Acromegaly Diagnosis: How Doctors Identify This Rare Hormonal Disorder

Acromegaly usually progresses gradually throughout a long period and is difficult to be detected at its initial stages. The condition is mostly prevalent in middle-aged adults but it may also be experienced at any age. Gradual changes in the appearance of the patients such as enlargement of hands and feet, changes of facial features and skin thickness are noted by the patients. The physical changes are so slow that the relatives and even the sufferers themselves might not notice them as the symptoms of some medical disease at first. Physicians initiate the process of diagnosis by the physical examination and medical history. They seek typical features like swollen feet and hands, protruded jaw, bulging forehead, enlarged interdental distance and thickened skin. Additional changes that can be observed include deepening of the voice, sweating too much, joint pains and vision problems. These physical findings taken together have given reason to doubt and provide further investigation with special testing.

Gonadotropin Tests to Diagnose Acromegaly

The foundation of the diagnosis of acromegaly is the assessment of the level of growth hormone and insulin-like growth factor 1 (IGF-1) in the blood. The diagnosis of this hormonal disorder cannot be made only by a specific blood test as opposed to several tests since the level of growth hormone varies during the day. A basic random growth hormone test might not be enough, because the level can always shoot up in healthy people as they are under particular stress, exercise or sleep habits. IGF-1 blood examination is a better first screening tool as it is comparatively quite constant all day long. In the case when excess growth hormone is produced by the pituitary gland, it is responded by liver producing excess levels of IGF-1. Assuming that the level of the IGF-1 is too large according to the age and sex of the patient, doctors carry out further confirmation measures. This biomarker would be a good piece of evidence that would assist medical practitioners in differentiating normal hormonal fluctuations and pathological excess.

Oral Glucose Tolerance Test Acromegaly

The oral glucose tolerance test is one of the most conclusiveness diagnostic tests, specifically meant to assess the growth hormone suppression. When a healthy person is fed with a glucose solution, the concentration of growth hormone reduces dramatically. This normal suppression, however, is not seen in acromegaly patients and after the intake of glucose, growth hormone levels are not suppressed. The patients are administered with sweet glucose solution during this test and medical personnel take blood samples at fixed intervals within two to three hours. In this test, it is vital to note that the inability of the growth hormone to reduce to a specific level is a great indication of the diagnosis. This is regarded to be the gold standard process since it shows the direct evidence of the abnormal regulation of growth hormone which is the profile of the condition. The findings of the test, along with the high level of IGF-1, renders strong evidence on which a treatment choice can be made.

Imaging Investigations in the Search of Pituitary tumors in Acromegaly

After biochemical tests reveal excessive production of growth hormone, it is necessary to localize the source of the issue with the help of sophisticated imaging methods. The hormonal imbalance is in most instances caused by a benign tumor on the pituitary gland. The choice of imaging technique is magnetic resonance imaging (MRI) of the brain with particular attention paid to the pituitary area as it allows seeing the soft tissues in detail and detecting even minor tumors. The MRI assists the doctors in finding the size and precise location of the pituitary tumor, details that would be critical in the planning of treatment methods. Some rare instances exist that MRI is not advised or is not available, and in those instances, computed tomography (CT) scans can be considered. 

Other Diagnostic Assessments

In addition to the main tests, physicians might prescribe some other examinations in order to determine the overall effect of acromegaly on the body. These can be a visual field test to examine the presence of vision impairment when a tumor is pressing on the optic nerves, an echocardiogram test to assess the structure and functionality of the heart, colonoscopy screening in case of the presence of higher risk of cancer and sleep studies in case of suspicion of sleep apnea. Monitoring blood pressure and testing glucose helps to determine related disorders such as high blood pressure and diabetes which often accompany this hormonal imbalance.

Diagnosis of Acromegaly in Early Stages

Early diagnosis of acromegaly is a big difference in the quality of life and outcome of the patient. Early diagnosis can be effectively treated before it develops severe complications on the heart, joints and metabolism. It is a pity that, due to the insidious and slow presence of the symptoms, it might take an average of 7 to 10 years before the symptoms are diagnosed. This latency may cause some irreversible changes and health hazards. Equally, primary care doctors who identify the typical physical manifestations can hasten the referrals to endocrinologists to undergo a special examination and testing.

Conclusion

Acromegaly diagnosis should be done using a holistic method incorporating both clinical examination and biochemical and more elaborate imaging studies. The diagnostic process starts with the identification of physical changes and the confirmation of the presence of the hormonal abnormalities with the help of the IGF-1 test and the oral glucose tolerance tests. Excess growth hormone is consequently produced by a pituitary tumor which is then identified by imaging studies. In case you suspect that you are having the symptoms that are in line with this condition, the most essential step that should be taken to validate that is to seek an audience with a healthcare provider to be properly assessed to either be diagnosed with it and properly managed.