You know how important our tongue is, right?

Let's find out more about it!

The tongue is a muscular organ located within our mouth that facilitates mastication, phonation, and respiration.

It helps us chew and swallow our food, makes us speak clearly, and even makes sure we can breathe properly. It's basically a superhero in our mouth!

Most of the composition of our tongue consists of muscle tissue and is also covered in various bumps known as papillae that house taste buds.

Taste buds are specialized cells located on the tongue that facilitate the perception of various tastes, such as sweet, salty, sour, bitter, and umami. Taste buds are known to regenerate approximately every 10 days, thus serving as a self-repair mechanism for injured taste buds.^2,13

What is macroglossia?

Macroglossia, the enlargement of the tongue, is a rare condition that usually affects children more frequently than adults.

Macroglossia can be something you're born with or something that happens later in life.¹

How can one determine if they are experiencing symptoms of macroglossia?

If you have macroglossia, your tongue might stick out of your mouth and you could struggle with eating, breathing, or talking.

Macroglossia is a relatively rare anatomical condition, and it's usually a sign that there may be something else going on in the body. It's pretty rare to see it all by itself.¹²

Symptoms commonly associated with macroglossia may include:

• difficulty speaking
• snoring while sleeping
• challenges with chewing, or respiration
• auditory high-pitched noise during inhalation (stridor)
• excessive saliva production
• unusual development of the jawbone and teeth

People with macroglossia might find themselves breathing through their mouth more often, which can lead to dryness in the mouth and increase the likelihood of getting upper respiratory infections.

What could be causing macroglossia?

Macroglossia is a sign of a bigger issue that you can either be born with or develop from being sick. Certain surgeries and treatments can also lead to macroglossia.¹

• Down syndrome: is when people are born with an additional chromosome. They will experience some form of learning disability³
• Hurler and Hunter syndromes: is a genetic condition characterised by insufficient production of an enzyme, which plays a crucial role in the breakdown of specific sugars within the body⁴
• Beckwith-Wiedemann syndrome: is a growth disorder syndrome that can result in physical differences and heightened susceptibility to certain childhood cancers in affected children⁵
• Amyloidosis: Amyloidosis comprises a collection of rare conditions in which an abnormal protein known as amyloid accumulates within the body⁶
• Hypothyroidism: Hypothyroidism is a pretty common condition where your thyroid doesn't make enough hormones to keep your body running smoothly⁷
• Diphtheria: Diphtheria is a contagious illness caused by bacteria that make toxins. It can spread when someone who's infected coughs or sneezes around others⁸
• Hemangioma: A hemangioma is a non-cancerous tumour consisting of blood vessels⁹
• Lymphoma: Lymphoma is a comprehensive term for cancer that originates in cells of the lymphatic system¹⁰
• Acromegaly: Macroglossia is a well-known sign for acromegaly (condition with high growth hormone)

What are the diagnostic procedures and tests for macroglossia?

A physician will utilise a variety of tests to diagnose macroglossia. These tests may consist of:

• Physical examination, by assessing the dimensions of the tongue, checking the presence of any abnormalities such as lesions, swelling, or changes in the colour
• Blood tests based on physical examination and medical history
• Imaging tests like Computed tomography scan (CT) and Magnetic resonance imaging (MRI)¹²

What is the treatment of macroglossia?

Healthcare providers initiate the treatment of macroglossia by first diagnosing and addressing the underlying condition, followed by addressing the macroglossia itself. Treatment options include:¹

• Medication, such as corticosteroids, may be prescribed for the treatment of the tongue swelling
• Orthodontic therapy
• Speech therapy
• Surgery

What is acromegaly?

Acromegaly is a rare and progressive medical condition characterised by an overproduction of growth hormone.¹¹

Acromegaly is frequently diagnosed in individuals of middle age, although symptoms may manifest at any stage of adulthood.

Cause: The surplus hormone arises from a minor growth, known as a tumour, located in the pituitary gland, which is a gland of pea-like size situated below the brain. This extra hormone makes the bones and tissues grow too much, which can make certain parts of the body, like hands, feet, and face, get bigger than normal.

Signs and Symptoms: Symptoms of acromegaly may manifest differently in individuals, with typical alterations in physical appearance including:

• Changes in the bone structure include the brow and lower jaw sticking out more, the bridge of the nose getting larger, and the gap between teeth widening
• The hands and feet may experience enlargement and swelling
• The lips, nose and tongue may become enlarged
• Over time, the skin on the face may thicken and exhibit increased oiliness and perspiration
• Women may encounter irregular or absent menstruation
• Fatigue and mild muscular weakness
• Headaches
• Joint discomfort
• Visual impairments

How do doctors diagnose acromegaly?

• A blood test to check the level of insulin-like growth factor 1 (IGF-1) is done if doctors suspect acromegaly. It can also help keep track of how well treatment is going
• Oral glucose tolerance test: for this test the person should drink a sugary liquid. Then, a series of blood tests are done every two hours. Normally, the glucose should bring down the growth hormone level in the blood. But if acromegaly is present, the growth hormone level will stay high
• Magnetic resonance imaging (MRI): is done if the blood tests confirm that the body is making too much growth hormone. MRI is the preferred test to diagnose Acromegaly. The MRI scan employs radio waves and magnets to generate comprehensive images of internal organs and soft tissues without the use of x-rays¹¹

Treatment

The treatment options include surgical interventions, pharmaceutical interventions, and radiation therapy. The most typical form of treatment involves the surgical removal of the tumour. There are two distinct surgical approaches for conducting this procedure:¹¹

• using a microscope - a magnification tool
• utilising an endoscope - a slender, illuminated tube equipped with a small camera

Medication can be used if surgery is not an option or not wanted. There are three types of medicines used to treat Acromegaly. They can be taken on their own or used together. They are: Somatostatin analogs (a hormone that regulates the production of other hormones in the body), Dopamine agonists (are pharmaceutical compounds that stimulate specific cell receptors within the brain), and Growth hormone-receptor antagonists.¹⁴

Radiation therapy is the third option of treatment. Might be suggested if surgery is not recommended or unsuccessful in completely eradicating the tumour tissue, and when medications are either not a viable option or are ineffective for the individual.

Summary

Typically, macroglossia is indicative of an underlying medical condition. On rare occasions, individuals may be born with tongues that are larger than average. Manifestations of macroglossia include difficulty in verbal communication, respiration, and ingestion.

The treatment for macroglossia varies based on the root cause. Different ways of treating macroglossia, like meds, surgery, radiation, and orthodontic treatment, can be used for the treatment. Acromegaly is a rare and progressive medical condition characterised by an overproduction of growth hormone, and without the right treatment, acromegaly can cause some serious health issues and even reduce life expectancy.

Approximately four to six individuals per one million individuals develop acromegaly annually in the United Kingdom. This condition predominantly occurs in adults between 30 and 50 years of age. The treatment for Acromegaly is medicine, surgery and radiotherapy.