Thyroid Eye Disease (Grave's Ophthalmopathy) treatment with Chinese Medicine 1

How do I know if I have thyroid eye disease (TED)?

Do you notice yourself having bulging eyes that are easily irritated or puffy? Keep a look out for the following symptoms to see if you should be consulting your doctor on a thyroid eye disease (TED), otherwise known as Grave’s ophthalmopathy!

Possible symptoms include:

  1. bulging, irritated and puffy eyes
  2. light sensitivity
  3. pressure or pain in the eyes
  4. blurred or double vision

How can I tell if it’s TED and not other eye diseases?

TED is caused by hyperthyroidism or an overactive thyroid, which affects your thyroid hormones and the way your body uses energy.

If you have TED, more often than not you will be presented with other symptoms such as:

  1. weight loss, in spite of an increase in appetite
  2. rapid or irregular heartbeat
  3. nervousness, irritability, trouble sleeping and fatigue
  4. shaky hands and muscle weakness
  5. sweating or trouble tolerating heat
  6. frequent bowel movements
  7. an enlarged thyroid gland (goiter)

What are some of the current treatments for TED?

In most cases, the symptoms of TED are often mild and can be controlled by proper eye care such as using eye drops, eye masks and sunglasses. However, in more severe cases, your doctor may recommend treatments such as steroids, surgery or radiation therapy.

Should I seek treatment for TED if the symptoms are not so serious?

Definitely! TED when untreated could ultimately lead to vision loss!


In TED, there is an increase stuff accumulating in your eye socket.

This happens because:

  1. Extraocular muscles becoming grossly enlarged, mostly due to fluid swelling
  2. Production of glycosaminoglycans by orbital fibroblasts, which absorb water and swell
  3. Fat tissue in the eye socket actually get bigger!

In combination, these cause proptosis (bulging) and compression of the optic nerve, which may result in diplopia (double vision) and even loss of sight.
Recent studies show that fat tissue accumulation is one big factor that aggravates Thyroid Eye Disease.

Adipose tissue volume increases through a combination of increased cell number (hyperplasia) and expanded cell size (hypertrophy).

Moreover, hyperthyroidism can often progress to serious complications such as heart-related problems, muscle problems and thinning bones (osteoporosis), and fertility problems, so it’s good to seek early treatment.

How can TCM can help me with Thyroid Eye Disease?

In recent years, research has shown that TCM can be very helpful as adjunctive treatment for Thyroid Eye Disease.


Put simply, Chinese herbs can either relieve the ongoing inflammation, or it can reduce the overgrowth of fat tissue in the eyes.

Herbs that reduce ongoing inflammation include Celastrus (南蛇藤) and Gynnostemma (绞股蓝). Celastrus does so by inhibiting the production of inflammatory cytokines which exacerbate the inflammatory response in the eyes, while Gynnostemma plays an anti-inflammatory and antioxidant role, thereby reducing eye tissue damage.

Herbs such as Herba Epimedii (淫羊藿) and Prunella vulgaris L (夏枯草) are able to reduce the growth of fat tissues in TED.

Epimedii does so by inhibiting the differentiation of immature fat cells into mature fat cells, while Prunella promotes the cell death of fat tissues in the eyes.

Tripterygium (雷公藤) and Astragalus (黄芪) are herbs that can do both. Tripterygium can relieve the clinical symptoms of TED caused by inflammation and accumulation of fat tissues in the eyes. Astragalus also reduces inflammatory cytokine production and fat accumulation, thereby exerting its protective effect on eye tissues.


By reducing inflammation and by slowing down the accumulation of fat tissue, these herbs can prevent further damage to muscles and tissue of the eyes, hence providing much needed protection against vision loss.

What about Acupuncture for Thyroid Eye Disease?

Yes, Chinese herbs and Acupuncture work together in the treatment of Graves Hyperthyroidism, Graves Ophthalmopathy and Thyroid Eye Disease. You can click here to find out more about Acupuncture for Thyroid Eye Disease.

Appendix: Compounds in TCM Herbs and their effect on Thyroid Eye Disease (TED)

Diosgenin From Trigonella foenum-graecum (胡芦巴) or Dioscorea Bulbifera (黄药子)

  • Dio selectively affects the proliferating thyroid rather than the normal thyroid, suggesting that Dio may be a safe anti-goiter agent to avoid hypothyroidism. 
  • The target of Dio may not be expression of TRAB, but thyroid cell proliferation. 
  • Dio can inhibit the overexpression of proliferation-related proteins in the thyroid in GD.

Resveratrol From Reynoutria japonica Houtt (虎杖)

  • GO orbital fibroblasts are hypersensitive to oxidative stress. 
  • Resveratrol can reduce the production of ROS, adipogenesis of orbital fibroblasts, and lipid droplet accumulation.

Icariin From Epimedium Brevicornu Maxim (淫羊藿)

  • Icariin inhibits the differentiation of preadipocytes into mature adipocytes by inhibiting autophagy. 
  • Icariin reduces adipose tissue dilation in orbital muscle and lipid drop accumulation by inhibiting autophagy.

Celastrol From Celastrus orbiculatus Thunb (南蛇藤)

  • It has been reported that IL-1β expression is higher in orbital tissues of GO patients, and IL-1β mediates inflammatory response. 
  • Celastrol inhibits IL-1β, and thus inhibits IL-1β-induced production of orbital fibroblast cytokines IL-6, IL-8, ICAM-1, and COX-2, all of which are key to the inflammatory response of GO patients.

Gypenosides From Gynostemma pentaphyllum (Thunb.) Makino (绞股蓝)

  • Gypenosides may play anti-inflammatory and antioxidant roles in GO, thereby reducing tissue damage and remodeling caused by orbital inflammation and oxidation.

Astragaloside IV From Astragalus mongholicus Bunge (黄芪)

  • Astragaloside IV treatment reduces IL-1β-induced inflammatory cytokine production and reduces GO orbital inflammation, fat accumulation, collagen deposition, and macrophage infiltration. 
  • Its protective effect is also associated with decreased autophagy activity of orbital fibroblasts and orbital tissues.

Active Ingredients From Prunella vulgaris (夏枯草)

  • Spica Prunellae promotes adipocyte apoptosis in GO.

Triptolide From Tripterygium wilfordii (雷公藤)

  • Triptolide can relieve the clinical manifestations of exophthalmos, diplopia and periorbital swelling caused by inflammatory cell infiltration and accumulation of adipose tissue in the extraocular muscle and orbital connective tissue. 
  • Triptolide inhibits IFN-γ-induced orbital fibroblasts activation and cell in GO patients.

Bupleurum Saponins From Bupleurum Falcatum (柴胡)

  • Bupleurum Saponins have good bidirectional regulation effects on hyperthyroidism and secondary hypothyroidism.