A New Treatment For Thyroid Eye Disease
Although most cases of thyroid eye disease are mild, some people with this condition do experience moderate to severe symptoms. This can include symptoms such as eye bulging, pain, difficulty closing the eye, and double vision. While the goal should be to address the underlying cause of the problem, there are situations when conventional treatment is necessary. On January 21st 2020 a new medication was approved by the FDA that looks very promising for those with moderate to severe thyroid eye disease.
Whenever I write a blog post related to conventional medical treatment Im sure there are some people who question why a natural-related site would put out such content. The obvious reason is because while the focus of this website will always be on natural solutions, there is a time and place for conventional medical treatment, and I think its important to keep an open mind. Everything comes down to risks vs. benefits, and while Ive had success using natural treatment methods in people with thyroid eye disease, more severe cases are less likely to respond to a natural treatment approach.
The Relationship Between IGF-1R and Thyroid Eye Disease
What Is Teprotumumab?
Teprotumumab vs. Other Thyroid Eye Disease Treatments
What Does The Research Show?
Dosing and Administration
Side Effects and Contraindications
These are some of the potential side effects of teprotumumab:
Are There Long Term Side Effects?
Does Teprotumumab Address The Cause of Thyroid Eye Disease?
How Revitalife Can Help You
RevitaLife provides integrative medicine when conventional medicine and treatments arent quite delivering. Our founder, Dr. Jorge Peláez, is an integrative physician with one goal in mind: to provide people with consistent and customizable healthcare through a science-based approach.
We offer a comprehensive 5-step process that is entirely customizable, taking into account the importance of psychology, integrative medicine, and wellness practices.
Check With Your Healthcare Provider
Some treatments can interfere with medications or cause side effects. Always discuss all your OTC, herbal, vitamin, and mineral supplements with a healthcare provider.
Research indicates that some people who have thyroid eye disease may be deficient in selenium and vitamin D.
Taking supplements with selenium and vitamin D may be helpful, but studies are limited on the effectiveness of this treatment. Selenium supplements may be more useful for people who live in areas with soil that is deficient in this mineral.
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Relation With Thyroid Dysfunction
Most patients affected with GO are hyperthyroid , but a substantial proportion, ranging from 0.2 to 11% in different studies , are euthyroid or subclinical/overt hypothyroid. TSH-receptor antibodies are the ultimate responsible for hyperthyroidism due to Graves disease , but they also strongly correlate with the clinical activity and severity of GO . But, in a series of 700 unselected patients with chronic autoimmune thyroiditis, overt GO was present in 44 : among them TRAb bioassay for stimulating activities tested positive in 30/44 patients with GO vs. 36/656 patients without GO . Thus, it is conceivable that TRAbs can explain the rare occurrence of GO in patients without hyperthyroidism. A note of caution should be added by mentioning that cases of so-called euthyroid/hypothyroid GO might indeed be a manifestation of another emerging disease, IgG4 ophthalmic disease, which has clinical features similar to GO . This underscores again the need for a careful differential diagnosis in doubtful cases.
Risk Factors And Prevention
GO results from a complex interaction of endogenous and exogenous/environmental risk factors. The former include age, gender, and genetic factors. As described in a previous section of this manuscript, GO tends to be more severe in men, in whom it occurs at an older age than in women. A search for genetic factors did not provide unequivocal information, with particular regard to differentiation between Graves patients with or without GO . Likewise, results are conflicting as to the association between GO and Major Histocompatibility Complex , cytotoxic T-lymphocyte-associated antigen-4 , protein tyrosine phosphatase or non-receptor type 22 , interleukins, intercellular adhesion molecule 1 gene polymorphisms, adipogenesis-related genes, TSH receptor or thyroglobulin .
Several modifiable risk factors for the occurrence/progression of GO have been identified. This is a very important issue, because controlling them may positively affect the course of GO .
Table 2 Risk factors for the occurrence/progression Graves orbitopathy and preventive actions.
