What To Eat And What To Avoid
One way to manage hyperthyroidism is to have a healthy diet.
If you have hyperthyroidism, your doctor might prescribe a low-iodine diet before starting medical treatment. This increases the effectiveness of the treatment.
According to the American Thyroid Association, a low-iodine diet means you should avoid:
How Can The Long
In most people, the active inflamed stage of TED resolves within about two years. In a few people, active TED can recur again after it has burnt out, although this becomes less likely the longer that the condition has been inactive.
Treatment after TED has burnt out is aimed at dealing with any remaining double vision, providing better eyelid protection for your eyes and improving the appearance of your eyes.
The swelling caused by TED can often improve once the active stage has passed, meaning there can be some improvement in the appearance of your eyes. However, you might be left with some changes caused by the swelling, such as eyelid retraction , exophthalmos , large eyelid bags or double vision. This is because the tissues that have been inflamed are often less flexible once the active phase of the condition has passed, and theyre not able to return to their original position.
If this is the case, then you may wish to decide whether to have further surgery to help improve these changes. Sometimes the problems that are left may only be minor and you may feel treatment is not necessary, or that the risks of the surgery outweigh the problems that you have.
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.
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How Is Thyroid Eye Disease Treated
Your provider will begin by treating you for thyroid disease if you have it. Treating thyroid diseases doesnt treat thyroid eye disease, so your provider may suggest one or more of these therapies:
Over-the-counter medications to treat TED
Eye drops to relieve dryness and irritation are generally non-prescription. You can buy them over the counter. You should use the drops that lubricate but avoid those that take away redness.
Your provider may also suggest selenium supplements if your blood levels of this mineral are low.
A few studies have shown that drinking aloe vera juice reduced inflammation levels in some cases.
Prescription medications to treat TED
Your provider may prescribe anti-inflammatory drugs like prednisone and other systemic steroids and/or rituximab. Discuss the side effects of these treatments with your provider.
Theres also a new medicine available only for thyroid eye disease called teprotumumab .
Lifestyle changes and home remedies to treat TED
The most important lifestyle change you can make is to quit smoking if you smoke. It raises your risk of developing TED by seven to eight times and makes TEDs active disease phase longer. In addition, smoking decreases the effectiveness of treatment for thyroid eye disease. Other things you can do to be more comfortable include:
Surgery to treat TED
Radiation to treat TED
Your provider may suggest radiation therapy to treat the inflammation of thyroid eye disease.
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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What Are Treatments For Thyroid Eye Disease
- Bookmark for later
Thyroid eye disease is a progressive condition. This means that it gets worse over time. There are 2 phases of TED: an active phase and an inactive phase. Each phase is different. Treatment goals for each phase are also different.1
The goal of treatment in the active phase is to reduce inflammation. Treatment goals in the inactive phase focus on repairing damage of tissue.1,2
It is possible for TED to flare after the inactive phase, causing active symptoms to reappear. TED is a rare condition and can cause serious vision issues if left untreated.1
Seeing a TED specialist is important. TED specialists are eye doctors who specialize in diagnosing and treating the disease. These doctors will recommend the best treatment for you, depending on your symptoms and history.2
The treatments most commonly used for the different phases of TED include:1,3
- Supportive treatments
Misconceptions About Graves Disease
There are about 3 million people in the United States living with Graves disease. The US incidence is 0.05%, or 136 000 people per year. Although Hashimotos is much more common, Graves should not be an obscure footnote to Hashimotos.1
Although uncommon, it is possible for Graves disease to flair into a potentially-fatal thyroid storm. A study of the incidence of thyroid storm in Japan concluded that it occurs in about 0.22% of all thyrotoxic patients.2 Often this occurs in patients who have been non-compliant with medications.
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Coping With Changes To Your Appearance
It is well known that TED can affect your psychological and social well-being. You may feel anger, loss of self-esteem or confidence, or socially isolated, because of the change in the appearance of your eyes. Your mood can also be affected by medications you may be taking, such as steroids. TED can change your facial appearance and alter your expression which may affect the way people react to you which, understandably, can be difficult to cope with. Treatment, which may include surgery, can often improve this and counselling, or contact with others who have TED, can help you find coping strategies.
