Pay attention to the growth of hands and feet, Assoc. dr. Göknur does not get tired: “changes in the body may not be noticed for years”

Eskişehir Osmangazi University (ESOGÜ) Faculty of Medicine, Department of Internal Medicine, Department of Endocrinology and Metabolic Diseases, Faculty Member Assoc. Dr. Göknur Yorulmaz said that the growth of the hands and feet can be an indicator of the disease “acromegaly”.
Stating that acromegaly is caused by pituitary tumors in adults that secrete excessive growth hormone, Assoc. Dr. Göknur Yorulmaz said symptoms such as increased sweating and enlarged hands and feet can be indicators of the disease. Symptoms include enlargement of the lower jaw, nose, lips, and tongue; Stating that there is coarsening of facial features, deterioration of tooth structure, excessive oily skin, thickening of the skin, numbness or tingling in the hands, thickening of the voice, nasal congestion, fatigue, pain in the joints, Yorulmaz stressed that as a result of such complaints, a doctor should be consulted.

“May shorten life expectancy when untreated”
Claiming the condition has been named “Acromegaly,” meaning growth in the hands and feet, Assoc. Dr. Yorulmaz said that if excess growth hormone and the adenoma in the pituitary gland that causes it are not noticed, it can lead to other diseases. Yorulmaz, who said it will negatively affect the person’s quality of life, said, “It can cause health problems such as type 2 diabetes mellitus, hypertension, cardiovascular disease and heart failure caused by cardiac hypertrophy, polyps in the large intestine, enlargement of the thyroid gland and thyroid nodules, cerebrovascular diseases, curvature of the spine. It negatively affects a person’s quality of life and can shorten life expectancy if left untreated.

“Bones in adults grow transversely rather than longitudinally”
Assoc. Dr. Yorulmaz said, “As growth is terminated in adults, the bones do not grow lengthwise, but transversely, so there is transverse expansion in the form of thickening in the hands and feet. Pituitary adenoma is usually large and can cause headaches, vision problems, hormonal deficiencies, menstrual irregularities in women and decreased sexual potency in men by pressing on the surrounding tissues.

“The change in the body may not go unnoticed”
Stating that the disease develops slowly, relatives of patients may not notice the change in appearance, Assoc. Dr. Yorulmaz said, “Over the years pituitary adenoma also grows and usually the size of the adenoma is large when diagnosed. Laboratory tests are absolutely necessary for the diagnosis of the disease, and these tests are ordered and interpreted by the specialist in endocrinology. Blood growth hormone and insulin-like growth factor1 (IGF1) levels are measured. Additionally, in non-diabetic patients, a sugar load test is used to assess if there is a decrease in growth hormone. If acromegaly is suspected in the patient with the analyzes performed, a pituitary MRI should be requested and the presence of an adenoma should be revealed.

“It can lead to additional illnesses such as respiratory distress, heart disease, diabetes”
Stating that the first option in the treatment of acromegaly is removal of the tumor by pituitary surgery, Assoc. Yorulmaz said: “The goal of surgery is to completely remove the adenoma, if possible, and to correct this situation if it has caused damage to the tissues adjacent to the pituitary gland. If the tumor is completely removed by surgery, the level of growth hormone in the blood returns to normal. These surgeries are performed by the neurosurgery department of our ESOGU hospital.
Stating that in some patients the adenoma cannot be completely removed by surgery, Assoc. Dr. Yorulmaz said that in this case, although it decreases, the uncontrolled release of growth hormone will continue. Emphasizing that this is an undesirable situation, Yorulmaz said, “The continuation of the epidemic is causing additional illnesses such as respiratory distress, heart disease and diabetes in patients. For this reason, medical treatment is administered to reduce the level of growth hormone in patients. Radiation therapy or direct medical therapy may be given to patients who are too risky to undergo surgery. Radiotherapy is applied to eligible patients in the radiation oncology department of our hospital. The endocrinologist who follows the patient decides on the choice of drugs to be used in the treatment and the setting of their doses.

“The diagnosis is made after at least 10 years in the world”
Stating that excessive growth hormone secretion may not be noticed for many years, Assoc. Dr. Yorulmaz said the diagnosis was made with a delay of at least 10 years globally. Yorulmaz said, “In order to raise awareness and raise awareness about diseases caused by acromegaly and deterioration of quality of life, April 15 has been designated as Acromegaly Awareness Day in Turkey. The diagnosis, treatment and follow-up of patients with this important disease are carried out by us as the Department of Endocrinology and Metabolism Diseases of ESOGU.




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