Many cells in the body secrete hormones, which control important bodily functions like sexuality, metabolism, body temperature, memory, muscle strength, growth, reproduction and appetite. The most commonly known are estrogen, testosterone, growth hormone and insulin.

Usually hormones work in harmony to ensure a balance in maintaining normal, day-to-day functions, but problems can arise when these hormones do not function properly. This usually occurs when people produce a particular hormone in the wrong amount, either too much or too little. As a result, serious hormonal disorders can develop that need to be corrected or regulated with medication. One chronic and life-threatening disease resulting from hormonal imbalance is Acromegaly.

Acromegaly is caused by excessive secretion of growth hormone resulting from a non-cancerous tumor on the pituitary gland, which is located at the base of the brain. A life-threatening disorder, its mortality rate is two to four times higher than that of the general population-comparable to that of more prevalent diseases, such as diabetes and Parkinson's disease. On average, individuals with acromegaly die up to 10 years earlier than healthy individuals.

Why Such a High Death Rate?

There are two primary reasons why acromegaly has a high death rate in comparison to other diseases: physiologic complications associated with the disease and the delay in its diagnosis. Growth hormone is a key factor in body growth and organ development. Its hyper secretion-which results from acromegaly-can cause overgrowth of body parts and enlargement of various organs. The consequences of this can result in complications associated with increased morbidity and mortality. In addition, acromegaly is a rare condition that physicians recognize infrequently, and the signs and symptoms develop so gradually that the diagnosis may be missed for up to 15 years or more.. Acromegaly affects an unknown number in the tens of thousands adults in the United States alone. Undiagnosed patients probably constitute a greater number, given the 15 year interval between onset and diagnosis. Family physicians rarely recognize acromegalic patients, forgetting often that a blood test, not a visual diagnosis, is the correct way to "find" the acromegalic patient.

The Keys to Controlling the Disease

There are two critical factors in controlling acromegaly. Diagnosis is the first step, but diagnosis is dependent on recognizing the characteristic signs and symptoms, which include:

• Enlarged hands and feet, such as:
  • Thickened fingers
  • Increased length and width of feet
  • Thickening of heel pads
• Increased ring, glove or shoe size
• Enlarged tongue
• Wide spacing of teeth
• Enlarged internal organs, such as liver, colon, heart and spleen
• Sweating
• Arthralgia or joint pain
• Headaches
• Carpal tunnel syndrome

Diagnosis of acromegaly itself is accomplished by testing the blood for elevated levels of growth hormone or IGF-1 (insulin growth factor) or by more elaborate tests, such as a magnetic resonance imaging (MRI) or computerized tomography (CT) of the pituitary gland. These can determine if a tumor exists.

The second critical factor in controlling the disease is treatment, and options for acromegaly can include surgery to remove the pituitary tumor, radiation and/or drug therapies. Whatever treatment is chosen, ultimate control of the disease is necessary, and is achieved by substantially reducing or normalizing growth hormones and/or IGF-1 (insulin growth factor) levels. This can sometimes be accomplished by use of treatments concurrently. Recently, a long-acting, once-a-month synthetic hormone therapy, SANDOSTATIN LAR Depot (octreotide acetate for injectable suspension), was approved by FDA that helps keep these levels within the optimal balance. The active component in this new long-acting formulation - octreotide acetate - is well established as an effective agent in treating acromegaly.

Whatever treatment regimen is followed, people diagnosed with acromegaly should be monitored for the rest of their lives to ensure the balance of their hormone levels.