If you’ve noticed that your eyes seem to be bulging, irritated, or puffy, you might be wondering if something more serious is going on. Don’t worry—you’re not alone. Thyroid Eye Disease (TED), also known as Graves’ ophthalmopathy, can be a bit tricky to pinpoint, but understanding it is the first step toward getting the help you need.
In this guide, we’ll explore what TED is, how to identify it, and what thyroid eye disease treatment available. Whether you’re experiencing symptoms yourself or just curious, we’re here to break it down in a way that’s easy to grasp and helpful.
What is Thyroid Eye Disease (TED)?
Thyroid Eye Disease (TED) is an autoimmune condition that affects the eyes and is associated with thyroid dysfunction, particularly hyperthyroidism. In TED, the tissues around the eyes become inflamed and swollen, leading to various symptoms that can affect your vision and eye comfort. The disease is often linked to Graves’ disease, a common cause of hyperthyroidism, but it can also occur in individuals with other thyroid disorders.
Do your eyes look or feel different lately? Here are some signs that might indicate TED:
- Bulging, irritated, and puffy eyes
- Sensitivity to light
- Pressure or pain in the eyes
- Blurred or double vision
Differentiating TED from Other Eye Diseases
Dry eye, allergy and conjunctivitis all cause redness and irritation, so TED gets mistaken for them early on. Three things separate it: the eyes look pushed forward rather than simply red, the swelling sits in the lids and in the tissue behind the eye rather than on the surface, and it arrives with thyroid symptoms elsewhere in the body.
TED is typically caused by hyperthyroidism, where your thyroid gland is overactive. This condition affects your thyroid hormones and how your body uses energy. If you have TED, you might also notice symptoms related to hyperthyroidism, such as:
- Weight loss despite an increased appetite
- Rapid or irregular heartbeat
- Nervousness, irritability, trouble sleeping, and fatigue
- Shaky hands and muscle weakness
- Excessive sweating or trouble tolerating heat
- Frequent bowel movements
- An enlarged thyroid gland (goiter)
Why Treat When TED is Mild?
For mild cases of TED, symptoms can often be managed with simple measures such as eye drops, eye masks, and sunglasses. But why would patients still seek out TCM?
Because this diseases is cumulative, some patients come in because they know there is a life trigger, and they just want to make sure they don’t tip over. Because this disease causes an increase in material accumulating in your eye socket, reducing inflammation even during a mild flare is crucial.
How Do Chinese Herbs Help?
1. Reducing Inflammation
- Celastrus (南蛇藤) inhibits inflammatory cytokines that worsen eye inflammation.
- Gynnostemma (绞股蓝) offers anti-inflammatory and antioxidant effects, reducing eye tissue damage.
2. Reducing Fat Tissue Overgrowth
- Herba Epimedii (淫羊藿) inhibits the transformation of immature fat cells into mature ones.
- Prunella vulgaris L (夏枯草) promotes the death of excess fat cells in the eyes.
3. Combining Both Effects:
- Tripterygium (雷公藤) alleviates symptoms caused by inflammation and fat accumulation.
- Astragalus (黄芪) reduces both inflammation and fat accumulation, offering protective benefits to eye tissues.
Acupuncture for TED
Herbs work from the inside. Acupuncture works locally, on the tissue that is actually swollen — the points sit on the extraocular muscles around the eye, never on the eye itself, and the needles used there are as fine as 0.20mm. Both are aimed at the same two problems: the inflammation, and the fluid that inflammation holds.
Acupuncture, alongside Chinese herbs, can also be beneficial in treating Graves’ Hyperthyroidism and TED. For more information about how acupuncture can aid in managing TED, click here.
Taking The Next Step
If you’re experiencing symptoms of TED, don’t hesitate to reach out to a healthcare provider. Understanding your condition and exploring treatment options is the best way to take control of your health. TED can be challenging, but with the right information and support, you can manage it effectively and protect your vision.
Who Would Be Treating You
Thyroid eye disease is inflammation behind the eye, and steroids are the usual answer. They work while you are on them. What is harder is holding the ground once the dose comes down.
I’m Dr Mark Chern, PhD, registered with the TCM Practitioners Board of Singapore. Inflammatory conditions are what I treat, at 545 Orchard Road.
Come In and Talk About Your Eyes
Tell us what your eyes are doing and what treatment you have had so far.
