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Once acromegaly is suspected, diagnosis is straightforward.
An elevated serum insulin-like growth factor -1 (IGF-1), in the appropriate clinical setting, is adequate for the diagnosis of acromegaly. This blood test can be drawn anytime during the day, and does not need to be fasting.
A glucose tolerance test is another test, and, following ingestion of the glucose drink (75 gm glucola), GH levels in normals should fall to below 1 ng/mL. If they do not fall to that level, acromegaly is strongly suggested.
A brain MRI should be performed to locate the tumor and confirm the diagnosis. In most cases of acromegaly, a pituitary macroadenoma (greater than 10 mm) is found.
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