Some adenomas are aggressive, growing quickly. In these cases, the signs and symptoms of acromegaly tend to develop fairly quickly. Others grow more slowly, causing very gradual onset of symptoms. In these cases, symptoms might appear several years before the disease is diagnosed.

Symptoms can be divided into 2 groups: those that are effects of the tumor pressing on surrounding tissues and those caused by excess growth hormone and IGF-1 in the blood.

Symptoms due to pressure on surrounding tissues depend on the size of the tumor.

• Headaches and partial loss of vision are the most common symptoms.
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• Partial loss of vision may occur in one or both eyes.
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• Pituitary tumors also can damage the pituitary gland itself, disrupting hormone production. The resulting hormone imbalances are responsible for symptoms such as impotence, low sex drive, and changes in the menstrual cycle. 

Symptoms due to excess growth hormone or IGF-I vary widely.

• Increase in ring size or tightness of rings (due to hand swelling, “sausage-like” fingers)
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• Increase in shoe size (due to foot swelling)
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• Increased sweating
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• Coarsening or thickening of facial features, especially the nose
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• Increased prominence of jaw and/or forehead
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• Thickened skin, especially on palms of hands or soles of feet
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• Oily skin or acne
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• Swelling of tongue
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• Thickening or swelling of the neck (due to goiter)
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• Arthritis (pain, swelling, or stiffness in any joint)
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• Difficulty breathing during sleep (sleep apnea), causing poor sleep and excessive sleepiness during the day
  
  
• Pain, numbness, tingling, or weakness in hands and wrists (carpal tunnel syndrome)
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• New overbite, underbite, or spreading out of teeth
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• Large numbers of skin tags

Acromegaly that affects the heart or blood pressure or causes diabetes may have another set of symptoms. These do not occur in everyone with acromegaly.

• Irritability
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• Fatigue
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• Fainting
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• Weakness
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• Increased thirst or urination
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• Shortness of breath
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• Chest pain
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• Palpitations or rapid heart beat
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• Poor exercise tolerance

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