FAQs
1. Will thyroid eye disease go away?
Yes, thyroid eye disease (TED) is typically self-limiting. Most patients transition from the active inflammatory phase to a stable phase within 1 to 3 years. While symptoms may worsen initially, they often improve over time. However, there is a 5-10% risk of recurrence.
2. What vitamins help thyroid eyes?
Selenium is beneficial for managing thyroid eye disease, particularly in mild cases. It may reduce inflammation and improve quality of life. While vitamins A, C, and E support overall eye health, specific evidence linking them to TED management is limited.
3. What worsens thyroid eye disease?
Factors that can worsen TED include:
- Smoking: Significantly increases severity.
- Radioactive Iodine Treatment: May exacerbate symptoms.
- Thyroid Dysfunction: Fluctuations in hormone levels can aggravate symptoms.
- Stress: Can trigger immune responses that worsen TED.
- Pregnancy: Hormonal changes may lead to new or worsening symptoms.
4. Which Chinese herbs are used for thyroid eye disease?
The research on TED centers on a handful of herbs, each studied for a specific active compound:
- Celastrus (南蛇藤) — celastrol
- Astragalus (黄芪) — astragaloside IV
- Gynostemma (绞股蓝) — gypenosides
- Epimedium (淫羊藿) — icariin
- Prunella vulgaris (夏枯草) — spica prunellae
- Japanese knotweed (虎杖) — resveratrol
- Tripterygium (雷公藤) — triptolide
- Bupleurum (柴胡) — bupleurum saponins
- Fenugreek (胡芦巴) and Dioscorea bulbifera (黄药子) — diosgenin
They are not taken as single herbs. A prescription combines several according to what your presentation calls for.
5. How do Chinese herbs reduce the swelling behind the eye?
Much of the swelling in TED is fat. The orbit has fibroblasts that turn into fat cells and hold water, and the eye socket has nowhere to expand into. Three compounds act on that:
- Icariin (淫羊藿) blocks immature fat cells from maturing, and reduces fat expansion in the muscle behind the eye and the lipid droplets inside it.
- Spica prunellae (夏枯草) pushes excess orbital fat cells into cell death.
- Resveratrol (虎杖) cuts the reactive oxygen species that orbital fibroblasts are unusually sensitive to, and with it the fat formation and lipid accumulation.
6. Do Chinese herbs reduce the inflammation in thyroid eye disease?
That is the other half of the problem. IL-1β sits higher in the orbital tissue of people with thyroid eye disease and drives the inflammatory response. Three compounds work on that pathway:
- Celastrol (南蛇藤) inhibits IL-1β, and with it the IL-6, IL-8, ICAM-1 and COX-2 that orbital fibroblasts produce in response.
- Astragaloside IV (黄芪) reduces the same IL-1β-driven cytokines, and also orbital inflammation, fat accumulation, collagen deposition and macrophage infiltration.
- Gypenosides (绞股蓝) act as anti-inflammatory and antioxidant, reducing the tissue damage and remodeling that inflammation leaves behind.
7. Can Chinese herbs help with bulging eyes and double vision?
Those two symptoms come from inflammatory cells and fat crowding the extraocular muscles and the connective tissue around them. Triptolide, from Tripterygium wilfordii (雷公藤), has been studied for exactly that picture — bulging, double vision and swelling around the eye — and works by blocking the IFN-γ signal that activates orbital fibroblasts.
Tripterygium is a potent herb and is prescribed rather than self-administered.
8. Do Chinese herbs affect thyroid hormone levels?
Some do, and this matters because TED usually travels with a thyroid problem.
- Bupleurum saponins (柴胡) regulate in both directions, which is useful when treatment for an overactive thyroid has tipped you into an underactive one.
- Diosgenin (胡芦巴, 黄药子) acts on the proliferating thyroid rather than normal thyroid tissue, which is what makes it interesting as an anti-goiter agent that does not push you hypothyroid. It appears to work on thyroid cell proliferation rather than on TRAb.
9. Can Chinese medicine cure thyroid eye disease?
No, and be wary of anyone who says otherwise. Thyroid eye disease is largely self-limiting — most people move from the active inflammatory phase to a stable one within one to three years.
What treatment changes is what that period costs you, and what is left at the end of it. Herbs and acupuncture are aimed at the inflammation and the fat accumulation while the disease is active, alongside whatever your endocrinologist or ophthalmologist has you on — not instead of it.
