Hypothyroidism

Share on facebook Share on twitter Bookmark & Share Printer-friendly version

Hypothyroidism is a condition in which the thyroid gland does not make enough thyroid
hormone. This condition is often called underactive thyroid.
Causes
The thyroid gland is an important organ of the endocrine system. t is located at the front
of the neck! "ust above where your collarbones meet. The thyroid makes hormones that
control the way every cell in the body uses energy. This process is called metabolism.
Hypothyroidism is more common in women and people over age #$.
The most common cause of hypothyroidism is thyroiditis. Swelling and
in%ammation damage the thyroid gland&s cells.
'auses of this problem include(
The immune system attacking the thyroid gland
)iral infections *common cold+ or other respiratory infections
Pregnancy *often called postpartum thyroiditis+
,ther causes of hypothyroidism include(
'ertain medicines! such as lithium and amiodarone
'ongenital *birth+ defects
-adiation treatments to the neck or brain to treat di.erent cancers
-adioactive iodine used to treat an overactive thyroid gland
Surgical removal of part or all of the thyroid gland
Sheehan syndrome! a condition that may occur in a woman who bleeds severely
during pregnancy or childbirth and causes the destruction of the pituitary gland
Pituitary tumor or pituitary surgery
Symptoms
/arly symptoms(
Hard stools or constipation
ncreased sensitivity to cold temperature
0atigue or feeling slowed down
Heavier and irregular menstrual periods
1oint or muscle pain
Paleness or dry skin
Sadness or depression
Thin! brittle hair or 2ngernails
3eakness
3eight gain
4ate symptoms! if untreated(
5ecreased taste and smell
Hoarseness
Pu.y face! hands! and feet
Slow speech
Thickening of the skin
Thinning of eyebrows
Exams and Tests
The health care provider will do a physical e6am and 2nd that your thyroid gland is
enlarged. Sometimes! the gland is normal si7e or smaller-than-normal. The e6am may
also reveal(
Brittle nails
'oarse features of the face
Pale or dry skin! which may be cool to the touch
Swelling of the arms and legs
Thin and brittle hair
Blood tests are also ordered to measure your thyroid hormones TSH and T8.
9ou may also have tests to check(
'holesterol levels
'omplete blood count *'B'+
4iver en7ymes
Prolactin
Sodium
Treatment
Treatment is aimed at replacing the thyroid hormone that you are lacking.
4evothyro6ine is the most commonly used medicine(
9ou will be prescribed the lowest dose possible that relieves your symptoms and
brings your blood hormone levels back to normal.
f you have heart disease or you are older! your doctor may start you on a very
small dose.
:ost people with an underactive thyroid will need to take this medicine for life.
3hen starting your medicine! your doctor may check your hormone levels every ; to <
months. =fter that! your thyroid hormone levels should be monitored at
least once every year.
3hen you are taking thyroid medicine! be aware of the following(
5o not stop taking the medicine when you feel better. 'ontinue taking it e6actly as
your doctor prescribed.
f you change brands of thyroid medicine! let your doctor know. 9our levels may
need to be checked.
3hat you eat can change the way your body absorbs thyroid medicine. Talk with
your doctor if you are eating a lot of soy products or are on a high-2ber diet.
Thyroid medicine works best on an empty stomach and when taken > hour before
any other medications. =sk your doctor if you should take your medicine at
bedtime. Studies have found that taking it at bedtime may allow your body to
absorb the medicine better than taking it in the daytime.
3ait at least 8 hours after taking thyroid hormone before you take 2ber
supplements! calcium! iron! multivitamins! aluminum hydro6ide antacids!
colestipol! or medicines that bind bile acids.
3hile you are taking thyroid replacement therapy! tell your doctor if you have any
symptoms that suggest your dose is too high! such as(
Palpitations
-apid weight loss
-estlessness or shakiness
Sweating
Outlook (Prognosis)
n most cases! thyroid hormone levels return to normal with proper treatment. 9ou will
likely take a thyroid hormone medicine for the rest of your life.
