What's acromegaly?
Acromegaly is an acquired endocrine disorder of growth hormone excess, in the vast majority of cases from a benign GH-secreting pituitary adenoma (somatotroph tumour); the GPR101 and AIP genes are linked only to rare familial pituitary-adenoma predisposition, not to typical sporadic acromegaly. GH drives hepatic IGF-1 production, so elevated IGF-1 with failure of GH to suppress on an oral glucose tolerance test is the biochemical hallmark. Clinical features include acral (hand and foot) enlargement, coarsening facial features, soft-tissue and organ overgrowth, sweating, arthralgia, sleep apnoea, impaired glucose tolerance, and, from the adenoma's mass effect, headache and visual-field loss. First-line treatment is transsphenoidal surgery; medical options include somatostatin analogues, the GH-receptor antagonist pegvisomant, and dopamine agonists such as cabergoline.
| Also indexed as | ORPHA:963, MONDO:0019933 |
|---|---|
| Features mapped | 14 |
| Treatments mapped | 8 |
| Published sources | 16 |
| Last reviewed | 2026-08-04 |
Signs and symptoms
Sleep apnea
Sleep apnea — repeated pauses in breathing during sleep — is one of the nonspecific symptoms that can develop in acromegaly. Because soft-tissue overgrowth narrows the upper airway, it can appear well before the more obvious facial and hand changes are recognized.
Constrictive median neuropathy
Carpal tunnel syndrome — pressure on the median nerve at the wrist, causing tingling, numbness, or weakness in the hand — is one of the nonspecific symptoms that can develop early in acromegaly, before the more obvious changes are noticed.
Headache
Headache is one of the most common presenting symptoms of acromegaly. It can come from the pituitary tumor itself as well as from the wider effects of growth hormone excess, and it is often present at the time the condition is first recognized.
Acral overgrowth
Acral enlargement — the gradual enlargement of the hands and feet — is one of the most commonly described features of acromegaly. It comes from the soft-tissue and bone overgrowth driven by long-term excess growth hormone, and it is often what prompts a person to notice that rings, gloves, or shoes no longer fit.
Increased circulating insulin-like growth factor 1 concentration
Insulin-like growth factor 1 (IGF-1) is the blood marker used to screen for the disease. Growth hormone drives the liver to make IGF-1, so a raised level reflects ongoing excess and is the main test for diagnosis and follow-up.
Elevated circulating growth hormone concentration
Growth hormone (GH) is the hormone produced in excess. Because levels swing through the day, doctors confirm the diagnosis with an oral glucose tolerance test: in acromegaly, GH fails to fall (suppress) after a sugary drink as it normally would.
Hyperhidrosis
Excessive sweating, often with oily skin, is one of the most common presenting features of acromegaly. It reflects the effect of growth hormone excess on the skin's sweat and oil glands.
Visual field defect
When the pituitary tumor grows large it can press on the nearby optic nerves, causing loss of side (peripheral) vision. This is a reason to have formal visual-field testing and is one of the tumor's mass-effect signs.
Pituitary growth hormone cell adenoma
The usual cause is a pituitary somatotroph tumor, a benign growth of the pituitary's growth-hormone-producing cells. Treating this tumor is the central goal of care.
Pituitary macroadenoma
A pituitary macroadenoma is a noncancerous tumor of the pituitary gland larger than about 1 cm. In acromegaly it is usually the source of the excess growth hormone, and because of its size it can press on nearby structures or, rarely, bleed.
Diabetes mellitus
Diabetes and impaired blood-sugar control are common because excess growth hormone works against insulin.
Infertility
Prolactinomas are the most common type of pituitary tumor, and they can cause infertility by lowering sex hormone levels in the body.
Coarse facial features
Coarsening of the facial features is one of the classical signs of acromegaly. The features broaden and thicken slowly over years as soft tissue and bone enlarge, so the change is often only obvious when older photographs are compared.
Vertebral compression fracture
Fragility fractures of the spine — vertebrae that collapse under normal load because the bone has weakened — occur more often in people with acromegaly. Long-term exposure to high growth hormone and IGF-1 changes how bone is built and broken down, raising the risk of these fractures.
How it is diagnosed
Acromegaly
Diagnosed using: Magnetic resonance imaging.
