production of the HGH in the pituitary. “ Normally, GHRH, somatostatin, GH, and IGF-I levels in the body are tightly regulated by each other and by sleep, exercise, stress, food intake, and blood sugar levels.” (Klibanski & Melmed, 2012) The tumor allowing the HGH to act independently allows the IGF-I to rise, which inevitably leads to overgrowth of bones and organs. Diabetes, high blood pressure, and heart disease may also result from the overproduction of insulin-like growth factor I. Acromegaly is characterized by a plethora of physical abnormalities that can go unnoticed for a long period of time. “ Because acromegaly tends to progress slowly, early signs may not be readily apparent for several years. Sometimes, people notice the condition only by comparing old photographs.” (Mayo Clinic Staff, 2018) Although signs and symptoms can differ from person to person, the most common sign would be the enlargement of hands and feet. Individuals may notice that their shoes feel tighter or that wedding rings no longer fit their hands. Comparing photographs, people may notice that their nose and forehead are comparably larger, their lips are thicker than they were before, jaw and eyebrows may now appear to be protruding, and even the spacing between teeth may seem larger. Vocal cords and sinuses are enlarged, so those affected by acromegaly may notice that their voices are deeper and coarser than normal, and they may snore at night due to upper respiratory obstruction and enlarged tongues. Females will notice that their menstrual cycles have become irregular, and males will experience erectile
dysfunction. There is also an increase in chest diameter present, known as barrel chest. Only through diagnostic tests will the enlargement of organs, such as the heart, kidney, and spleen, be noticed. According to the Mayo Clinic Staff, doctors use three methods when diagnosing a patient with acromegaly: growth hormone and insulin-like growth hormone I measurement, a growth hormone suppression test, and imaging. The GH and IGF-I measurement is found in blood samples after the patient has abstained from eating overnight. Elevated levels indicate that the patient has acromegaly. The next test, the growth hormone suppression test, requires consumption of glucose. Levels of growth hormone are measure before and after consumption of the glucose drink. Glucose is supposed to depress the levels of growth hormone in the blood stream, but it will remain high in the patient who has acromegaly. The imaging procedure requires the use of magnetic resonance imaging (MRI) to locate and measure the pituitary tumor.
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- Summer '18