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Thyroid Eye Disease & Natural Treatment Methods
Thyroid Eye Disease, also known as Graves ophthalmopathy, is an inflammatory eye condition which affects a small percentage of people with Graves Disease, as well as some people with Hashimotos Thyroiditis. It involves the same antibodies which attack the thyroid gland, as these antibodies can also attack the tissues of the eyes. Of those people this condition does affect, only a small percentage will have severe symptoms. The good news is that this condition will self-resolve in most people, but it still can cause problems that remain, most commonly exophthalmos .
Although this condition usually self-resolves, sometimes conventional medical treatment is necessary to help manage the symptoms. For example, corticosteroids are used in some cases to help with the inflammation. And in some cases more extreme treatment methods are used, such as radiation, immunosuppressant drugs, and sometimes even surgery.
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Why Nutrition Plays An Important Role When You Are Managing Hyperthyroidism And Thyroid Eye Disease
Medically reviewed in February 2021
Thyroid Eye Disease is a condition that usually develops in people with an overactive thyroid caused by an autoimmune disorder called Graves disease.
When it comes to managing TED, diet plays an important role. Some foods may exacerbate symptoms of Graves disease or hyperthyroidism. In addition, if you eat foods that youre sensitive to, this could impact your immune system and cause your Graves disease to flare.
Iodine Excessive intake of iodine may trigger hyperthyroidism in older adults or those with a pre-existing thyroid disease. Foods that are naturally high in iodine include things that come from the sea as well as seaweed, kelp, and some other sea vegetables. Some foods are often fortified with iodine, meaning iodine is added to them. These include salt, bread, and dairy products such as milk, cheese, and yogurt. Other iodine-rich foods include egg yolks, milk chocolate , and commercially prepared bakery products that are made with iodate dough conditioners.
Gluten A significant number of people with thyroid disease also have celiac disease . Gluten is a general name for a proteins found in wheat, rye, barley, and triticale .
Foods for a healthier thyroid Just as certain foods may exacerbate some aspects of thyroid disease, other foods contain specific nutrients that are an important part of a healthy diet when you have TED. They include food and drinks that are rich in:
Medically Reviewed in February 2021.
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Elevate Your Head In Bed
Swollen eyelids are a common symptom of thyroid eye disease. Instead of lying flat as you sleep, raise the head of your bed. You can either sleep on extra pillows or place rolled up towels under your mattress to create an angle. When your head is higher than the rest of your body, it keeps fluid from building up and relieves pressure on your eyes.
Is Thyroid Eye Disease Curable
Thyroid eye disease cannot be cured but can be managed well with appropriate treatment. The inflammation phase may last from six months to two years, but usually, the eyes become stable once normal thyroid levels are maintained.
Some of the changes that come from thyroid eye disease can be surgically corrected once the inflammation subsides, however, some changes may be permanent, depending on the severity of the condition.
Permanent loss of vision is extremely rare but can happen if the disease is left untreated until a late stage of the disease. After treatment, thyroid hormone levels, as well as the condition of the eyes, must be evaluated on a regular basis and treated as needed.
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How Graves Disease Develops
Normally, thyroid-stimulating hormone is released by the pituitary gland in the brain and usually determines how much hormones the thyroid produces. But people with Graves disease experience a break in normal communication between the pituitary glad and thyroid gland, resulting in abnormal antibodies being released that mimic TSH and therefore cause too much thyroid hormone to be circulated into the bloodstream.
These antibodies are called thyroid stimulating immunoglobulin and thyrotropin receptor antibody . TSI cells have a similar effect to TSH, which we need in adequate amounts to help the thyroid function normally. But TSI antibodies cause the thyroid gland to produce excess thyroid hormones above and beyond what is necessary and healthy.
Since the thyroid mistakes these antibodies for TSH, they can override normal signals sent from the pituitary gland and therefore cause hyperthyroidism. As TSI and TRAb levels rise, inflammation increases, which indicates that the immune system is working on overdrive and accidentally attacking the bodys own healthy tissue. A harmful cycle can develop in people with Graves disease because the more active the immune system becomes, the more bodily tissue is damaged and then more activated T-cells and auto-antibodies are released.
