In Australia, May marks Thyroid Awareness Month and according to the Australian Thyroid Foundation, well over one million Aussies are living with an undiagnosed thyroid disorder.
Around 14 percent of middle-aged and older Australians will suffer from a clinically relevant thyroid disorder and women around 10 times more likely to be affected than men, although when men are affected it tends to have a worse prognosis.
What role does the thyroid gland play?
Regulating metabolism, growth and development in the body, the thyroid gland produces hormones, primarily thyroxine (T4) and triiodothyronine (T3), which control various bodily functions such as heart function, brain development, muscle control, bone health, reproductive health, cholesterol levels and digestive function.
What happens when you have a thyroid disorder?
Thyroid disorders occur when the thyroid gland produces too much or too little thyroid hormone, leading to various symptoms and health issues. These disorders include:
- Hypothyroidism (insufficient hormone production)
- Hyperthyroidism (excessive hormone production)
- Thyroid nodules (lumps or growths, mostly benign)
- Thyroiditis (inflammation of the thyroid gland)
- Thyroid cancer (relatively rare)
Symptoms of thyroid disorders
Hypothyroidism: fatigue, weight gain, cold intolerance, constipation, dry skin, hair loss, depression and cognitive impairment
Hyperthyroidism: weight loss, rapid heartbeat (tachycardia), heat intolerance, sweating, tremors, anxiety, irritability, insomnia and frequent bowel movements
Thyroid nodules: may lead to symptoms such as difficulty swallowing, neck swelling or changes in voice quality
Thyroiditis: neck pain, swelling, fever, fatigue and thyroid dysfunction (either hyperthyroidism or hypothyroidism)
Thyroid cancer: lump or swelling in the neck, hoarseness, difficulty swallowing and enlarged lymph nodes
How can a thyroid disorder affect eye health?
Graves' disease, an autoimmune disorder, is the most common cause of hyperthyroidism.
In individuals with Graves' disease, the immune system mistakenly attacks the thyroid gland, causing it to produce excessive amounts of thyroid hormones.
While Graves' disease primarily affects the thyroid gland, it can also have significant implications for eye health. Approximately 30 percent of individuals with Graves' disease experience eye-related symptoms, a condition known as Graves' ophthalmopathy or thyroid eye disease (TED).
What happens when you have thyroid eye disease?
TED occurs when the immune system attacks the tissues surrounding the eyes, leading to inflammation and swelling. This inflammation can cause a range of eye-related symptoms.
- Proptosis (eye bulging) is of the most noticeable symptoms of TED, causing the eyes to protrude from their sockets. This bulging can be cosmetically distressing and can lead to discomfort, dryness and irritation. Difficulty in blinking or closing the bulging eyes can cause redness, tearing and a sensation of grittiness or foreign body sensation
- Affecting the alignment of the eyes, TED can lead to double vision. This occurs when the muscles that control eye movement are affected by inflammation
How is TED managed?
Managing TED requires a multidisciplinary approach involving endocrinologists, optometrists and ophthalmologists. Treatment aims to address both the underlying hyperthyroidism and the eye-related symptoms.
Eye-related symptoms of TED can be managed through various approaches, including lubricating eye drops and other strategies to relieve dryness, spectacles prescribed with prism to alleviate double vision, corticosteroids to reduce inflammation and, in some cases, orbital decompression surgery to alleviate pressure on the eyes.
Those with Graves' disease should also undergo regular eye examinations to monitor any changes in eye health and adjust treatment as needed. Early detection and intervention can help prevent complications and preserve vision. Cigarette smoking greatly exacerbates thyroid eye disease, so quitting smoking is crucial.
If you or someone you know is experiencing symptoms of Graves' disease or thyroid eye disease, it's essential to seek medical attention promptly. With timely intervention and appropriate management, individuals with Graves' disease can effectively manage their thyroid and eye health.
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