Possible Complications
:y6edema coma! the most severe form of hypothyroidism! is rare. t occurs when thyroid
hormone levels get very low. t can be caused by an infection! illness! e6posure to cold!
or certain medicines in people with untreated hypothyroidism.
:y6edema coma is a medical emergency that must be treated in the hospital. Some
patients may need o6ygen! breathing assistance *ventilator+! %uid replacement and
intensive-care nursing.
Symptoms and signs of my6edema coma include(
Below normal temperature
5ecreased breathing
4ow blood pressure
4ow blood sugar
?nresponsiveness
nappropriate or uncharacteristic moods
People with untreated hypothyroidism are at increased risk of(
nfection
nfertility! miscarriage! giving birth to a baby with birth defects
Heart disease because of higher levels of 454 *@bad@+ cholesterol
Heart failure
Alternatie !ames
:y6edemaA =dult hypothyroidism
Hyperthyroidism is a condition in which the thyroid gland makes too much thyroid
hormone. The condition is often called overactive thyroid.
Causes
The thyroid gland is an important organ of the endocrine system. t is located at the front
of the neck "ust above where your collarbones meet. The gland makes the hormones that
control the way every cell in the body uses energy. This process is called metabolism.
:any diseases and conditions can cause hyperthyroidism! including(
/ating too much of foods that contain iodine
Braves disease *most cases of hyperthyroidism+
n%ammation *thyroiditis+ of the thyroid due to viral infections! after pregnancy! or
other causes
Concancerous growths of the thyroid gland or pituitary gland
Some tumors of the testes or ovaries
Taking large amounts of thyroid hormone
Betting medical imaging tests with contrast dye that has iodine
Symptoms
'ommon symptoms include(
5iDculty concentrating
0atigue
0reEuent bowel movements
Boiter *visibly enlarged thyroid gland+ or thyroid nodules
Hand tremor
Heat intolerance
ncreased appetite
ncreased sweating
rregular menstrual periods in women
Cervousness
-estlessness
Sleep problems
3eight loss *or weight gain! in rare cases+
,ther symptoms that can occur with this disease(
Breast development in men
'lammy skin
5iarrhea
Hair loss
High blood pressure
tching - overall
4ack of menstrual periods in women
Causea and vomiting
Protruding eyes *e6ophthalmos+
-apid! forceful! or irregular heartbeat *palpitations+
Skin blushing or %ushing
3eakness
Exams and Tests
The health care provider will do a physical e6am. The e6am may 2nd the following(
High systolic blood pressure *the 2rst number in a blood pressure reading+
ncreased heart rate
/nlarged thyroid gland
Shaking of the hands
Swelling or in%ammation around the eyes
Blood tests are also ordered to measure your thyroid hormones TSH! T<! and T8.
9ou may also have blood tests to check(
'holesterol levels
Blucose
-adioactive iodine uptake
Treatment
Treatment depends on the cause and the severity of symptoms. Hyperthyroidism is
usually treated with one or more of the following(
=ntithyroid medications
-adioactive iodine to destroy the thyroid gland and stops the e6cess production of
hormones
Surgery to remove the thyroid
f your thyroid is removed with surgery or destroyed with radiation! you must take
thyroid hormone replacement pills for the rest of your life.
:edicines called beta-blockers may be prescribed to treat symptoms such as fast heart
rate! sweating! and an6iety until the hyperthyroidism can be controlled.
Outlook (Prognosis)
Hyperthyroidism is treatable. Some of its causes may go away without treatment.
Hyperthyroidism caused by Braves disease usually gets worse over time. t has many
complications! some of which are severe and a.ect Euality of life.
Possible Complications
Thyroid crisis *storm+! also called thyroto6icosis! is a sudden worsening of
hyperthyroidism symptoms that may occur with infection or stress. 0ever! decreased
alertness! and abdominal pain may occur. Patients need to be treated in the hospital.
