Acromegaly is a condition due to the production of too much growth hormone by the pituitary gland after the end of adolescence. When there is secretion of too much growth hormone before the end of adolescence, gigantism results.

A pituitary adenoma is the usual cause. Growth hormone (GH) secreting tumors cause acromegaly in adults and gigantism in children.

Onset of the condition often starts between the ages of 30 and 50, affecting both men and women equally. The face, hands, and feet are the sites usually involved. Facial appearance changes with lower jaw enlargement, misalignment of the teeth, and tongue enlargement. The voice becomes husky, and sleep apnea can occur. The soft tissue of the hands and feet grow larger, and the major organs increase in size. Painful joints and compressed nerves may be present. Secretions from the sebaceous and sweat glands increase, resulting in offensive body odor.

Measurement of blood levels of the growth hormone of the pituitary gland is indicated. Diagnosis is based on physical appearance, clinical findings and radiology studies, including magnetic resonance imaging (MRI). Serum phosphate levels are usually elevated, and the glucose tolerance test is abnormal.

Removal of the tumor is done by radiation or surgery. The transphenoidal (through the sphenoid) surgical approach is currently the preferred method. Drug therapy is utilized to lower GH levels.

Acromegaly causes an increase in mortality related to cardiac or neurovascular problems. Diabetes mellitus, as well as an increase in rectal polyps resulting in colon cancer, are additional life-shortening conditions.

• Consider service connection on a presumptive basis as a chronic condition (38 CFR §3.307; §3.309 (a)). 

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