For people with ongoing symptoms related to acromegaly, the first step is to confirm that IGF-1 is normal and, if not, prescribe medications that reduce or blunt the effects of growth hormone, says Dr. Stamatiades.
Once normal hormone levels are confirmed, “The next step is to systematically evaluate for other contributors, including sleep apnea, joint disease, carpal tunnel syndrome, hypopituitarism [loss of pituitary function], diabetes, cardiovascular disease, depression, anxiety, or medication-related side effects,” says Stamatiades.
Fleseriu says that it’s common to refer patients to other specialists, including to treat joint problems, sleep difficulties, or mental health issues. “The ultimate treatment goal is not only biochemical remission, but also improvement in how patients feel and function in daily life,” she says.
You may be referred to any of the following specialists, according to Stamatiades:
- Sleep medicine specialist
- Physical therapist
- Pain management specialist
- Rheumatologist or orthopedic specialist
- Mental health specialist
Generally, health issues related to acromegaly are treated the same as for anyone with arthritis, diabetes, or high blood pressure, according to Blevins. Coordinating this care often falls to a patient’s primary care doctor, he says. “It requires good communication between the endocrinologist and primary care doctor to make sure these patients get the healthcare they need.”
But ruling out elevated growth hormone production as a cause of ongoing symptoms is critical, Blevins says — even for people with IGF-1 levels that fall in the higher end of the normal range. “It may be that you have mild active disease,” he says. “A ‘normal result’ may not be entirely normal.”
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