Acromegaly is a rare hormonal disorder that occurs when the pituitary gland produces excessive growth hormone (GH) after the closure of the growth plates in bones. This condition leads to an abnormal enlargement of body tissues, mainly affecting the bones, soft tissues, and organs.
Symptoms
Common symptoms include:
Enlarged hands and feet (including fingers and toes)
Coarse facial features, such as enlarged nose, lips, and tongue
Thickened skin and enlarged pores
Deepening of the voice due to vocal cord thickening
Joint pain and limited joint mobility
Added-on organs including the spleen, liver, and heart are all enlarged
Sleep apnea and snoring
Excessive sweating and body odor
Headaches and impaired vision
Changes in facial appearance, including protruding jaw and brow
Causes
The primary cause of acromegaly is the presence of a pituitary adenoma, which secretes excess GH. These tumors are usually benign and arise from the pituitary gland, a small gland located at the base of the brain. In rare cases, acromegaly can result from tumors outside the pituitary gland that produce GH-releasing hormone (GHRH).
Pathophysiology
The pituitary adenoma in acromegaly leads to the overproduction of GH. Insulin-like growth factor 1 (IGF-1) is a hormone that is produced by the liver and other organs in response to an excess of GH. Both GH and IGF-1 contribute to the growth-promoting effects seen in acromegaly. The increased GH and IGF-1 levels cause abnormal tissue growth, leading to the characteristic features and symptoms of the condition.
Diagnosis
The following tests are commonly used:
Measurement of GH levels: Blood tests are performed to assess GH levels. Normally, GH secretion is pulsatile, so multiple blood samples may be necessary.
Oral glucose tolerance test (OGTT): This test involves measuring GH and glucose levels before and after consuming a glucose solution. In acromegaly, GH levels remain elevated even after glucose administration.
Measurement of IGF-1 levels: IGF-1 levels are usually elevated in acromegaly and can help confirm the diagnosis.
Pituitary imaging: Imaging techniques like magnetic resonance imaging (MRI) are used to visualize the pituitary gland and detect the presence of pituitary adenomas.
Treatment
The goals of acromegaly treatment are to reduce GH and IGF-1 levels, alleviate symptoms, and prevent complications. The treatment options include:
Surgery: Transsphenoidal surgery is the primary treatment for acromegaly.
In some cases, if the tumor is large or invasive, a more extensive surgical approach or radiation therapy may be necessary.
Radiation therapy:
Radiation therapy may be recommended if surgery fails to completely remove the tumor or if the tumor regrows after surgery.
Medications:
Somatostatin analogs
Dopamine agonists
Growth hormone receptor antagonists
Prognosis
The prognosis for individuals with acromegaly depends on various factors, including the severity of the disease, the presence of complications, and the timeliness of diagnosis and treatment. The prognosis can be enhanced via early detection and effective care.
Complications
Cardiovascular complications
Diabetes mellitus
Joint problems
Sleep apnea
Vision problems
Increased risk of tumors
Psychological and emotional impact
Acromegaly in ayurveda
In Ayurveda, Acromegaly is described as a disorder related to the imbalance of the Kapha and Vata doshas. It is known as “Granthishoola” or “Granthi Rog” in Ayurvedic terms. Ayurveda views Acromegaly as a result of the vitiation of the bodily tissues (dhatus) and the channels (srotas) involved in growth and metabolism.
Nidana
Ama (toxic accumulation): When there is incomplete digestion and metabolism, toxins called ama can accumulate in the gastrointestinal tract, leading to abdominal pain.
Agnimandya (impaired digestion): Weak digestion can result in undigested food particles that form a lump or knot in the abdomen, causing pain.
Vata vitiation: Imbalance or aggravation of the Vata dosha, which governs movement in the body, can lead to the formation of knots or lumps in the abdomen and associated pain.
Mutraghata (urinary obstruction): Obstruction in the urinary tract, such as kidney stones, can cause referred pain in the lower abdomen.
Poorvaroopana
The poorvaroopana or premonitory symptoms of Granthishoola may include:
Indigestion, loss of appetite, or altered bowel movements
Feeling of bloating or heaviness in the abdomen
Gurgling sounds in the abdomen
Occasional or intermittent abdominal pain
Increased flatulence or passing of gas
Samprapti
According to Ayurveda, the primary cause of Acromegaly is an aggravated Kapha dosha. Kapha represents the earth and water elements and is responsible for nourishment and growth in the body. When Kapha dosha becomes imbalanced, it leads to the formation of abnormal growths or “granthi” in the body, particularly in the endocrine system
The vitiated Kapha dosha blocks the channels (srotas) responsible for the proper transport and metabolism of nutrients, leading to excessive tissue growth. In the case of Acromegaly, this excessive tissue growth primarily affects the bones, soft tissues, and organs.
Lakshana
Localized pain: The presence of a granthi or knot can cause pain or discomfort in the affected area. The pain may be dull, throbbing, or sharp.
Restricted movement: Granthishoolas can limit the range of motion in the affected area, leading to stiffness or difficulty in movement.
Swelling or inflammation: In some cases, the presence of a granthi may cause swelling or localized inflammation in the area.
Numbness or tingling: Depending on the location of the granthishoola, you may experience sensations of numbness, tingling, or pins and needles.
