What does your immune system and your thyroid gland have to do with health issues involving your eyes and vision? Plenty. In fact, there are a number of symptoms that point to thyroid eye disease, as the culprit.
Commonly known as TED, thyroid eye disease is a medical condition featuring symptoms that can include irritated, red, teary, or bulging eyes; eye pain or pressure; sensitivity to light; blurry or double vision; impaired vision or loss of color in your vision; puffy or retracted eyelids; or eyes that point in different directions.
TED is related to another, better-known medical condition called Graves’ disease, in which the body’s immune system attacks the thyroid gland. The thyroid gland is part of the endocrine system, which includes the adrenal glands, hypothalamus, pituitary gland, ovaries, and testes.
It releases hormones into the bloodstream that help to regulate metabolism, bone growth, brain development, heart rate, digestion, muscle function, body temperature, menstrual cycles, and more.
With TED, immune and thyroid dysfunctions trigger an inflammatory response in the muscles around the eyes, causing them to swell. Because the eyes are held in place by orbits (sockets in the skull), the swelling can cause pain, irritation, vision problems, and structural anomalies such as bulging and misaligned eyes.
In today’s post, we take a deeper dive into symptoms. Then we cover different medical terms used to describe the condition and factors that may cause or contribute to the onset of the illness.
We wrap up with a discussion of our functional medicine approach at BioDesign Wellness to treat thyroid eye disease and other illnesses related to autoimmune conditions that impact thyroid health and function.
Thyroid Eye Disease Symptoms in Greater Detail
We already mentioned most of the symptoms related to thyroid eye disease (TED), so let’s look at them more closely, so you’ll have a better understanding of them when you discuss symptoms with your doctor:
- Bulging eye(s) (proptosis, prop-toe-sis, or exophthalmos, eks-off-thal-muhs): Approximately 60 percent of people with TED have bulging eyes. Doctors can diagnose this by using a special ruler called an exophthalmometer (eks-off-thuhl-mom-ih-ter).
- Blurry vision: About 30 percent of people with TED report blurry vision.
- Double vision (diplopia, dih-ploe-pee-uh): About 50 percent of people with TED report having double vision.
- Impaired color vision: In most cases, colors just don’t seem to be as bright and bold as they used to appear in one or both eyes. In rare cases, TED patients become color blind, which could indicate that the optic nerve is being damaged, increasing the risk of vision loss.
- Vision loss: Swelling that presses on the optic nerve can cause vision loss, which may require emergency surgery.
- Dry eyes: Your eyes may feel dry or gritty.
- Excessively watery eyes: Your eyes seem more watery or teary than they should.
- Foreign body sensation: You may feel as though something is stuck in your eye even though nothing really is.
- Eye pain/pressure: You feel pain or pressure in, around, or behind one or both eyes, especially when looking up, down, to the side. Approximately 30 percent of TED patients experience eye pain or pressure.
- Headaches: Pressure and pain in, around, or behind the eye may cause headaches.
- Light sensitivity (photophobia, foe-tuh-foe-bee-uh): Any bright light, especially sunlight, causes pain or discomfort.
- Misaligned eyes (strabismus, struh-biz-muss): Eyes pointing in different directions, which may cause double vision.
- Puffy eyelids (eyelid edema, ih-dee-muh): Your eyelids are swollen, and the swelling can’t be attributed to allergies or infection.
- Red eyes (erythema, er-uh-thee-muh): Your eyes and eyelids look red or bloodshot, and the redness can’t be attributed to allergies or infection.
- Retracted eyelids: Approximately 90 percent of people with TED have retracted eyelids — eyelids that are difficult to close or don’t close all the way.
TED Causes, Triggers, and Risk Factors
As with most chronic illnesses, a genetic vulnerability, combined with one or more environmental triggers, seems to be responsible for the onset of TED. If you have TED, you may wonder what triggered your immune system to attack your thyroid gland or eyes.
While pinpointing one common denominator isn’t always easy or even possible, the immune system is highly susceptible to the following stressors:
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Hormone fluctuations: Hormone fluctuations commonly occur in endometriosis, polycystic ovary syndrome (PCOS), pregnancy, or menopause or as a result of excess or chronic stress.
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Recurrent infections: Yeast overgrowth (candida), irritable bowel disease (IBD), the Epstein-Barr virus (EBV), chronic sinusitis, and shingles may contribute to the onset of TED.
If your body is struggling with a chronic virus, yeast, or bacterial infection, the immune system can overreact, causing inflammation and attacking the body it’s meant to protect. This can cause autoimmunity to the thyroid, eyes, joints, and more.
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Exposure to toxins: One recent study — Thyroid eye disease: what is new to know?
