Unexplained Height Increase in Adults: Causes and Concerns

Q: Unexplained Height Increase in Adults: Causes and Concerns

Hello： (1) Today, when reviewing the report, it was mentioned that if the size is less than one centimeter, there is no need for concern, surgery, or medication. <br>However, I still have doubts about whether the pituitary gland could enlarge in this condition, or if regular foll

Questions about unexplained height increase in adults?

Hello, Dr.
Jiang.
I am 27 years old this year.
I started my menstrual period in the sixth grade of elementary school, and at that time, my height was 163 cm.
After graduating from high school until I was 25, my height remained around 166 to 166.5 cm (this has been recorded in previous school and company health checks).
In my junior year of college (at age 21), due to family and academic pressures, I experienced significant stress and lost weight down to 43 kg.
I also had symptoms of arrhythmia and a thickening neck.
My mother was alert to these changes and took me to the hospital, where I was diagnosed with hyperthyroidism.
My condition has been stable since then, and I take half a pill of medication daily, with regular follow-ups every three months.
After graduating, I went directly into the workforce and have annual health checks.
During a health examination two years ago, my height was recorded at 168 cm.
Although friends questioned whether I had grown taller, I thought it was within the normal range and didn’t worry much.
In October of last year, while on a business trip to Japan, I began to feel that my perception of distance while walking or interacting with objects and the ceiling seemed off.
During a follow-up for my thyroid condition, I measured my height at the hospital and it was 168.3 cm.
I mentioned this to my family medicine and thyroid specialists, and initially, they reassured me that there was no need for concern, as there were no visible abnormalities in my appearance or limbs.
However, during my follow-up in March of this year, my height was recorded at 169.1 cm.
I brought this up again with my thyroid specialist, and (1) I underwent growth hormone testing, which returned normal but on the lower side.
In April, I consulted with an orthopedic specialist, (2) who examined my spine and growth plates, both of which were normal, and my height was measured at 169.3 cm (all measurements since 2018 have been taken using the same automatic height measurement machine at the hospital).
The orthopedic doctor recommended that I see a specialist in metabolic disorders, who listed possible causes.
Last week, I underwent (3) MRI of the brain, adrenal testing, and checks for conditions like hirsutism.
Today, I reviewed the report and found that my pituitary gland has a growth of 0.4 cm (the latter two tests showed no abnormalities).

I am feeling anxious about this unusual height increase (which has been noticed by all my relatives and friends, who are concerned) and the inability to find a reason for it.
I have been experiencing insomnia and loss of appetite for nearly six months.
I would like to ask the doctor: (1) The report indicated that a growth of less than one centimeter does not require concern, surgery, or medication, but I still have doubts.
Is it possible for the pituitary gland to grow larger, or should I have regular follow-ups? (2) Is the abnormal height increase related to hyperthyroidism or the pituitary gland? (3) Since the cause is still unclear, do you have any recommendations on how I can further clarify the reason and stop the height increase? Thank you for your hard work.

Meng Meng, 20~29 year old female. Ask Date: 2020/05/13

Dr. Jiang Junyi reply Neurology

Hello: (1) Today, when reviewing the report, it was mentioned that if the size is less than one centimeter, there is no need for concern, surgery, or medication.
However, I still have doubts about whether the pituitary gland could enlarge in this condition, or if regular follow-up visits are necessary? A: If there is pituitary hyperplasia but no abnormal hormone secretion, regular imaging follow-up is not necessary.
However, regular hormone level checks are required.
Additionally, it is important to monitor for any visual deficits that may arise from pituitary tumor growth.
(2) Is the abnormal continued growth in height related to hyperthyroidism or the pituitary gland? A: Your height appears to be within the normal range, and in adults, growth hormone primarily causes acromegaly.
(3) Since the cause is still unclear and symptomatic treatment is being considered, do you have any recommendations on how I can further clarify the cause and stop the growth? A: Endocrinologists have more experience in this area, so it is advisable to consult with an expert at a medical center specializing in this field.
Wishing you good health and happiness.
Dr.
Jiang from the Department of Neurology cares about you.

Reply Date: 2020/05/13

More Info

Unexplained height increase in adults can be a perplexing issue, especially when it occurs after the typical growth periods of adolescence. In your case, it seems that you have experienced a gradual increase in height from 166 cm to 169.3 cm over a span of a few years, which has raised concerns for you. Let's address your questions and provide some insights into the potential causes and implications of this phenomenon.

1. Concerns about Pituitary Gland Growth: You mentioned that a recent MRI revealed a slight increase in the size of your pituitary gland (0.4 cm). While this may sound alarming, it's important to note that not all pituitary gland enlargements are indicative of a serious problem. If the gland is not secreting excess hormones, regular monitoring may be sufficient. However, it is crucial to keep an eye on any changes in your symptoms or health status. Regular follow-ups with your endocrinologist or a specialist in pituitary disorders can help ensure that any potential issues are caught early. If there are no significant hormonal imbalances or symptoms indicating a problem, the need for aggressive intervention may be minimal.

2. Connection Between Height Increase and Thyroid or Pituitary Issues: Your history of hyperthyroidism could potentially play a role in your height changes. Thyroid hormones are critical for growth and metabolism, and fluctuations in these hormones can lead to changes in height, even in adulthood. However, the relationship is complex. In adults, excessive thyroid hormone levels can lead to various metabolic changes, but they typically do not cause significant height increases unless there is an underlying condition affecting growth hormone levels as well. The pituitary gland is responsible for producing growth hormone, and any abnormalities here could also contribute to changes in height. Given that your growth hormone levels were found to be normal but on the lower side, it suggests that while your body is still capable of growth, it may not be at the same rate as during your teenage years.

3. Further Investigations and Management: Since you are experiencing unexplained height increase, it would be prudent to continue working with your healthcare providers to explore potential underlying causes. This could include further hormonal assessments, genetic testing, or additional imaging studies if warranted. Keeping a detailed record of your height measurements, along with any accompanying symptoms (like changes in appetite, sleep disturbances, or emotional health), can provide valuable information for your doctors.
In terms of managing your anxiety about this situation, it may be beneficial to engage in stress-reduction techniques, such as mindfulness, yoga, or counseling. The psychological impact of health concerns can often exacerbate physical symptoms, including sleep disturbances and appetite changes.
In conclusion, while unexplained height increases in adults can be concerning, they are not always indicative of a serious health issue. Regular monitoring, open communication with your healthcare providers, and addressing any psychological stressors are key steps in managing your health. If you continue to have concerns, seeking a second opinion from a specialist in endocrinology or a pituitary expert may provide additional reassurance and clarity. Remember, your overall health and well-being are paramount, and addressing both physical and mental health aspects is essential in navigating this situation.

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