Features of excess growth hormone

The most striking is the enlargement and coarsening of the facial features, hands, and feet - namely 'megaly' of the acral parts. When fully expressed the protruding jaw, thick lips, overly large tongue, and accentuated orbit and frontal ridges can be recognised at a distance

Other features include:

• headache - this is an early feature and is due to the skull enlargement and stretching of the dura mater.
• metabolic changes may also be present, among which are glucose intolerance (30%) (and sometimes overt diabetes mellitus (10%)), and hypertension (15%).
• cutaneous manifestations include:
  • skin may be leathery and furrowed
  • seborrhoea, acne
  • soft tissue hypertrophy eg causing carpal tunnel syndrome
  • skin tags in the axillae (molluscum fibrosum which are non-tender skin coloured protrusions)
  • hirsutism, excessive sweating
  • acanthosis nigracans
• may be a proximal myopathy. Also acromegaly is one of the causes of thickened peripheral nerves.
• enlarged organs - heart, liver, thyroid
• libido is reduced - due to impaired gonadotrophin secretion and/or associated hyperprolactinoma