Digestive disturbances: Granthishoolas can disrupt the flow of energy and affect the functioning of related organs. This can lead to digestive disturbances such as bloating, indigestion, or constipation.
Emotional imbalances: Ayurveda recognizes the interconnectedness of the body and mind. Granthishoolas can also impact the subtle energy channels and contribute to emotional imbalances such as anxiety, stress, or mood swings.
Division based on dosas
Vata Granthishoola: In this condition, there is an aggravated Vata dosha, leading to the formation of knots or cysts. The person may experience severe pain, stiffness, and tenderness. Examples of Vata Granthishoola include conditions like rheumatoid arthritis, sciatica, and certain types of cysts.
Pitta Granthishoola: When Pitta dosha gets imbalanced, it can cause the formation of inflammatory masses or cysts, resulting in pain and discomfort. Pitta Granthishoola may manifest as conditions like abscesses, certain types of tumors, and inflammatory disorders.
Kapha Granthishoola: When Kapha dosha becomes aggravated, it can lead to the formation of cysts, tumors, or growths with a thick, sticky, or mucus-like consistency. Kapha Granthishoola can present as conditions like fibroids, lipomas, and certain types of tumors.
Prognosis
Yapya
Treatment
Ayurvedic treatment for Acromegaly aims to balance the aggravated Kapha dosha and restore the normal functioning of the affected tissues and channels. The treatment approach may involve the following:
Panchakarma Therapy:
Sodhana
This Ayurvedic detoxification procedure helps eliminate accumulated toxins and balances the doshas. It may include procedures like Vamana (therapeutic vomiting) and Virechana (therapeutic purgation) to remove excess Kapha and toxins from the body.
Samana
Herbal Medicines: Ayurvedic herbs with anti-Kapha and rejuvenating properties are used to balance the doshas and promote healthy tissue growth. Examples of herbs that may be used include Guggulu (Commiphora mukul), Haridra (Turmeric), Shilajit (mineral pitch), and Ashwagandha (Withania somnifera).
Commonly used medicine
Ashwagandha (Withania somnifera): Known for its adaptogenic properties, ashwagandha may help in managing stress and supporting the endocrine system.
Shilajit: It is believed to have rejuvenating effects on the body and may support hormonal balance.
Guggulu: This resinous substance derived from the Commiphora mukul tree is used in Ayurveda to support thyroid function and metabolism.
Triphala: A combination of three fruits (amalaki, bibhitaki, and haritaki), triphala is often used for its digestive and detoxifying properties, which may indirectly support overall health.
Brand available
Dabur
Baidyanath
Zandu
Himalaya herbals
Kottakkal
Patanjali ayurved
Home remedies
Maintain a healthy diet: Focus on consuming a well-balanced diet rich in fruits, vegetables, whole grains, and lean proteins. Reduce the amount of processed foods, sweet snacks, and saturated fats you consume. A balanced diet can enhance overall health, lower inflammation, and aid with weight management.
Stress Management: Stress can worsen the imbalances in the body. Ayurveda emphasizes the importance of managing stress through practices like meditation, relaxation techniques, and adequate .
Adequate sleep: Prioritize getting sufficient restful sleep each night. Create a calming bedtime routine, maintain a regular sleep schedule, and ensure your sleeping environment is comfortable and conducive to quality sleep.
Avoid alcohol and smoking: Both alcohol and smoking can have negative effects on your health and may exacerbate certain symptoms associated with acromegaly. It’s advisable to avoid these habits.
Support groups and counseling: Joining a support group or seeking counseling can provide emotional support and help you connect with others who may be facing similar challenges. Sharing experiences, concerns, and coping strategies can be beneficial.
Yoga
Child’s Pose (Balasana): This restorative pose helps stretch the lower back, hips, and ankles while promoting relaxation. It can be particularly beneficial for relieving tension in the spine and hips.
To perform Child’s Pose:
Kneel on the floor with your knees hip-width apart and toes touching.
As you progressively lower your torso between your thighs, lean back on your heels.
Extend your arms forward or alongside your body, resting your forehead on the mat or a bolster.
Stay in this position for 1-3 minutes, focusing on deep, relaxed breathing.
Supine Twist (Supta Matsyendrasana):
This gentle twist helps release tension in the spine, hips, and shoulders, promoting flexibility and alleviating discomfort in the joints.
To perform Supine Twist:
Lie on your back with your arms extended out to the sides, forming a T-shape.
Bend your knees and lift your feet off the floor, bringing them to hip height.
Slowly lower both knees to one side, keeping your shoulders grounded.
Turn your head to the opposite side and gaze in that direction.
Hold the twist for 1-2 minutes, breathing deeply.
Repeat the twist on the other side.
Diet and Lifestyle Changes: A balanced diet that avoids heavy, oily, and processed foods is recommended. Consuming warm, light, and easily digestible foods helps in maintaining a healthy metabolism. Regular exercise, yoga, and pranayama (breathing exercises) are also beneficial in managing Acromegaly.
Research link
Acromegaly: An overview of clinical manifestations, diagnosis, and treatment.”
Link: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5718410/
Acromegaly and cancer: a meta-analysis.”
Link: https://pubmed.ncbi.nlm.nih.gov/27268289/
Management of acromegaly: an update.”
Link: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5436361/
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