,ther complications of hyperthyroidism include(
Heart problems such as fast heart rate! abnormal heart rhythm! heart failure
,steoporosis
Surgery-related complications! including(
Scarring of the neck
Hoarseness due to nerve damage to the voice bo6
4ow calcium level due to damage to the parathyroid glands *located near the
thyroid gland+
Hypothyroidism *underactive thyroid+
"hen to Contact a #edical Pro$essional
'all your health care provider if you have symptoms of hyperthyroidism. Bo to an
emergency room or call the local emergency number *such as F>>+! if you have(
'hange in consciousness
5i77iness
-apid! irregular heartbeat
'all your health care provider if you are being treated for hyperthyroidism and you
develop symptoms of underactive thyroid! including(
5epression
:ental and physical sluggishness
3eight gain
Alternatie !ames
Thyroto6icosis
Cushing syndrome
Share on facebook Share on twitter Bookmark & Share Printer-friendly version
'ushing syndrome is a disorder that occurs when your body is e6posed to high levels of
the hormone cortisol. t may also occur if you take too much cortisol or other steroid
hormones.
See also( 'ushing&s disease *pituitary 'ushing&s+
Causes
'ushing syndrome may be caused by taking too much corticosteroid medications! such
as prednisone and prednisolone. These drugs are used to treat conditions such
as asthma and rheumatoid arthritis.
,ther people develop 'ushing syndrome because their bodies produce too much cortisol!
a hormone normally made in the adrenal gland. 'auses of too much cortisol are(
'ushing&s disease! when the pituitary gland makes too much of the hormone ='TH.
='TH then signals the adrenal glands to produce cortisol. Tumor of the pituitary
gland may cause this condition.
Tumor of the adrenal gland
Tumor elsewhere in the body that produces cortisol
Tumors elsewhere in the body that produce ='TH *such as the pancreas! lung! and
thyroid+
Symptoms
:ost people with 'ushing syndrome will have(
?pper body obesity *above the waist+ and thin arms and legs
-ound! red! full face *moon face+
Slow growth rate in children
Skin changes that are often seen(
=cne or skin infections
Purple marks *>G; inch or more wide+ called striae on the skin of the abdomen!
thighs! and breasts
Thin skin with easy bruising
:uscle and bone changes include(
Backache! which occurs with routine activities
Bone pain or tenderness
'ollection of fat between the shoulders *bu.alo hump+
-ib and spine fractures *caused by thinning of the bones+
3eak muscles
3omen with 'ushing syndrome often have(
/6cess hair growth on the face! neck! chest! abdomen! and thighs
:enstrual cycle that becomes irregular or stops
:en may have(
5ecreased or no desire for se6
mpotence
,ther symptoms that may occur with this disease(
:ental changes! such as depression! an6iety! or changes in behavior
0atigue
Headache
ncreased thirst and urination
Exams and Tests
Blood sugar and white blood cell counts may be high. Potassium level may be low.
4aboratory tests that may be done to diagnose 'ushing syndrome and identify the cause
are(
Serum cortisol levels
Salivary cortisol levels
5e6amethasone suppression test
;8-hour urine for cortisol and creatinine
='TH level
='TH *cosyntropin+ stimulation test
Tests to determine the cause or complications may include(
=bdominal 'T
='TH test
Pituitary :-
Bone density! as measured by dual 6-ray absorptiometry *5/H=+
High cholesterol! including high triglycerides and low high-density lipoprotein *H54+ may
also be present.
Treatment
Treatment depends on the cause.
'ushing syndrome caused by corticosteroid use(
Slowly decrease the drug dose *if possible+ under medical supervision.
f you cannot stop taking the medication because of disease! your high blood
sugar! high cholesterol levels! and bone thinning or osteoporosis should be closely
monitored.
