.
Conventional radiation therapy — small doses over 4 to 6 weeks; higher risk of pituitary damage; full effect may take 10 years or more.
Prognosis and Life Expectancy
In the past, people with untreated acromegaly often had a shorter life expectancy because of heart disease, diabetes, sleep apnea, and cancer complications. Today, with earlier diagnosis and better treatments, life expectancy with treatment is close to that of people without acromegaly. Many people can live a typical lifespan if GH and IGF-1 levels are lowered and maintained at healthy levels.
The prognosis depends on how early the condition is diagnosed and how well treatment controls hormone levels. Surgery that completely removes a small pituitary tumor may cure acromegaly. Large tumors are harder to remove completely, but medicines and radiation can usually bring hormone levels down to safe ranges.
Even after treatment, some physical changes — such as bone growth in the jaw, hands, or feet — may not fully reverse. But controlling hormone levels improves symptoms and reduces the risk of serious complications. Regular follow-up is important to keep hormone levels in check and monitor for any return of tumor growth.
Preparing for Your Appointment
You'll likely first see your primary healthcare professional, or be referred to an endocrinologist — a doctor who finds and treats hormone conditions. Here is how to prepare:
Ask about restrictions — you may be asked to fast for a number of hours before a test.
Write down your symptoms — headaches, vision changes, hand discomfort; include anything that doesn't seem related to the visit.
Note key personal information — including any changes in your sex life or menstrual cycle.
List all medicines, vitamins, and supplements with their doses.
Bring old pictures — photos from about 10 years ago through the present help the doctor compare your appearance.
Bring a family member or friend — they may remember something you miss.
Write down your questions, such as: What's the most likely cause of my symptoms? What tests do I need? What treatments do you recommend? How long before my symptoms improve? Could treatment help me look and feel as I did before? Will I have long-term complications?
Your doctor will likely ask: When did your symptoms start? Have you noticed changes in how you look? How much have your features changed (old photos help)? Any changes in sleep, sex life, headaches, joint pain, vision, or sweating? Do your old shoes and rings still fit? Have you had a colon cancer screening?
Frequently Asked Questions
What is acromegaly and what causes it?
Acromegaly is a rare hormonal condition in adults in which some bones, organs, and tissues grow bigger. It is caused by too much growth hormone (GH) and IGF-1 — almost always due to a benign (noncancerous) pituitary tumor called an adenoma. Excess GH triggers the liver to make too much IGF-1, which drives the tissue growth.
What are the first signs of acromegaly?
The earliest signs are often subtle: a slow change in ring or shoe size. Over time, hands and feet enlarge, the jaw and brow jut forward, gaps form between teeth, lips and ears thicken, and the nose broadens. Headaches, extra sweating, fatigue, joint pain, a deeper voice, and sleep apnea are also common.
How is acromegaly different from gigantism?
Both come from excess growth hormone, but the timing differs. Gigantism happens in children before puberty, when growth plates are still open, causing extreme height. Acromegaly develops in adults after the growth plates close — so height doesn't change, but the hands, feet, and facial bones grow bigger.
Is acromegaly dangerous if left untreated?
Yes. Without treatment, it can lead to high blood pressure, narrowed arteries, heart muscle disease, type 2 diabetes, sleep apnea, colon polyps, a higher risk of several cancers, and vision loss — and it can shorten life expectancy. Early treatment prevents or limits these complications.
Can acromegaly be cured?
Surgery that completely removes a small pituitary tumor may cure it, but acromegaly is not always curable — it can often be controlled. Medicines and radiation can bring GH and IGF-1 down to safe ranges, and with treatment, life expectancy is close to that of people without acromegaly. Note that bone enlargement usually cannot be reversed, even with successful treatment.
What tests diagnose acromegaly?
The main tests are an IGF-1 blood test (a high level suggests high GH), an oral glucose tolerance test (GH stays high after a glucose drink in acromegaly, instead of falling), and an MRI of the pituitary gland to locate and size the tumor. Hand and foot X-rays may also check for bone changes.
Conclusion: What to Remember About Acromegaly
Acromegaly grows quietly — but it does not have to take your health with it. The three lessons to carry from this guide are:
Small changes are early warnings. A ring or shoe size that no longer fits, a slowly changing jaw, or gaps forming between teeth can be the first signs of a condition that builds over years — noticing them early is your best protection.
Treatment transforms the outlook. Surgery, medicines, and radiation can control hormone levels, relieve symptoms, and bring life expectancy close to normal — but the sooner treatment begins, the more complications are prevented.
Follow-up is lifelong. Hormone levels need ongoing monitoring, leftover tumor cells may need further treatment, and bone changes usually don't reverse — so staying engaged with your healthcare team matters long after treatment ends.
If your ring or shoe size has been quietly changing, don't wait it out — mention it at your next checkup.
References
Mayo Clinic. Acromegaly — Symptoms & causes. mayoclinic.org
Mayo Clinic. Acromegaly — Diagnosis & treatment. mayoclinic.org
This article is for informational purposes only and is not a substitute for professional medical advice. Always consult a qualified healthcare provider for diagnosis and treatment.
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