Early Thyroid Eye Disease Treatment Can Help Prevent Serious Eye Damage
Thyroid Eye Disease is a serious, vision-threatening condition that can get worse over time, if left untreated. The longer that TED goes untreated, the more likely it is for serious damage to happen to your eyes. The earlier you start treatment for your Thyroid Eye Disease, the better. Read on to learn about your TED treatment options.
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Prediction Of Go Occurrence In Newly Diagnosed Graves Patients
Because of the major role of exogenous factors in the development of GO, a prospective observational study was carried out in 10 EUGOGO centers to construct a predictive score for the development/progression of GO in 348 newly diagnosed and untreated Graves patients without obvious GO . Four independent variables composed the PREDIGO score, i.e., the Clinical Activity Score, TRAbs , duration of hyperthyroidism, and smoking. Of the 348 patients, all submitted to antithyroid drug treatment, 53 developed GO, which was mild in 46 and moderate-to-severe in 7 . The PREDIGO score proved to be much better in identifying patients who will not develop GO than those who will . Although this represents an evident limitation and underpins the need for the improvement and refinement of this score with additional biomarkers, the PREDIGO score may represent a simple and useful tool to consider when discussing the general treatment plan of newly diagnosed Graves patients with absent or very mild GO. Moreover, as mentioned earlier, early referral of patients with mild and active GO and/or effective control of modifiable risk factors for development/progression of the disease may substantially contribute to exacerbation of GO .
Age Gender And Ethnicity
In the Olmsted County study, GO of all degrees showed a bimodal peak, 4044 years and 6064 years in women, 4549 years and 6569 years in men . In an observational Japanese study of 10,931 consecutive patients, the mean age of GO occurrence was 39 years in women and 43 years in men . In a study of 101 consecutive patients referred to a combined thyroid-eye clinic, the mean age was lower in patients without GO than in those with GO . In an Italian study mean age did not differ in Graves patients without GO and in those with mild GO , but was significantly higher in patients with moderate-to-severe GO . Likewise, in a Danish study of patients with moderate-to-severe GO, the median age was 50 and 56 years before and after salt iodization, respectively, and the risk of developing moderate-to-severe GO was lower in patients aged < 40 years .Thus, age is a relevant factor affecting severity of GO, and the disease tends to be more severe in older patients . Although a questionnaire-based survey among European thyroidologists reported the presence of GO of all degrees in approximately one third of juvenile Graves disease , clinically relevant GO in childhood is in general rarer than in adults and usually mild .
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How Do You Know If You Have Graves Disease
If you suspect it, a doctor will need to confirm the diagnosis. Once we see suspicious symptoms, the next step is to run blood tests. An excess of thyroid hormones is the first finding. At the earliest stages, this shows up as a TSH level that is below range. As hyperthyroidism progresses, the T4 gets too high and eventually the T3 does also.
Other tests can show the antibodies that cause Graves disease. These include Thyroid Stimulating Immunoglobulins and Thyroid Receptor Antibodies . In some cases, the same antibodies associated with Hashimotos disease may also be present such as antithyroid peroxidase and antithyroglobulin .
If the Graves antibodies are not present, or if the thyroid is swollen, the doctor may do an iodine uptake scan. This scan can help show if there are toxic nodules or other possible causes of hyperthyroidism.
What Are The Most Common Treatments
Most conventional doctors treat with permanent procedures. These include radioactive iodine to destroy the thyroid, or thyroidectomy to remove it. These procedures work to slow the thyroid, but they usually create lifelong dependency on thyroid medication.
Radioactive iodine can raise the risk of some types of cancer. Thyroidectomy can cause trauma to the nerves involved with speech and to the parathyroid glands.
In many cases these treatments are appropriate and lifesaving. Yet because of their risks and permanent nature many people like to find other options.
