Some patients may need long-term medical treatment to maintain acceptable GH levels. High levels of GH , even when the patient has no symptoms, are associated with a 2-3 fold increase in mortality. Stabilisation of GH may be achieved with a dopamine agonist such as bromocriptine, particularly if the tumour is also secreting prolactin. However, somatostatin analogues, such as octreotide, which act by inhibiting GH release from the pituitary, are more effective in reducing GH to acceptable levels. Some patients suffer gastrointestinal side effects with these drugs and there is some risk of developing gall stones.
Growth can occur in the connective tissue of the carpal tunnel compressing the median nerve.
A large tumour may compress surrounding tissues. Hypertrophy of the soft tissues of the joints causes enlargement of hands and feet. Growth of the mandible disturbs dental occlusion and puts increased strain on the temporomandibular joints. GH promotes growth of the tongue. Growth of cartilaginous tissues cause musculoskeletal abnormalities and degenerative changes.