'ushing syndrome caused by a pituitary or a tumor that releases ='TH *'ushing&s
disease+(
Surgery to remove the tumor
-adiation after removal of a pituitary tumor *in some cases+
9ou may need hydrocortisone *cortisol+ replacement therapy after surgery! and
possibly continued throughout your life
'ushing syndrome due to an adrenal tumor or other tumors(
Surgery to remove the tumor
f the tumor cannot be removed! medications to help block the release of cortisol
Outlook (Prognosis)
-emoving the tumor may lead to full recovery! but there is a chance that the condition
will return.
Survival for people with ectopic tumors depends on the tumor type. ?ntreated! 'ushing
syndrome can be life-threatening.
Possible Complications
5iabetes
/nlargement of pituitary tumor
0ractures due to osteoporosis
High blood pressure
Iidney stones
Serious infections
"hen to Contact a #edical Pro$essional
'all your health care provider if you have symptoms of 'ushing syndrome.
Alternatie !ames
Hypercortisolism
Addison disease
=ddison disease is a disorder that occurs when the adrenal glands do not produce
enough hormones.
Causes
The adrenal glands are small hormone-releasing organs located on top of each kidney.
They are made up of an outer portion! called the corte6! and an inner portion! called the
medulla.
The corte6 produces three hormones(
Blucocorticoid hormones *such as cortisol+ maintain sugar *glucose+ control!
decrease *suppress+immune response! and help the body respond to stress.
:ineralocorticoid hormones *such as aldosterone+ regulate sodium and potassium
balance.
Se6 hormones! androgens *male+ and estrogens *female+! a.ect se6ual
development and se6 drive.
=ddison disease results from damage to the adrenal corte6. The damage causes the
corte6 to produce hormone levels that are too low.
This damage may be caused by the following(
The immune system mistakenly attacking the adrenal glands *autoimmune
disease+
nfections such as tuberculosis! H)! or fungal infections
Hemorrhage into the adrenal glands
Tumors
-isk factors for the autoimmune type of =ddison disease include other autoimmune
diseases(
'hronic thyroiditis
5ermatis herpetiformis
Braves& disease
Hypoparathyroidism
Hypopituitarism
:yasthenia gravis
Pernicious anemia
Testicular dysfunction
Type diabetes
)itiligo
'ertain rare genetic defects may also cause adrenal insuDciency.
Symptoms
Symptoms of =ddison disease include(
'hronic diarrhea! nausea! and vomiting
5arkening of the skin in some places! causing the skin to look patchy
5ehydration
5i77iness when standing up
Paleness
/6treme weakness! fatigue! and slow! sluggish movement
:outh lesions on the inside of a cheek *buccal mucosa+
Salt craving
3eight loss with reduced appetite
Exams and Tests
4aboratory tests may show(
ncreased potassium
4ow blood pressure! especially with a change in body position
4ow cortisol level
4ow serum sodium
4ow blood pH
Cormal se6 hormone levels
=dditional laboratory tests may be ordered.
,ther tests may include(
=bdominal 6-ray
=bdominal 'T scan
Treatment
Treatment with replacement corticosteroids will control the symptoms of this disease.
These medicines usually need to be taken for life.
Cever skip doses of your medication for this condition because life-threatening reactions
may occur.
9our doctor may increase your dosage because of(
nfection
n"ury
Stress
Surgery
5uring an e6treme form of adrenal insuDciency! called adrenal crisis! you must in"ect
hydrocortisone right away. Treatment for low blood pressure is usually needed as well.
Some people with =ddison disease are taught to give themselves an emergency in"ection
of hydrocortisone during stressful situations. =lways carry medical 5 *card! bracelet! or
necklace+ that says you have adrenal insuDciency. The 5 should also say the type of
medicine and dosage you need in case of an emergency.
Outlook (Prognosis)
3ith hormone therapy! most people with =ddison disease are able to lead a normal life.
Possible Complications
'omplications can occur if you take too little or too much adrenal hormone.
