Question 1

elevated igf-1 212 (53-191)-no signs of acromegaly; endo won't retest-wants an mri; have pots/dysautonomia; do i need the mri? tired of testing

Accepted Answer

2nd opinion: Hi. I would not do a pituitary MRI based on that IGF-1! Is it reproducible? Did the endo do a GH suppression test (GHST? The pituitary is famous for "incidentalomas", tumors that are incidentally found, but play no role in any pathophysiology. So if a tumor is seen, will the endo send a surgeon in?! Get a 2nd opinion from an experienced endo. I bet IGF-1 isn't reproducibly elevated. And do GHST.

Question 2

how could one treat acromegaly to become healthy?

Accepted Answer

Acromegaly : Hi. Treating acromegaly is a multi-pronged approach. The first step is almost always surgery, however surgery is often not curative. Subsequent lines of treatment include somatostatin analogs (e.g., lanreotide) and maybe the GH receptor antagonist, pegvisomant. Sometimes pituitary radiation is necessary. Good luck!

Question 3

how is a diagnostic test of acromegaly (gigantism) done?

Accepted Answer

DX acromegaly: Igf1 screening followed if positive by a gh suppression test two hours after a 100 gm gtt, plus an mri.

Question 4

what are signs and symptoms of acromegaly?

Accepted Answer

Acromegaly: Widened and thickened nose, prominent cheekbones, bulging forehead and thickened overlying skin, thick lips, marked facial lines, large tongue, mandibular overgrowth, prognathism,  enlarged jaw (macrognathia), maxillary widening, teeth separation, jaw malocclusion, enlarged hands, elengated arms/legs, headache, visual problems, deepening of the voice, carpal tunnel, just to name a few.

Question 5

what are the side effects of disease acromegaly?

Accepted Answer

Acromegaly: Complications are
severe headache
 arthritis and carpal tunnel syndrome
 enlarged heart
 hypertension
 diabetes mellitus
 heart failure
 kidney failure
 compression of the optic chiasm leading to loss of vision in the outer visual fields (typically bitemporal hemianopia)
 increased palmar sweating and sebum production over the face (seborrhea).

Question 6

can the face puffiness be a symptom of acromegaly?

Accepted Answer

Possible, not likely: Puffiness suggests increased fluid in the soft tissue, or enlargement of the soft tissue itself.  While the latter could be due to acromegaly, edema, or increased fluid is much more likely, and would not be indicative of acromegaly.

Question 7

do acromegaly and plagiocephaly share any common symptoms?

Accepted Answer

Not really: Both involve changes in head shape, but nothing else. Acromegaly involves abnormal growth and/or thickening of the brow, jaw, and other bones due to gh excess.  More growth than thickening in children. It is a serious condition. Plagio is a flattening due to a constant position in a growing infant skull.  Like the flat (earthen) side of a pumpkin that has sat in a field.

Question 8

can gh levels be high without the presence of tumours or acromegaly?

Accepted Answer

: Yes, in growth hormone insensitivity syndromes the GH level can be high but patients have short stature instead of acromegaly.

Question 9

can the bony signs of acromegaly return to normal over time, if treated?

Accepted Answer

Not usually: Once bones have expended in size, they will generally not shrink, even if growth hormone (gh) and igf-1 levels are normalized.  However, much of the increase in size of hands & feet and the face is caused by soft tissue enlargement, which will shrink in response to treatment.

Question 10

is this ogtt gh supressiontest suggestive for acromegaly? 0.18/0.09/0.12/0.20/1.12  thank you very much for an answer.

Accepted Answer

Which test was done: It depends on what kind of immunoassay the laboratory you were at was doing.When a typical oggt GH suppression test is done, we generally look for any reading over 1ng/ml 2 hours after the glucose for the diagnosis.With the newer immunoradiometric assays, any readying over 0.3nl/ml is considered a positive diagnostic test.So without knowing which test was used,it's hard to say based on your values

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Acromegaly gold standard testing

A member asked:

Elevated igf-1 212 (53-191)-no signs of acromegaly; endo won't retest-wants an mri; have pots/dysautonomia; do i need the mri? tired of testing

A member asked:

How could one treat acromegaly to become healthy?

A member asked:

How is a diagnostic test of acromegaly (gigantism) done?

A member asked:

What are signs and symptoms of acromegaly?

A member asked:

What are the side effects of disease acromegaly?

A member asked:

Can the face puffiness be a symptom of acromegaly?

A member asked:

Do acromegaly and plagiocephaly share any common symptoms?

A member asked:

Can gh levels be high without the presence of tumours or acromegaly?

A member asked:

Can the bony signs of acromegaly return to normal over time, if treated?

A member asked:

Is this ogtt gh supressiontest suggestive for acromegaly? 0.18/0.09/0.12/0.20/1.12 thank you very much for an answer.

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