Osteoporosis, Type 2 Diabetes, and Cardiovascular Problems
If left untreated, acromegaly—when your body produces too much growth hormone—can lead to various complications. The most common acromegaly complications involve joint problems, pituitary hormone deficiency, and respiratory problems.
It's also possible to develop complications if acromegaly is undertreated, which is why it's so important to work closely with your doctor to monitor hormone levels.
Bone Complications from Acromegaly
Excess growth hormone (GH) secreted by a tumor (usually a pituitary tumor) can cause your bones to grow too much.
Bone overgrowth is especially noticeable in the face, and it can cause problems for your teeth if your jaw grows too much. Unfortunately, it's not possible to reverse this bone overgrowth, but it is possible to stop it by treating acromegaly.
To deal with enlarged bones, you may need to have surgery to reshape the bones, but that isn't recommended until your growth hormone and insulin-like growth factor-1 (IGF-1) levels are back in a normal range.
Bone health can also be affected by acromegaly. Too much GH can change the way your body uses vitamin D, a vitamin that's absolutely essential for bone health. Without it, your body can't use calcium well, so your bones don't get the calcium they need. This may lead to osteoporosis—low bone density—and that puts you at a higher risk of a fracture.
Hypercalcemia (too much calcium in the blood) and hypercalciuria (too much calcium in the urine) are possible complications of acromegaly; both of them mean that your body isn't using calcium. However, with treatment, your body should again be able to properly use vitamin D and calcium to build strong, healthy bones.
Soft Tissue Complications from Acromegaly
Unlike bone overgrowth, soft tissue changes are often reversible with acromegaly treatment to control GH and IGF-1. Soft tissues, such as cartilage and ligaments, can become bigger and that can lead to joint problems. Enlarged soft tissues can make it painful to move because joints may not be able to work as well as they should.
Once your GH and IGF-1 levels return to normal, soft tissues should also return to a more normal size, and you should have less joint pain.
However, if your joint pain is caused by arthritis—and not just by enlarged soft tissues—then your joint pain may not change because of acromegaly treatment. If that's the case (you have arthritis in addition to acromegaly), your doctor will treat the arthritis separately from the acromegaly.
Pituitary Hormone Deficiencies
In some people with pituitary tumors causing acromegaly, the tumor can actually affect the other hormones that the pituitary gland releases. The pituitary gland helps regulate the function of other endocrine glands; if its hormones are off, that can cause other endocrine-related problems. Your doctor should closely monitor the levels of other pituitary hormones to make sure they stay in a normal range.
Because of overgrowth in the airway, people with acromegaly can sometimes develop sleep apnea (when you have extended pauses in your breathing while sleeping). This leads to not-as-restful sleep, and a lack of sleep can affect many areas of your life.
Acromegaly treatment may eliminate sleep apnea and help the soft tissues in the airway return to their normal size. Treatment isn't a guarantee that you won't have sleep apnea anymore, though; you and your doctor should be monitoring to see if the sleep apnea goes away.
Excessive growth hormone can cause the heart to grow too large, putting people with acromegaly more at risk for cardiovascular disease, including arrhythmia (abnormal heart beat). Your doctor should monitor your heart health and see if lowering the GH levels improves your heart function.
As you may know, excessive GH secretion causes the body to produce too much insulin-like growth factor-1. Too much IGF-1 in the body changes the way your body uses glucose (an energy source), in addition to causing tissue overgrowth. People with acromegaly may develop diabetes because of the changes in how their body processes glucose.
Again, controlling GH levels may help you better control your blood glucose levels. If you do develop diabetes, your doctor will give typical treatment recommendations for that—read our article on diabetes treatments to find out more.
In addition to causing growth of bones, ligaments, and cartilage, GH can lead to the growth of polyps in the colon. Polyps can be a precursor to colon cancer—and people with acromegaly need to be watched for the formation of polyps to prevent them from becoming cancerous. Your doctor will recommend regular colonoscopies to find and treat any polyps.
Acromegaly Complications Conclusion
With an accurate diagnosis of acromegaly and a carefully monitored treatment plan, you should be able to avoid many of the complications associated with too much growth hormone in the body.