'omplications also may result from the following related illnesses(
5iabetes
Hashimoto thyroiditis *chronic thyroiditis+
Hypoparathyroidism
,varian hypofunction or testicular failure
Pernicious anemia
Thyroto6icosis
"hen to Contact a #edical Pro$essional
'all your health care provider if(
9ou are unable to keep your medicine down due to vomiting.
9ou have stress such as infection! in"ury! trauma! or dehydration. 9ou may need to
have your medication ad"usted.
9our weight increases over time.
9our ankles begin to swell.
9ou develop new symptoms.
,n treatment! you develop signs of 'ushing syndrome
f you have symptoms of adrenal crisis! give yourself an emergency in"ection of your
prescribed medication. f it is not available! go to the nearest emergency room or call
F>>.
Symptoms of adrenal crisis include(
=bdominal pain
5iDculty breathing
5i77iness or light-headedness
4ow blood pressure
-educed consciousness
Alternatie !ames
=drenocortical hypofunctionA 'hronic adrenocortical insuDciencyA Primary adrenal
insuDciency
%iabetes mellitus
Share on facebook Share on twitter Bookmark & Share Printer-friendly version
5iabetes is usually a lifelong *chronic+ disease in which there is a high level of sugar in
the blood.
Causes
nsulin is a hormone produced by the pancreas to control blood sugar. 5iabetes can be
caused by too little insulin! resistance to insulin! or both.
To understand diabetes! it is important to 2rst understand the normal process by which
food is broken down and used by the body for energy. Several things happen when food
is digested(
= sugar called glucose enters the bloodstream. Blucose is a source of fuel for the
body.
=n organ called the pancreas makes insulin. The role of insulin is to move glucose
from the bloodstream into muscle! fat! and liver cells! where it can be used as fuel.
People with diabetes have high blood sugar because their body cannot move sugar into
fat! liver! and muscle cells to be stored for energy. This is because either(
Their pancreas does not make enough insulin
Their cells do not respond to insulin normally
Both of the above
There are two ma"or types of diabetes. The causes and risk factors are di.erent for each
type(
Type > diabetes can occur at any age! but it is most often diagnosed in children!
teens! or young adults. n this disease! the body makes little or no insulin. 5aily
in"ections of insulin are needed. The e6act cause is unknown.
Type ; diabetes makes up most diabetes cases. t most often occurs in
adulthood. But because of high obesity rates! teens and young adults are now
being diagnosed with it. :any people with type ; diabetes do not know they have
it.
There are other causes of diabetes! and some patients cannot be classi2ed as type
> or type ;.
Bestational diabetes is high blood sugar that develops at any time during pregnancy in a
woman who does not have diabetes.
5iabetes a.ects more than ;$ million =mericans. ,ver 8$ million =mericans have pre-
diabetes *which often develops before type ; diabetes+. f your parent! brother or sister
has diabetes! you may be more likely to develop diabetes.
Symptoms
High blood sugar level can cause several symptoms! including(
Blurry vision
/6cess thirst
0atigue
Hunger
?rinating often
3eight loss
Because type ; diabetes develops slowly! some people with high blood sugar have no
symptoms.
Symptoms of type > diabetes develop over a short period. People may be very sick by
the time they are diagnosed.
=fter many years! diabetes can lead to other serious problems. These problems are
known as diabetes complications and include(
/ye problems! including trouble seeing *especially at night+! light sensitivity!
blindness in the future
Painful sores and infections of the leg or foot! which if left untreated! leads to
removal of the foot or leg
Cerves in the body can become damaged! causing pain! tingling! and a loss of
feeling! problems digesting food! erectile dysfunction
Iidney problems! which can lead to kidney failure
3eakened immune system! which can lead to more freEuent infections
ncreased chance of having a heart attack or stroke
Exams and Tests
= urine analysis may show high blood sugar. But a urine test alone does not diagnose
diabetes.
9our health care provider may suspect that you have diabetes if your blood sugar level is
higher than ;$$ mgGd4. To con2rm the diagnosis! one or more of the following tests must
be done.
