Robert Wadlow — Tallest man in history
Robert Pershing Wadlow (1918–1940), known as the “Alton Giant,” holds the record as the tallest verified human in history. He reached a height of 2.72 m (8'11") and weighed over 220 kg at the time of his death — the result of uncontrolled growth hormone excess due to a pituitary adenoma.
👶 Early Life and Accelerated Growth
Born in Alton, Illinois, Robert Wadlow's birth weight and length were normal — around 3.8 kg and 51 cm. But by six months, his growth had already accelerated beyond typical percentiles. His parents noticed he was outgrowing clothes and furniture at an astonishing rate.
📈 Growth Timeline
- Age 1: 1.0 m tall
- Age 5: 1.6 m
- Age 8: 1.8 m
- Age 13: 2.2 m
- Age 18: 2.6 m
- Age 22: 2.72 m (8 feet 11 inches)
His growth was continuous and relentless, driven by a GH-secreting pituitary tumour that was never surgically treated. Because his epiphyseal growth plates remained open, the excess GH and IGF-1 led to ongoing longitudinal bone growth throughout adolescence and early adulthood.
🧠 Unlike acromegaly, which causes thickening of bones after growth plates fuse, Wadlow’s condition was pure gigantism — his height kept increasing until his death.
🩺 Clinical Features
- Extraordinary height with proportionate limbs
- Joint instability and muscle weakness — his frame outpaced his connective tissue strength
- Peripheral neuropathy from nerve compression — contributed to unnoticed injuries
- Required leg braces and assistance to walk
- Skin fragility and reduced sensation — made wound care difficult
- Metabolic strain — required ~8,000 kcal/day to sustain his size
Despite these challenges, Robert remained active and ambitious. He graduated high school, studied law at Shurtleff College, and became a Master Mason. He toured with Ringling Brothers Circus and later worked with International Shoe Company — but insisted on being treated as a professional, not a spectacle. (in this photo he is a teenager travelling with his mother)
⚕️ Medical Context — Then and Now
Robert lived in a time before:
- Pituitary imaging (CT/MRI)
- GH suppression testing (e.g. glucose tolerance test)
- Somatostatin analogues (developed in the 1970s)
- GH receptor antagonists (e.g. pegvisomant — 2000s)
- Antibiotics — penicillin wasn’t widely available until after his death
He died at age 22 from septic shock following a minor foot infection, caused by an ill-fitting leg brace. The infection progressed to cellulitis and osteomyelitis, and without antibiotics, became fatal. He was still growing up until his death.
💡 Wadlow’s case shows what happens when GH excess is left untreated — and why early recognition matters. Today, pituitary adenomas can be managed with surgery, medication (e.g. somatostatin analogues), and radiotherapy. His story is a reminder that extreme growth can create physical vulnerabilities. His size made mobility difficult, sensation reduced, and wound care complex. In a pre-antibiotic era, even a minor infection could become life-threatening. Today, GH excess is treatable with surgery, medication, and radiotherapy.
Zeng Jinlian - Tallest woman in history
🧠 Clinical Features
- Rapid growth from infancy — well beyond population percentiles
- Proportionate limb length — consistent with open growth plates
- Spinal curvature and joint instability — common in extreme stature
- Mobility challenges — required assistance to walk
- Likely GH excess — though no formal diagnosis was documented
- Died young — from complications likely related to cardiopulmonary strain
🎬 Life and Legacy
- Lived in rural China during a time of limited medical infrastructure
- Her height was documented by Chinese and international researchers
- Died at age 17, making her one of the youngest deaths among extreme height cases
Sultan Kösen — Tallest Living Man
Sultan Kösen (born 1982 in Mardin, Turkey) holds the Guinness World Record for the tallest living man, standing at 251 cm (8 ft 2 in). His extraordinary height is the result of a GH-secreting pituitary tumour, which caused gigantism during childhood and acromegaly in adulthood.
