The main treatment for acromegaly — which is typically caused by a tumor on your pituitary gland, at the base of your brain — is surgery to remove this tumor. After this, you’ll need a series of follow-up tests to see if your body is producing normal levels of growth hormone.
“Acromegaly is a chronic condition that requires lifelong monitoring,” says George Stamatiades, MD, PhD, an endocrinologist at Brigham and Women’s Hospital in Boston. “Patients often undergo frequent blood tests, MRI scans, clinic visits, and ongoing screening for disease-related complications.”
The main aspects of monitoring after surgery for acromegaly include:
- IGF-1 This blood test measures a hormone produced by your liver in response to growth hormone, and it is the most commonly used measure of growth hormone production.
- Growth Hormone In some cases, growth hormone in your blood may be measured directly, but this test is less widely used since levels tend to fluctuate over time.
- Magnetic Resonance Imaging (MRI) Imaging scans can show any residual tumor in the area of your pituitary gland.
Your doctor should also ask about any ongoing issues you’re experiencing. “Persistent joint disease, skeletal changes, sleep disturbances, fatigue, and metabolic or cardiovascular complications can continue even after normalization of IGF-1 levels,” says Maria Fleseriu, MD, director of the Pituitary Center at Oregon Health & Science University in Portland.
Generally, complications of acromegaly warrant the same treatment approach as in any other context, such as taking medications for high blood pressure or diabetes. But it’s also important to rule out mild active disease, meaning that your body is still producing too much growth hormone. In this case, you can take medications to reduce or block excess growth hormone.
Even if your IGF-1 falls in the normal range, “some of those people need medical therapies to improve quality of life,” says Lewis Blevins, MD, an endocrinologist at UCSF Health in San Francisco. “A normal result may not be entirely normal” for a given person, he says, especially at the higher end of the range defined by a laboratory as normal.
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