You ran into a friend you hadn’t seen for a long time, and the first thing they said to you was, “What happened to your facial features — have you changed a bit?” Perhaps the wedding ring you’ve worn for years now feels tight on your finger, or even though you’re well into adulthood, your shoes are starting to feel too narrow. Most of us brush off such changes by saying “I’m getting older,” “I’m gaining weight,” or “my body is retaining water.”

Yet beneath this insidious change in the mirror, beneath your widening jaw or your enlarging hands, there may lie a health problem hidden deep within your brain: Acromegaly.

Commonly known among the public as the “growth disease,” acromegaly is a serious illness that progresses millimeter by millimeter over the years, is very difficult for the patient and those around them to notice, but quietly wears down the body when left untreated. So, what does this change in our hands and face have to do with our brain?

The Body’s Orchestra Conductor: The Pituitary Gland

Just behind the root of our nose, at the base of the brain, lies a gland about the size of a chickpea: the Pituitary Gland. This tiny tissue is the main center governing the entire hormone balance in our body — from the thyroid to reproduction, from stress to growth — in other words, the orchestra conductor of our body.

Acromegaly arises precisely as a result of this pituitary gland producing far more growth hormone than normal. In 99 percent of cases, the cause is tumors that form on the pituitary gland and are usually entirely benign (Pituitary Adenomas).

While the excessive secretion of this hormone in childhood leads to excessive height (giantism/gigantism), in adulthood height does not increase because the growth plates have closed. Instead, the bones begin to thicken in width, and the hands, feet, facial bones, and internal organs begin to enlarge.

What Signals Does Acromegaly Give in Our Body?

The disease progresses so slowly that the clear emergence of symptoms and the establishment of a correct diagnosis can sometimes take 7 to 10 years. However, our body actually gives us many clues:

Changes in the Shape of Hands and Feet: An increase in shoe size, gloves becoming too tight, a doughy thickening in the hands, and a sensation of swelling.

Coarsening of Facial Features: The brow bone becoming more prominent, the lower jaw extending forward, and the nose and lips enlarging.

Dental Problems: Gaps opening up between the teeth due to the widening of the jawbone, and a disruption of the bite between the upper and lower jaw.

Voice and Skin Changes: The voice becoming hoarse and deep due to the thickening of the vocal cords; excessive oiliness and thickening of the skin, and severe sweating episodes.

Sleep Apnea: Severe snoring and episodes of stopped breathing during sleep, developing due to the enlargement of the tissues in the respiratory tract.

It Affects Not Only Outward Appearance, but the Internal Organs Too

Acromegaly is not merely a cosmetic problem or bone growth. The real danger is the damage the disease causes to the body’s internal systems. The excessively secreted growth hormone can cause enlargement of the heart muscle (risk of heart failure), high blood pressure, persistent joint pain, and severe diabetes resulting from an inability to overcome insulin resistance.

In addition, the pituitary tumor, which continues to grow at the base of the brain, begins to press on the optic nerves that pass just above it. Over time, patients notice that they cannot see to the right and left edges, and that their field of vision has narrowed as if they were “wearing blinders.” This is usually accompanied by persistent, unrelenting headaches.

Diagnosis and the Gold-Standard Treatment Method

If you are experiencing one or several of these symptoms, you should definitely consult a healthcare facility. Measuring the levels of growth hormone (GH) and IGF-1 in the blood is the first step. When elevated hormone levels are detected, a Brain MRI is performed to clearly map the location and size of the tumor.

Although its diagnosis may be delayed, acromegaly is a disease that can be successfully treated today.

The most effective method and gold standard in treatment is the surgical removal of the tumor. The Endoscopic Transsphenoidal Surgery method, performed by Brain and Nerve Surgery (Neurosurgery) specialists, offers great comfort for patients.

Brain Surgery Without Opening the Skull

In this modern microsurgical method, no incision is made in the patient’s skull. Using special cameras (endoscopes) and micro-instruments, entry is made directly through the nostrils. Passing through the sinus cavities, the tumor at the base of the brain is reached, and only the tumor is removed without harming the surrounding healthy brain tissue.

The greatest advantages of this method are that there is no externally visible surgical scar, the hospital stay is very short, and the patient can quickly return to daily life.

The moment the tumor is removed, growth hormone levels begin to drop rapidly. The swelling in the soft tissues (the edema in the hands and face) visibly subsides within weeks, and the sleep apnea and headaches improve. Although the structural changes in the bones do not reverse, the progression of the disease and the damage it causes to the internal organs are completely halted.

Remember: Listen to the signals your body whispers to you. Look again at the face in the mirror, comparing it with your old photographs. Stepping into a healthy, comfortable life through early awareness and an expert surgical intervention is in your hands.

I wish you healthy days.

Prof. Dr. Mehmet Şenoğlu Brain and Nerve Surgery Specialist, İzmir