🧠 Medical Diagnosis
- Gigantism: GH excess before epiphyseal fusion → extreme longitudinal growth
- Acromegaly: Continued GH excess after fusion → soft tissue and bone thickening
- Cause: Noncancerous pituitary adenoma
Clinical features:
- Enlarged hands and feet (record-breaking hand length: 28.5 cm)
- Coarse facial features, prominent jaw and forehead
- Joint pain, muscle weakness, and mobility issues
- Required crutches to walk
👤 Personal Life and Public Role
- Grew up in a farming family; left school early due to mobility challenges
- Married in 2013; divorced in 2021
- Toured with the Magic Circus of Samoa
- Celebrated his 40th birthday by visiting a life-sized statue of Robert Wadlow, the tallest man in history — a symbolic moment of connection between two lives shaped by GH excess
In 2010, Kösen underwent Gamma Knife radiosurgery at the University of Virginia Medical Center, followed by medication to suppress GH levels. By 2012, his growth had successfully stopped.
💡 His case illustrates how modern medicine can halt GH excess — even when surgery isn’t feasible due to tumour location.
Mary Ann Bevan - "The Ugliest woman on Earth"
Mary Ann Bevan (1874–1933) was a British woman whose life was shaped, and exploited, by acromegaly. Once a nurse and mother of four, she developed the condition in her early thirties, leading to progressive disfigurement, chronic pain, and social isolation. In a time before medical treatment or social support, and as a widow and no longer able to work as nurse, Mary Ann chose to exhibit herself in sideshows as "The Ugliest woman on Earth" in order to support her children - a decision born of necessity.
🧠 Clinical Features
- Normal appearance and function until early adulthood
- Progressive coarsening of facial features — enlarged jaw, nose, brow, and lips
- Soft tissue thickening — hands and feet became markedly enlarged
- Frontal bossing and prognathism — classic signs of acromegaly
- Joint pain and fatigue — common in untreated cases
- No access to surgery or GH-suppressing medication — lived before these were available
🎬 Life and Legacy
- Trained and worked as a nurse before developing acromegaly
- Widowed young, with four children to support
- Entered a “Homeliest Woman” contest — not for fame, but to earn a living
- She won, and then exhibited herself in sideshows, including touring the world with Barnum and Bailey circus, billed as "the Ugliest woman on earth"
- Earned enough to educate and support her children, despite public ridicule
- Died at age 59, having lived with untreated GH excess for nearly three decades
"André the Giant " - WWE Wrestler and actor
While we featured WWE wrestler "the Great Khali" in the previous post, few public figures embody the clinical reality of GH excess as vividly as André the Giant. Born André René Roussimoff in 1946, he became a global icon through professional wrestling and film — but behind his fame lay a lifelong struggle with untreated pituitary pathology. He was diagnosed with gigantism in childhood, progressing to acromegaly in adulthood due to a pituitary adenoma that was never treated. His height was over 224cm (7'4") and he weighed 240kg.
🧠 Clinical Features
- Massive hands, feet, and facial bones
- Deep voice and enlarged tongue
- Progressive joint pain and spinal degeneration
- Coarse facial features and frontal bossing
- Enlarged organs (visceromegaly) and metabolic strain
🎬 Life and Legacy
- Became a global wrestling icon in the 1970s and 1980s
- Starred in The Princess Bride (1987) as Fezzik — a gentle giant with immense physical presence
- Known for his immense strength, but also for his chronic pain and fatigue
- Required custom furniture, vehicles, and accommodations due to his size
- Reportedly consumed extraordinary quantities of food and alcohol, partly due to his metabolic demands
- Died at age 46 from congestive heart failure, a common complication of untreated acromegaly
Carel Struycken - Actor
Carel Struycken (born 1948) is a Dutch actor known for his roles in The Addams Family, Star Trek, Men in Black, and Twin Peaks. Standing at 213 cm tall (7'), he has confirmed acromegaly, diagnosed in adulthood.
🧠 Clinical Features
- Prominent jaw and brow — classic signs of frontal bone thickening
- Large hands and feet — soft tissue overgrowth
- Deep-set eyes and coarse facial features — slowly progressed over decades
- Postural changes — visible kyphosis and gait alterations in later roles
- Voice — deep and resonant, consistent with laryngeal thickening
💡 Unlike André the Giant, Struycken’s condition was diagnosed and managed — allowing him to maintain mobility and continue acting into his 70s.