“Heart failure arising from acromegaly was suspected due to her facial features, and confirmed through elevated levels of GH and a pituitary macroadenoma demonstrated by magnetic resonance imaging.”
Acromegaly
Diagnosed using: Biopsy.
“Chest imaging revealed a 75×87×106mm left lung mass, which was found to be a well-differentiated neuroendocrine tumor (NET) on biopsy.”
Acromegaly
Diagnosed using: Serum IGF-1.
“Serum IGF-I is the preferred initial screening test due to its stability and reflection of integrated GH…”
Acromegaly
Diagnosed using: Oral glucose tolerance test with growth hormone suppression.
“GH suppression during OGTT is the gold-standard confirmatory…”
Acromegaly
Diagnosed using: Pituitary MRI.
“…we propose a standardized, tiered approach to pituitary imaging in patients with…”
Treatment and management
What the research describes, not a recommendation. Treatment decisions belong with your clinician.
This covers treatments that appear in the published research mapped here. Investigational and experimental therapies are not included, so their absence is a boundary of this map, not a sign they do not exist.
transsphenoidal surgery
Surgery to remove the pituitary tumor through the nose and sphenoid sinus (transsphenoidal surgery) is the first-line treatment and can bring the disease into lasting remission when the whole tumor is removed.
Used to help with: Acromegaly.
“Transsphenoidal surgery was more successful after 2010 (75% vs.”
somatostatin analogues
Somatostatin analogues (such as octreotide and lanreotide) are injected medicines that lower growth hormone output. They are the main drug treatment, used when surgery does not fully control the disease.
Used to help with: Acromegaly.
“Among the patients on medical treatment, first-generation somatostatin receptor ligand (SRL) monotherapy was used with a median rate of 48.7%, followed by combination therapies with a median rate of 29.3%.”
pegvisomant
Pegvisomant is a growth-hormone-receptor blocker that stops growth hormone acting on the body. It is used, often when other drugs are not enough, and is judged mainly by normalizing IGF-1.
Used to help with: Acromegaly.
“Pegvisomant monotherapy was used in 7 centers and pasireotide monotherapy in 5 centers, with median rates of 7.9% and 6.3%, respectively.”
cabergoline
Cabergoline is an oral dopamine-agonist tablet that can lower growth hormone in some people, usually in milder disease or added to other treatment.
Used to help with: Acromegaly.
“Cabergoline monotherapy was used in 6.9% of patients.”
pasireotide
Pasireotide is a long-acting somatostatin medicine that binds to several somatostatin receptor types at once. In acromegaly it can achieve better control of growth hormone and IGF-1 levels than older somatostatin medicines, though it carries a higher risk of raised blood sugar.
Used to help with: Acromegaly.
“Pasireotide long-acting release, a somatostatin receptor multiligand, achieves more favorable biochemical control rates but is associated with an increased risk of…”
octreotide
Octreotide is a long-acting somatostatin receptor ligand — an injected medicine that lowers growth hormone release. Together with lanreotide it has been the cornerstone of long-term medical treatment for acromegaly.
Used to help with: Acromegaly.
“Long-acting somatostatin receptor ligand (SRL) therapy with octreotide or lanreotide has been the cornerstone of…”
radiotherapy
Radiation therapy is used in some people with acromegaly, usually when surgery and medicines have not fully controlled the growth hormone excess. It is given after surgery and chronic medical therapy as part of the overall treatment plan.
Used to help with: Acromegaly.
“Treatment of acromegaly includes surgery followed by chronic medical therapy for persistent growth hormone (GH) excess, and, in some patients…”
lanreotide
Lanreotide is a long-acting somatostatin analogue given by injection that lowers growth hormone and IGF-1. In studies of acromegaly it provided hormonal control and improved quality of life and symptoms in most people treated.
Used to help with: Acromegaly.
“Lanreotide ATG provided hormonal control and improved both health-related quality of life and acromegaly symptoms in most…”
How to read the evidence labels
Where this comes from
This guide is built from 16 published source(s). Every claim above links back to one of them. Click any source ID to read the original on PubMed.
Take it further
Printed, source-linked documents built from this condition's graph — ready to bring to an appointment or attach to a coverage request. Every claim carries its published source, the same as this guide.