Blood tests(
0asting blood glucose level -- diabetes is diagnosed if it is higher than >;J mgGd4
twice. 4evels between >$$ and >;J mgGd4 are called impaired fasting glucose or
pre-diabetes. These levels are risk factors for type ; diabetes.
Hemoglobin =>c test --
o Cormal( 4ess than #.KL
o Pre-diabetes( #.KL - J.8L
o 5iabetes( J.#L or higher
,ral glucose tolerance test -- diabetes is diagnosed if glucose level is higher than
;$$ mgGd4 ; hours after drinking a glucose drink. *This test is used more often for
type ; diabetes.+
Screening for type ; diabetes in people who have no symptoms is recommended for(
,verweight children who have other risk factors for diabetes! starting at age >$
and repeated every ; years
,verweight adults *B: greater than ;#+ who have other risk factors
=dults over age 8#! repeated every < years
Treatment
3ith type ; diabetes! the disease may be reversed with lifestyle changes! especially
losing weight through e6ercising and eating healthier foods. =lso! some cases of type ;
diabetes can be improved with weight-loss surgery.
There is no cure for type > diabetes.
Treating both type > diabetes and type ; diabetes involves medicines! diet! and e6ercise
to control blood sugar level.
Betting better control over your blood sugar! cholesterol! and blood pressure levels helps
reduce the risk of kidney disease! eye disease! nervous system disease! heart attack!
and stroke.
To prevent diabetes complications! visit your health care provider at least two to four
times a year. Talk about any problems you are having. 0ollow your health care provider&s
instructions on managing your diabetes.
Support &roups
=merican 5iabetes =ssociation M www.diabetes.org
Preention
Ieeping an ideal body weight and an active lifestyle may prevent type ; diabetes.
Type > diabetes cannot be prevented.
%iabetes insipidus
Share on facebook Share on twitter Bookmark & Share Printer-friendly version
5iabetes insipidus is an uncommon condition in which the kidneys are unable to prevent
the e6cretion of water.
Causes
5uring the day! your kidneys 2lter all your blood many times. Cormally! most of the
water is reabsorbed! and only a small amount of concentrated urine is e6creted. 5
occurs when the kidneys cannot concentrate the urine normally! and a large amount of
dilute urine is e6creted.
The amount of water e6creted in the urine is controlled by antidiuretic hormone
*=5H+. =5H is also called vasopressin. =5H is produced in a part of the brain called the
hypothalamus. t is then stored and released from the pituitary gland. This is a small
gland at the base of the brain.
5 caused by a lack of =5H is called central diabetes insipidus. 3hen 5 is caused by a
failure of the kidneys to respond to =5H! the condition is called nephrogenic diabetes
insipidus.
'entral diabetes insipidus can be caused by damage to the hypothalamus or pituitary
gland as a result of(
Benetic problems
Head in"ury
nfection
4oss of blood supply to the gland
Surgery
Tumor
Cephrogenic 5 involves a defect in the kidneys. =s a result! the kidneys do not respond
to =5H. 4ike central 5! nephrogenic 5 is very rare. Cephrogenic 5 may be caused by(
'ertain drugs *such as lithium+
Benetic problems
High level of calcium in the body *hypercalcemia+
Iidney disease *such as polycystic kidney disease+
Symptoms
Symptoms of 5 include(
/6cessive thirst that may be intense or uncontrollable! usually with the need to
drink large amounts of water or craving for ice water
/6cessive urine volume
/6cessive urination! often needing to urinate every hour throughout the day and
night
Exams and Tests
The health care provider will ask about your medical history and symptoms.
Tests that may be ordered include(
Blood sodium and osmolarity
5esmopressin *55=)P+ challenge
:- of the head
?rinalysis
?rine concentration
?rine output
Treatment
The cause of the underlying condition will be treated when possible.
'entral diabetes insipidus may be controlled with vasopressin *desmopressin! 55=)P+.
