Heart problems
People with acromegaly can develop hypertension and heart disease, particularly clogged arteries (atherosclerosis) and enlargement of the muscle of the heart (cardiomyopathy), which in turn can lead to heart failure if not recognised and appropriately treated. Controlling growth hormone levels is important for reducing the risk of heart disease in acromegaly.
These heart conditions can often also be managed by living a healthy lifestyle and by taking medications prescribed by a doctor, such as drugs that control blood pressure and prevent water retention, and drugs that lower the amount of cholesterol in your blood.
Sleep apnoea
Sleep apnoea is often seen in people with acromegaly.
Sleep apnoea occurs when the walls of your throat come together while you sleep, blocking off your airway. This causes you to stop breathing for a very short period of time (usually between ten seconds and up to one minute) until your brain notices and sends you a wake-up call. This causes you to wake to open your airway, possibly with a snort or a gasp, and then go back to sleep almost immediately. In most cases, you won’t realise you have woken up. This can occur hundreds of time each night, causing you to have very broken sleep.
People with sleep apnoea are often not aware that this is happening until their partner complains that this is keeping them awake at night.
Sleep apnoea is a long-term condition that is linked to other health problems such as heart disease, so it is important to talk to a doctor if you have trouble sleeping at night, do not feel refreshed when you wake in the morning, or feel tired throughout the day.
The first step to treating sleep apnoea is making lifestyle changes including losing weight and cutting down on alcohol.
In addition to lifestyle changes, your doctor may recommend you use a ‘continuous positive airway pressure’ (CPAP) machine when you sleep. This is a mask worn at night that prevents the throat from collapsing by sending increased air pressure to the throat.
Another possible treatment is the use of a specially made mouthguard which works by holding your jaw forward during sleep to prevent collapse of the throat.
Diabetes mellitus
People with acromegaly can develop type 2 diabetes mellitus.
Type 2 diabetes is a condition in which the body becomes resistant to the normal effects of insulin and/or gradually loses the ability to produce enough insulin. This results in blood glucose, also called blood sugar, levels that are too high. Type 2 diabetes usually develops over a long period of time.
Common signs and symptoms of diabetes include being more thirsty than usual, passing more urine, feeling tired, always feeling hungry, having cuts that heal slowly, and gradually putting weight on.
Diabetes is a serious condition that can affect many parts of the body. People with diabetes can develop other conditions such as heart problems, kidney problems and eye disease. However, diabetes can be managed.
Knowing how to look after yourself is important to minimise or prevent any complications. Eating well helps manage blood glucose levels and your body weight. Exercise helps insulin work more effectively, lowers your blood pressure and reduces the risk of heart disease.
Oral medications and insulin may be required if diet and exercise alone do not bring blood sugar levels down sufficiently.
Vision changes
The pituitary gland sits close to the nerves that permit sight. So when there is a tumour in the pituitary gland, this can enlarge and compress the nerves, which can lead to vision impairment and possible sight loss.
Diagnosing acromegaly as soon as possible and surgical removal of the tumour and other treatments for acromegaly may help to avoid or reduce the severity of this complication.
Carpal tunnel syndrome
If you experience a numbness, tingling or pain in your fingers you may have carpal tunnel syndrome. This is caused by excess fluid retention in the ‘tissue tunnel’ of the wrist that causes pressure on the median nerve which runs through this ‘tunnel’.
Treatment for carpal tunnel syndrome will depend on how severe your symptoms are. Treatments can range from simply resting your wrist(s) and using wrist-supporting splints, to taking pain-relieving medications, and, if no improvement, surgery.
Carpal tunnel syndrome in people with acromegaly may improve once the condition is treated and growth hormone and insulin-like growth factor 1 (IGF-1) levels are back within their normal ranges. However, if symptoms persist after biochemical control, patients may require surgery.
Speak to your doctor if you experience numbness, tingling or pain in your fingers and are concerned that you may have carpal tunnel syndrome.
Joint problems
Joint aches and pains, which your doctor may refer to as arthralgia or arthritis, can occur in people with acromegaly.
Joint problems can also occur as you age and be unrelated to your acromegaly.
Treatments are available to help alleviate painful joints so talk to your doctor for more information.
You might also find that exercise helps.
Bowel issues
Acromegaly can be associated with an increased risk of bowel polyps and diverticular disease (small outpouchings in the large bowel).
Colonic polyps are often asymptomatic but may present with blood in the stool or iron deficiency. Diverticular disease often does not cause symptoms but if the diverticula become inflamed you may experience pain, bloating, a change in bowel habit such as constipation or diarrhoea and fever.
Your treating specialist may recommend a colonoscopy to assess for these bowel conditions.
