Vitiligo and Thyroid Eye Disease: 5 Facts To Know | MyVitiligoTeam

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Vitiligo and Thyroid Eye Disease: 5 Facts To Know

Medically reviewed by Paul B. Griggs, M.D.
Posted on June 20, 2024

Members of MyVitiligoTeam have shared concerns about their eyes. “I’m experiencing severe dry eye symptoms, including swelling and watery eyes with any amount of ultraviolet exposure, even with eye protection. It has changed my life significantly,” said one member.

In some cases, eye problems are related to an underlying thyroid disease, known as thyroid eye disease (TED). Health experts recommend testing people with vitiligo for thyroid diseases because the two conditions can often happen at the same time. Specifically, autoimmune thyroid diseases, like Graves’ disease, share certain risk factors with vitiligo.

If you have a thyroid problem or notice changes to your eyes, here are some key facts to keep in mind about the relationship between vitiligo and TED.

1. People With Vitiligo May Have Other Autoimmune Conditions

An estimated 15 percent to 25 percent of people with vitiligo also have another autoimmune disorder, including autoimmune thyroid disease. Other autoimmune diseases that can occur with vitiligo include type 1 diabetes, psoriasis, and pernicious anemia.

Graves’ disease is an autoimmune thyroid condition that commonly causes TED. Graves’ disease causes the thyroid gland to produce too much thyroid hormone, a condition called hyperthyroidism.

Around 1 in every 3 people with Graves’ disease develops eye symptoms, usually within the first year of being diagnosed. People with low or normal thyroid hormone levels can also develop TED, but it’s rare.

Members of MyVitiligoTeam have shared that they developed Graves’ disease either before or after vitiligo. “I was treated for Graves’ disease in the mid-1970s. My vitiligo started in the late 1990s,” explained one member.

There’s also evidence that the overall incidence of autoimmune disorders tends to run in families. If possible, learn as much as you can about your family history. Sharing this information with your health care provider can give them valuable insights into your unique health risks.

2. Certain Factors Increase Your Risk of TED

Certain factors, such as your lifestyle and environment, can act as triggers for TED. Your genetic makeup may increase your susceptibility to the impact of triggers.

For example, potential triggers for TED include:

  • A history of radioactive iodine therapy (to treat hyperthyroidism)
  • Other autoimmune diseases, like systemic lupus erythematosus (the most common form of lupus) or rheumatoid arthritis
  • Selenium (a type of mineral) deficiency
  • Smoking
  • Vitamin D deficiency

There is evidence that the prevalence of autoimmune thyroid disorders goes up in older people with vitiligo. It’s essential to be more watchful for new symptoms in case a comorbidity (another condition) like TED develops.

There’s no guaranteed way to prevent TED. But although you don’t have control over all of your risk factors, changing the ones you can control (like smoking) gives you the best chances of avoiding more health problems.

3. Graves’ Disease Can Sometimes Have Skin Symptoms

Occasionally, people develop what’s called “Graves’ dermopathy,” skin that becomes thick and reddened, especially on the top of the foot or the shin. More common Graves’ symptoms include:

  • An enlarged thyroid gland
  • Changes in menstrual cycles, libido (sex drive), or the ability to get an erection
  • Increased fatigue, anxiety, or irritability
  • Heart palpitations
  • Tremors in the hands and/or fingers
  • New or increased problems sleeping
  • Increased sensitivity to heat or increased sweating
  • Weight loss without trying
  • More frequent bowel movements

If you have Graves’ disease, you should be on the lookout for TED symptoms, including:

  • Bulging eyes
  • Red or inflamed eyes
  • Eye pain or pressure
  • A gritty sensation, or the feeling that there’s something in your eye
  • Eyelid changes, like puffing up or retracting
  • Vision changes like seeing double
  • Increased sensitivity to light
  • Inability to close your eyes all the way
  • Difficulty moving your eye around in its socket

4. There Are Treatments for Graves’ Disease and TED

Treating Graves’ disease involves stopping the thyroid from producing too many hormones or blocking those hormones from affecting the body. Some possible treatment options include:

  • Antithyroid medications to stop the production of too much thyroid hormone
  • Radioactive iodine therapy to stop the production of too much thyroid hormone (may not be appropriate if you have TED symptoms)
  • Beta-blockers to lessen the impact of hormones on the body
  • Surgery to remove the thyroid gland

Treating your overactive thyroid may not improve your eye symptoms. However, not everyone with TED needs treatment. For some people, symptoms are mild and go away with time.

In more severe cases, surgery or medication can help treat TED. Your doctor may recommend corticosteroids or a medication called teprotumumab (Tepezza).

Nonmedication remedies can also help alleviate certain TED symptoms. These may include:

  • Applying a cold compress
  • Elevating your head when resting
  • Taping eyelids shut when sleeping
  • Using an eye patch or prism glasses for double vision
  • Wearing sunglasses

5. Self-Esteem May Be Affected

For some people, the hardest aspect of vitiligo and TED is how they affect the way you look and see yourself. Both can alter your appearance in different ways, with vitiligo affecting skin pigment and TED changing the appearance of your eyes. If you feel self-conscious about these changes, they can take a toll on your mental health and well-being. These feelings can have an impact on different aspects of life, including your personal relationships, job, and experience with the outside world.

Connecting with people who face similar challenges can help you feel less alone. On MyVitiligoTeam, members talk about getting diagnosed, the symptoms they experience, and how their condition affects their daily lives. One member wrote, “Please don’t leave out the daily mental battlefield and the fact that living with vitiligo changes your way of living, dressing, etc. For those who don’t have it, we appreciate the kind words and help, but walking in our shoes is not an easy task!”

Mental health care professionals can also play a vital role in helping you manage life with vitiligo. They can help teach you coping strategies to keep stress down and deal with other potential challenges, like TED. Ask your doctor for a referral to someone who can help support you on your journey.

Talk With Others Who Understand

On MyVitiligoTeam, the social network for people with vitiligo and their loved ones, more than 13,000 members come together to ask questions, give advice, and share their stories with others who understand life with vitiligo.

Have you experienced changes in thyroid function along with vitiligo? If so, has thyroid dysfunction led to changes to your eyes or eyesight? Share your experience in the comments below, or start a conversation by posting on your Activities page.

Posted on June 20, 2024
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Paul B. Griggs, M.D. is certified by the American Board of Ophthalmology. Learn more about him here.
Anastasia Climan, RDN, CDN is a dietitian with over 10 years of experience in public health and medical writing. Learn more about her here.

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