IGF1 and acromegaly: Common clinical manifestations of acromegaly are multisystem due to excess circulating GH and IGF-1, which can cause headaches, acral enlargement, skin and soft tissue changes (prognathism, macroglossia, prominent forehead creasing, jaw malocclusion, hypertrophy of frontal bones, and an enlarged nose), carpal tunnel syndrome, arthralgia, snoring, and visual field defects [1].