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Acromegaly

Also known as: growth hormone excess · pituitary gigantism

Excess growth hormone (almost always from a pituitary adenoma) in adults — insidious enlargement of the hands, feet and jaw (coarse features), with headaches, sweating, arthralgia and systemic effects (hypertension, diabetes, cardiomyopathy, sleep apnoea). Before growth-plate fusion in children it causes gigantism.

Source · Reviewed 2026-08-15 · v1.0— AI-assisted draft — verify against the cited guideline before clinical use.

⚕️ Education only — not medical advice. Verify against the latest official guideline and your local protocol; confirm every drug dose against the cited source before clinical use.

Who gets it

Adults, usually middle-aged; almost always a benign pituitary somatotroph adenoma.

Red flags — escalate / refer

Visual-field loss (bitemporal hemianopia from chiasmal compression), severe headache, or cardiovascular/metabolic complications → prompt endocrine/neurosurgical care.

Work-up / diagnosis

1Screen with IGF-1 (raised for age); confirm with an oral glucose tolerance test (GH fails to suppress).
2Then pituitary MRI to find the adenoma and assess the visual fields; screen for complications (glucose, BP, sleep apnoea, cardiac, colon).

Management — overview

Specialist-led; first-line is usually transsphenoidal surgery to remove the adenoma.
Medical therapy (somatostatin analogues, a GH-receptor antagonist, dopamine agonists) when surgery is insufficient/unsuitable; radiotherapy for residual disease.
Treat complications (diabetes, hypertension, sleep apnoea) and monitor with IGF-1/GH.

In-depthFull dosing & advanced protocol

Drug dosing

Surgery first-line; medical therapy adjunct

Normalise GH/IGF-1

Adult dose: Transsphenoidal surgery; somatostatin analogue/GH-receptor antagonist per endocrinology
Route: Surgical / SC / oral

ICMRStandard Treatment Workflows (STWs), India — Dept. of Health Research & ICMR (2022+) ↗

IGF-1 screens; OGTT confirms

Raised IGF-1 screens; failure of GH to suppress on an OGTT confirms it.
Look for chiasmal compression (visual fields) from the adenoma.
It raises cardiovascular/colon/metabolic risk; treatment normalises IGF-1 and reduces mortality.

ICMRStandard Treatment Workflows (STWs), India — Dept. of Health Research & ICMR (2022+) ↗

References

Guidelines change. If something here is out of date, tell us — we keep these current.

🚩 Report outdated / suggest update

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👤 Who gets it

🚩 Red flags — escalate / refer

🔎 Work-up / diagnosis

🧭 Management — overview

💊 Drug dosing

Surgery first-line; medical therapy adjunct

📈 IGF-1 screens; OGTT confirms

📚 References

More protocols

👤 Who gets it

🚩 Red flags — escalate / refer

🔎 Work-up / diagnosis

🧭 Management — overview

💊 Drug dosing

Surgery first-line; medical therapy adjunct

📈 IGF-1 screens; OGTT confirms

📚 References

More protocols

Who gets it

Red flags — escalate / refer

Work-up / diagnosis

Management — overview

Drug dosing

IGF-1 screens; OGTT confirms

References

Who gets it

Red flags — escalate / refer

Work-up / diagnosis

Management — overview

Drug dosing

IGF-1 screens; OGTT confirms

References