9ou take vasopressin as either an in"ection! a nasal spray! or tablets.
f nephrogenic 5 is caused by medication! stopping the medication may help restore
normal kidney function. But with some medications! such as lithium! after many years of
use! nephrogenic 5 can be permanent.
Hereditary nephrogenic 5 and lithium-induced nephrogenic 5 are treated by drinking
enough %uids to match urine output. :edicines that lower urine output also need to be
taken.
Cephrogenic 5 is treated with anti-in%ammatory medicines and diuretics *water pills+.
Outlook (Prognosis)
,utcome depends on the underlying disorder. f treated! diabetes insipidus does not
cause severe problems or result in early death.
Possible Complications
f your body&s thirst control is normal and you drink enough %uids! there are no
signi2cant e.ects on body %uid or salt balance.
Cot drinking enough %uids can lead to dehydration and electrolyte imbalance.
f 5 is treated with vasopressin and your body&s thirst control is not normal! drinking
more %uids than your body needs can cause dangerous electrolyte imbalance.
"hen to Contact a #edical Pro$essional
'all your health care provider if you develop symptoms of diabetes insipidus.
f you have diabetes insipidus! contact your health care provider if freEuent urination or
e6treme thirst return.
Acromegaly
Share on facebook Share on twitter Bookmark & Share Printer-friendly version
=cromegaly is a condition in which there is too much growth hormone in the body.
Causes
=cromegaly is a rare condition. t is caused when the pituitary gland makes too much
growth hormone. The pituitary gland is a pea-si7ed endocrine gland located at the base
of the brain. t controls! makes! and releases several hormones! including growth
hormone.
?sually a noncancerous *benign+ tumor of the pituitary gland causes the gland to release
too much growth hormone.
n children! too much growth hormone causes gigantism rather than acromegaly.
Symptoms
Symptoms of acromegaly may include any of the following(
Body odor
'arpal tunnel syndrome
5ecreased muscle strength *weakness+
5ecreased peripheral vision
/asy fatigue
/6cessive height *when e6cess growth hormone production begins in childhood+
/6cessive sweating
Headache
Hoarseness
1oint pain! limited "oint movement! swelling of the bony areas around a "oint
4arge bones of the face
4arge feet *change in shoe si7e+! large hands *change in ring or glove si7e+
4arge glands in the skin *sebaceous glands+
4arge "aw *prognathism+ and tongue *macroglossia+
Sleep apnea
Thickening of the skin! skin tags
3idely spaced teeth
3idened 2ngers or toes! with swelling! redness! and pain
,ther symptoms that may occur with this disease(
'olon polyps
/6cess hair growth in females *hirsutism+
Type ; diabetes
3eight gain *unintentional+
Exams and Tests
The health care provider will perform a physical e6am and ask about your symptoms.
The following tests may be ordered to con2rm diagnosis of acromegaly(
Blood glucose
Browth hormone
High insulin-like growth factor > *B0->+ level
Spine 6-ray
:- of the brain! including the pituitary gland
/chocardiogram
Prolactin
Treatment
Surgery to remove the pituitary tumor that is causing this condition often corrects the
abnormal growth hormone. Sometimes the tumor is too large to remove completely.
People who do not respond to surgery may haveradiation of the pituitary gland.
:edications are used after surgery. Some patients are treated with medicines instead of
surgery.
=fter treatment! you will need to see your health care provider regularly to make sure
that the pituitary gland is working normally. 9early evaluations are recommended.
Outlook (Prognosis)
Pituitary surgery is successful in most patients! depending on the si7e of the tumor and
the e6perience of the surgeon.
3ithout treatment! the symptoms will get worse. 'onditions such as high blood pressure!
diabetes! and heart disease may result.
"hen to Contact a #edical Pro$essional
'all your health care provider if(
9ou have symptoms of acromegaly
9our symptoms do not improve with treatment
Preention
=cromegaly cannot be prevented. /arly treatment may prevent complications of the
disease from getting worse.
Alternatie !ames
Somatotroph adenomaA Browth hormone e6cessA Pituitary giant *in childhood+