Some of the following organisations might be helpful:
- Thyroid Eye Disease Charitable Trust can help put you in touch with other people who have had similar experiences which is often helpful.
- The British Thyroid Foundation has a network of telephone support volunteers that can help. They also have closed Facebook groups for people with TED. You can email them at if you would like their support.
- The charity Changing Faces also offers a support service for anyone experiencing a condition or injury that affects their appearance.
- Our Counselling and Wellbeing team can offer telephone counselling to anyone affected by sight loss or an eye condition.
Page last reviewed: Sept. 1, 2022
Next review due: Jan. 31, 2023
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
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?
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Who Gets Thyroid Eye Disease
People with Graves’ disease are at higher risk for developing thyroid eye disease. By some estimates, up to 50% of people with Graves’ disease also have symptoms associated with thyroid eye disease.
The condition, however, is sometimes seen in people with no other evidence of thyroid dysfunction, and occasionally in patients who have Hashimoto’s disease. Most thyroid patients, however, will not develop thyroid eye disease, and if so, only mildly. Smoking is associated with a worsening of symptoms.
Lavender And Sandalwood Essential Oils
While many people swear by using essential oils to manage the symptoms of hyperthyroidism, theres insufficient research on this claim.
Lavender and sandalwood essential oils can, for example, reduce feelings of anxiety and help you feel calm. This might help you fight nervousness and sleeplessness, both symptoms of hyperthyroidism.
Beyond that, there isnt enough research out there to suggest that essential oils could help treat hyperthyroidism.
A dietary fiber, glucomannan is found in the form of capsules, powders, and tablets. Its often derived from the root of the konjac plant.
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Treatment Of Thyroid Eye Disease
For a mild case, use lubricating eye drops and artificial tears a few times during the day. Avoid wind and bright light.
If you have severe symptoms, your healthcare provider may prescribe corticosteroids such as prednisone to reduce swelling. In a very small percentage of patients, orbital decompression surgery may be recommended.
This procedure removes the bone between the eye socket and the air sinus behind it so your eye has more room. This can improve your vision but there is a risk of double vision.
Double vision can also occur when scar tissue from the ophthalmopathy makes an eye muscle too short. Eye muscle surgery can be used to attach the muscle at a point where it will again be the correct length to provide single vision. However, more than one surgery may be needed to be successful.
Are There Any Side
Long-term treatment with steroids used in severe cases of thyroid eye disease can cause side-effects such as weight gain, diabetes and osteoporosis .
Surgery for cosmetic reasons should be carried out after the inflammation has died down in order to avoid repeated operations. There are general risks associated with surgery and anaesthesia, which should be explained by the surgeon and/or anaesthetist.
Antithyroid tablets can very rarely suppress the production of white blood cells, making the individual more open to infections. Anyone who experiences a sore throat, mouth ulcers or a high temperature whilst taking the tablets should seek medical attention immediately.
Radioiodine therapy used to treat an overactive thyroid gland can worsen thyroid eye disease so this should be avoided while the eyes are inflamed. Radioiodine is therefore only used in mild eye disease if felt necessary and is usually combined with steroid treatment to minimise the risk.
Patients should discuss any concerns with their doctor in case steroids need to be given before or after treatment.
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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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What Are The Longer
With the correct treatment, thyroid eye disease can be well managed and patients can live full and active lives. Most of the effects of the thyroid eye disease will settle with time and when thyroid function is stabilised. Patients taking carbimazole tablets to treat hyperthyroidism may need to take them daily for life, although definitive treatment of the overactive thyroid gland with radioiodine or surgery is generally preferred, once the eye disease has settled down. Regular blood tests should be carried out to monitor thyroid hormone levels and the dose of carbimazole adjusted accordingly. However, there are other treatment options such as thyroidectomy or radioiodine treatment that can be considered once the eye disease has settled down.
The changes in the physical appearance of the eyes can have a psychological effect on the individual, causing low self-esteem. The long-term consequences of the disease, even after the thyroid has settled down, may be difficult to accept. Some patients may have a permanent change to their appearance, which may require surgery. Very rarely, there is a permanent loss of vision this can happen if the disease is left untreated at the sight-threatening stage.