🎬 Life and Legacy
- Trained as a cinematographer before becoming an actor
- Known for playing gentle, mysterious characters — often cast for his stature and presence
- Advocates for acromegaly awareness, having spoken publicly about his diagnosis
- Continues to work in film and photography, with a focus on panoramic landscapes
🧠Struycken’s case shows how acromegaly can be subtle and slow — and how early recognition can preserve function and quality of life. His features evolved over time, but with medical care, he avoided the severe complications seen in untreated cases.
Matthew McGrory - Actor
Matthew McGrory (1973–2005) was an American actor whose height of 229 cm ( 7'6") made him one of the tallest performers in film history. Known for his roles in Big Fish, House of 1000 Corpses, and Men in Black II, McGrory’s physical presence was both captivating and medically significant. Though never publicly confirmed, his features and health history strongly suggest a diagnosis of gigantism, likely caused by a GH-secreting pituitary adenoma. His case illustrates the systemic consequences of untreated GH excess, and the complex interplay between public visibility and private vulnerability.
🧠 Clinical Cues
- Extreme height — well beyond familial or population norms
- Proportionate limb length — consistent with pre-epiphyseal GH excess
- Massive hands and feet — soft tissue overgrowth
- Coarse facial features — suggestive of acromegalic progression
- Voice changes — deep and resonant, possibly due to laryngeal thickening
- Mobility challenges — required custom footwear and accommodations, had spinal deformity
- Cause of death: Heart failure at age 32, a known complication of prolonged GH excess
💡 His growth began early and continued unchecked — a classic presentation of gigantism evolving into acromegaly.
🎬 Life and Legacy
- Studied pre-law and criminal justice, but shifted to acting due to his unique appearance
- Cast in roles that emphasised his size — often as gentle giants or eerie figures
- Known for his intellect and kindness, despite being typecast for his stature
- Lived with chronic pain and fatigue, though rarely discussed publicly, and died young
🧠 Gigantism isn’t just about height — it’s about growth velocity, skeletal maturity, and systemic strain. McGrory’s case shows how GH excess can shape a career, but also shorten a life.
Richard Kiel — Actor
Richard Kiel (1939–2014) was an American actor best known for playing “Jaws” in the James Bond films The Spy Who Loved Me and Moonraker, and in Happy Gilmore. His towering height of 216 cm (7'1") and distinctive and progressive facial features made him instantly recognisable and have led many to speculate that he had acromegaly, though this was never publicly confirmed.
🧠 Clinical Clues
- Prominent jaw and brow — suggestive of frontal bone thickening
- Large hands and feet — consistent with soft tissue overgrowth
- Deep-set eyes and coarse facial features — evolved noticeably over his career
- Voice changes — his deep, resonant voice may reflect soft tissue thickening in the larynx
- Mobility issues — later in life, he used a scooter due to leg instability and joint pain
💡 These features are classic for acromegaly, especially when they progress over time. Kiel’s appearance in early films is noticeably different from his later roles — a subtle but telling sign of ongoing GH excess.
🎬 Life and Legacy
- Began acting in the 1960s, often cast in roles that emphasised his size
- Played both villains and gentle giants — his physicality was central to his screen persona
- Authored books and worked as a motivational speaker later in life
- Died in 2014 from a heart attack, a known complication in untreated acromegaly
🧠 Acromegaly often goes undiagnosed for years. Its signs are subtle, progressive, and often mistaken for normal aging or genetic variation. Kiel’s case reminds us to look for change over time, not just static features.
🧠 Summary
These individuals weren’t just tall, they had accelerated/unrelenting growth, coarse features, and often systemic complications. Their stories reveal the difference between constitutional tall stature and pathological GH excess, and why recognising that distinction is a critical clinical skill.
💡 Ask:
- Was the growth proportionate and steady, or rapid and excessive?
- Were there progressive changes in facial structure, hands, or feet?
- Is there evidence of metabolic strain — diabetes, joint pain, cardiac issues, or fatigue?
- Did the growth begin before or after epiphyseal fusion?
- Is there a history of pituitary pathology, or signs of soft tissue overgrowth?
🧠 Reasoning matters. GH excess isn’t just about stature — it’s about timing, progression, and systemic impact. These cases offer powerful anchors for clinical reasoning, empathy, and early recognition.
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