— singles out smoking as having “an impact on specific gene expression involved in several disease-related pathways, which seems to be reversible with smoking cessation.” (Smokers are twice as likely than non-smokers to develop Graves’ disease.) However, many toxins in the food we eat, the water we drink, the air we breathe, and various products we use can contribute to a toxin overload in the body that can trigger a variety of chronic illnesses, including TED.
- Nutritional deficiencies: Selenium deficiency, in particular, has been identified as a potential risk factor for TED, but other nutritional deficiencies may also contribute to its onset.
- High serum cholesterol: Serum cholesterol is the total cholesterol in the bloodstream, including high-density lipids (HDL) and low-density lipids (LDL). However, using medications to lower cholesterol can do more harm than good.
Conventional Medicine Treatments
Certain conventional medicine treatments have shown some promise in treating TED, including the following:
- Smoking cessation
- Mineral supplementation with selenium
- Immunosuppressants (corticosteroids): Be careful with these because merely suppressing the immune system makes you more susceptible to infections.
- Orbital radiotherapy (ORT): Radiotherapy uses a type of ionizing radiation (high energy) traditionally to kill cancer cells by altering their DNA. However, it’s also used to treat TED. Again, be careful with ORT; it can cause other, potentially serious health problems.
- Brachytherapy: A cancer treatment (usually for prostate cancer) that involves implanting radioactive material in the body to kill cancer cells. A new form of this therapy has shown promise in treating TED, but it poses other potential health risks.
Numerous treatments are also available to alleviate symptoms, including topical eye lubricants, sodium restriction to reduce water retention (which contributes to swelling), sleeping with the head elevated, taking non-steroidal-anti-inflammatories (NSAIDs) to reduce inflammation, beta blockers to decrease heart rate, and using temporary press-on prism lenses.
Functional Medicine Diagnosis and Treatment Protocols
If you have problems with your thyroid that are not resolving with the conventional approaches, we can provide a thorough analysis of your diagnostic workup and treatment protocol to identify anything that may be missing. The solution starts with a thorough evaluation of your thyroid and other factors that may impact thyroid health and function.
Here’s what we do at our Tampa functional medicine practice to diagnose and treat hypothyroidism (underactive thyroid):
- Thyroid sonogram: When called for, we order a thyroid sonogram, which is an ultrasound that checks for nodules and inflammation.
- Complete thyroid testing: Many healthcare providers test only for thyroid stimulating hormone (TSH), T4, and T3 uptake. At BioDesign Wellness Center, we add the following tests:
- Reverse T3 shows how much active thyroid hormone you’re getting rid of. Your body normally sheds some thyroid hormone as a waste product. If it’s shedding too much — usually in the context of inflammation — you can feel bad even on medications. Knowing this can help us identify and address the underlying issue, usually resulting in increased energy and decreased pain.
- Thyroid antibodies can help determine if your immune system is attacking your thyroid gland. In this case, your thyroid is not the only problem and working on your immune system will be advantageous.
- Total and Free T3: T3 is the active form of thyroid hormone.
- Thyroid hormone therapy: Depending on the test results, we may need to prescribe specific types of thyroid hormone. For example, if T3 is low and you’re already on Synthroid or levothyroxine, adding T3 hormone can resolve lingering issues.
- Nutrient evaluation and supplementation: We check your vitamin and mineral levels and address any nutritional deficiencies. Low levels of magnesium, iodine, selenium, or B vitamins can cause or contribute to the condition. Nutritional supplements can make a big difference in how you feel and heal.
- Sex hormone testing and treatment: Having too much estrogen and not enough progesterone can contribute to thyroid symptoms. We address any imbalances with bio-identical hormone replacement therapy, which is safer and more effective than using synthetic hormones.
- Cortisol testing and treatment: Cortisol mediates various metabolic processes and has anti-inflammatory and immunosuppressive properties. Excess or insufficient cortisol can contribute to thyroid symptoms. We have various treatment options to restore healthy cortisol levels.
Guided by your test results, we can create a personalized plan that restores thyroid health and function, addresses other related health issues, and relieves the swelling, pain, and discomfort associated with thyroid eye disease. If that sounds good to you, please contact our office at either (813) 445-7770 or biodesign@biodesignwellness.com to schedule an initial consultation.
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Disclaimer: The information in this blog post about eye and vision problems, including thyroid eye disease, is provided for general informational purposes only and may not reflect current medical thinking or practices. No information contained in this post should be construed as medical advice from the medical staff at BioDesign Wellness Center, Inc., nor is this post intended to be a substitute for medical counsel on any subject matter. No reader of this post should act or refrain from acting on the basis of any information included in, or accessible through, this post without seeking the appropriate medical advice on the particular facts and circumstances at issue from a licensed medical professional in the recipient’s state, country or other appropriate licensing jurisdiction.