Patients should stop smoking as this is known to aggravate the condition. Sunglasses may be necessary even when indoors. If double vision is not corrected, driving will be dangerous. Patients should discuss any concerns with their doctor.
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Ask Your Doctor If You Should Try A Selenium Supplement
Selenium is a nutrient thats important for normal thyroid hormone production. When people with mild Graves ophthalmopathy took 100 micrograms of selenium twice a day for 6 months, their disease didnt progress as quickly as in those who took a placebo, according to a study published in the New England Journal of Medicine. They also experienced an improvement in their quality of life.
Ilya Leyngold, MD, an ocular plastic surgeon at Duke Eye Center in Durham, North Carolina, cautions that this particular study was performed in Europe, where the soil is not rich in selenium. Americans generally get enough selenium through their diet already, according to the National Institutes of Health Office of Dietary Supplements, so supplementing may not be helpful. Plus, taking too much selenium can increase the risk of skin rashes, diarrhea, and other symptoms, along with increasing the risk of developing type 2 diabetes.
The Melbourne Functional Medicine Approach To Hyperthyroidism And Graves Disease
How to fix hyperthyroidism naturally
There is a common underlying factor to each of the causes and contributors to an overactive thyroid, and that is inflammation and immune dysregulation. While simply addressing inflammation is not sufficient for treating hyperthyroidism, it is often the first step to regaining control of autoimmune disorders.
Patients often come to Melbourne Functional Medicine with an aim to get off or avoid medication and surgery. Our practitioners approach hyperthyroidism and Gravesâ disease with a more holistic, proactive, and preventative approach.
Just some of the ways our practitioners can support your journey with hyperthyroid recovery include:
Optimise nutrition: Nutrition and diet for hyperthyroidism is about much more than just eating to gain weight. The foods we eat can either help or hinder autoimmune disorders and thyroid conditions, and our practitioners work with each individual to find the right foods, and supplements, for them.
Amy Myers MD, author of The Autoimmune Solution and The Thyroid Connection recommends people with hyperthyroidism and Gravesâ disease:
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Common And Conventional Treatments For Hyperthyroidism And Graves Disease
How to treat hyperthyroidism
Early diagnosis and intervention are essential to avoid adverse effects on the heart, eyes and bone structure, which makes it important to consult with a practitioner experienced in the diagnosis and treatment of hyperthyroidism.
However, diagnosing hyperthyroidism and Gravesâ disease can sometimes be challenging.
Presentation of the symptoms described above can raise suspicion of an overactive thyroid, and several testing options are available to confirm a hyperthyroid diagnosis.
Blood tests can be used to assess thyroid hormone and antibody levels, however, this isnât always an effective method in mild cases. Imaging tests can also be used to analyse iodine uptake, including a radioactive iodine uptake test, and thyroid ultrasound.
Conventional treatments include antithyroid medication, which achieves remission within a year for 50 percent of patients. If remission isnât achieved, or a relapse occurs, a thyroidectomy or radioactive iodine treatment may be explored.
Behavior Of Go Over Time
We examined the variation of the single GO features and of NOSPECS between first and last observation. As reported in Table 2, there was a significant reduction of CAS and NOSPECS, which was confirmed even when the five patients with a CAS > 3 were excluded . Likewise, the reduction of CAS and NOSPECS were confirmed when we considered separately the 45 patients with a GO duration at first observation 12 months and, limited to CAS, also when we considered only the 20 patients with a GO duration at first observation > 12 months . Exophthalmometry, eyelid aperture, diplopia, and visual acuity did not change significantly , which was the case even when the five patients with a CAS > 3 were excluded or when we considered separately patients with GO duration at first observation of 12 months or > 12 months.
We then analyzed the overall GO outcomes at last observation, according to the criteria reported above. As reported in Table 2, compared with the first observation, at last observation 50.8% of patients had improved, 33.8% had remained stable, and 15.4% had worsened.
Behavior over time of exophthalmometry , eyelid aperture , Clinical Activity Score , visual acuity, diplopia , and NOSPECS score in 65 patients with untreated Graves’ ophthalmopathy . The number of patients at each time period is indicated.
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