Sx
Uncontrolled HTN
Increase in ring size/hand size/feet size
Sweaty hands/increased oiliness of skin
Headaches
Visual changes
Visual field deficits
Skin tags
Capal tunnel syndrome
Workup
Free testosterone
PRL
TSH
Fasting glucose tolerance test showing suppression of GH and IGF-1
Dx
The most specific test/gold standard:
Measure GH levels following an oral glucose load
Give 75 g of oral glucose and most normal individuals will suppress serum GH levels to below 1 mcg/dL, whereas patients with acromegaly are unable to suppress or sometimes paradoxically increase serum GH levels