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Graves Disease Signs And Symptoms
Some of the most common signs and symptoms of hyperthyroidism caused by Graves disease include:
- changes in mood, including irritability and anxiousness
- muscle pains and weakness
- irregular periods
- erectile dysfunction or reduced libido
- changes in skin texture, including thickening of the skin on the lower legs or red bumps
- eye problems, including bulging of the eyes , which affects a high percentage of Graves patients
- pain in the eyes, red eyes, sensitivity to light or vision loss
Whos at the biggest risk for developing Graves disease? While autoimmune disorders of all kinds can affect both men and women, younger people and the elderly, and people of all nationalities, Graves disease is believed to be much more common among women, especially younger women who are below the age of 40. In fact, thyroid disorders and autoimmune disorders in general usually impact women much more than men, which is believed to be the case partially because womens hormones are more susceptible to changes caused by stress. Graves disease is seven to eight times more common in women than men, especially women between ages 30 and 60.
Thyroid storm is basically an extreme form of hyperthyroidism, in which symptoms suddenly become worse due to a flooding of thyroid hormones into the body. This excess amount of thyroid hormone may be the result of radioactive iodine therapy or too much thyroid hormone replacement.
Symptoms of thyroid storm can include:
What Is Hyperthyroidism
Your thyroid gland is located at the front of your neck, and it produces thyroid hormones. These hormones regulate many essential endocrine functions in your body, including energy production, digestive function, and more.
Hyperthyroidism also called an overactive thyroid is when your thyroid gland produces too much thyroid hormone. The most common reason for hyperthyroidism is an autoimmune attack on the thyroid gland called Graves disease. Though its far less common than other thyroid disorders, an estimated one in 200 Americans has Graves disease . The majority of thyroid patients, including hyperthyroid patients, are women [2
- Enlargement of your thyroid gland
- Increased sweating, or clammy skin
- Erectile dysfunction or decreased libido
- Graves ophthalmopathy
- Thick, red skin usually on the shins or tops of the feet
Your doctor usually diagnoses hyperthyroidism with:
- A blood test for levels of thyroid hormones
- Or, a radioactive iodine uptake test
If your blood test shows low TSH and high free T4 thyroid hormone, this means you are hyperthyroid . If you also have elevated thyroid antibodies, including thyroid-stimulating immunoglobulins , thyroid peroxidase , or thyroglobulin antibodies, you may be diagnosed with Graves disease .
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The Eye Specialist Role
Your specialist can provide simple solutions to the irritation, tearing and swelling often associated with TED. Often, this involves something as simple as using artificial tears during the day and lubrication ointment at night. Your specialist can determine when your eyes have stopped changing and whether corrective surgery is needed. Your specialist may also watch for the rare serious problems associated with TED that need prompt treatment.
What Is Thyroid Eye Disease
Thyroid eye disease, also known as Graves eye disease, is an autoimmune condition in which the bodys immune system attacks the fat and muscle tissue within the eye socket, causing inflammation. Thyroid eye disease is not directly caused by Graves disease but arises from the same autoimmune condition that causes Graves disease.
Graves disease is a condition in which the immune system attacks the thyroid gland, resulting in an overactive thyroid . Hyperthyroidism causes an abnormal increase in the metabolic rate that leads to symptoms such as fast and irregular heartbeat, tremors, fatigue, and weight loss.
Thyroid eye disease develops in approximately 50% of people with Graves disease. Thyroid eye disease is associated with hyperthyroidism in 90% of the cases. Approximately 5% of thyroid eye disease patients have an underactive thyroid and 5% have normal thyroid function.
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Thyroid Eye Disease Surgeries
Once Thyroid Eye Disease reaches the , surgery is sometimes used to correct serious damage caused by scarring.
Surgery may help correct a number of TED symptoms, including bulging eyes, double vision, retracted eyelids, misaligned eyes and other changes to your appearance and vision. While some people with TED may achieve the desired results with the first surgery, multiple surgeries are usually neededsometimes as many as 4 or more.
TED surgeries are often performed by an oculoplastic surgeon or strabismus surgeon. These surgeons are eye doctors who specialize in surgery of the eye.
Because TED surgeries are complex, they usually take place in a very specific order.