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Exams and Tests
Acromegaly is not an easy diagnosis, and it is often missed by health care providers. Some of the signs and symptoms of acromegaly are very distinctive. Others are subtle and can be misinterpreted. They are not always recognized as acromegaly because they develop so slowly. Enlargement of the hands, feet, or face is most often caused by accumulation of fluid in edematous states, but it can also be a finding of growth hormone excess from acromegaly.
If suspicious, your health care provider may ask you about your symptoms, your other medical problems now and in the past, your family members’ medical problems, what medications you take, your work history, your habits and lifestyle, and many other questions. A detailed physical examination will look for signs and symptoms that clarify the diagnosis.
If your health care provider suspects acromegaly, he or she will order blood tests to help confirm that diagnosis.
Random measurement of growth hormone in the blood is usually not useful, as levels of the hormone fluctuate unpredictably. IGF-1 level is much more stable and predictable than growth hormone level. Thus, measurement of IGF-1 level is considered the most reliable test for acromegaly.
Because growth hormone secretion is inhibited by glucose (blood sugar), some health care providers measure what is called "glucose nonsuppressibility."
The following tests may be ordered if your health care provider thinks they would be helpful:
After acromegaly has been confirmed by growth hormone and IGF-1 levels, you will probably undergo a CT scan or MRI of the head to confirm that you have an adenoma in your pituitary gland. If no pituitary tumor is detected, your health care provider will continue searching until the source of the excess growth hormone is found.
Hasnain M Khandwala, MD, FRCPC
Arthur B Chausmer, MD, PhD, FACP, FACE, FACN, CNS
Francisco Talavera, PharmD, PhD
George T Griffing, MD
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