Ocular motility - is there any link with hypothyroidism?

[AmandaK]

Hi everyone,

I've just returned from an eye test during which I mentioned that I've been referred to an endocrinologist who will carry out thyroid tests. The optician decided to do an ocular motility test. She found an anomaly and wants me to mention it to the endo.

However, an Internet search only links such a problem with Graves/hyperthyroidism, yet my symptoms are related to hypothyroidism (incidentally, as related in other posts, I've never had a formal diagnosis; recent tests ordered by my liver consultant have shown TSH and FT4 to be within range and the lab of this particular hospital refused to test FT3. However, the consultant was happy to refer me to an endo at another hospital and I know that the full range of thyroid tests are done there).

But I'm now very confused that I seem to have a symptom that suggests the opposite of hypothyroidism!

Could someone enlighten me please? Many thanks.

Amanda

[helvella]

Graves disease, as in the production of thyroid receptor antibodies that stimulate the thyroid to over-produce thyroid hormone is one thing. Graves Eye Disease/Graves Orbitopathy/Graves Ophthalmopathy/Thyroid Eye Disease is another thing.

That the two are intertwined to a remarkable degree, that the same antibodies appear to be causative, etc. does not, at the end,make them the same thing. Unfortunately it is often assumed that they are the same, or that you cannot have TED unless you are also hyperthyroid. It is clear that there are cases in people who are hypothyroid, and in people who have no identifiable issue with thyroid hormone levels.

Sorry to dump a raw search on you, but try this link:

ncbi.nlm.nih.gov/pubmed/?te...

tinyurl.com/TUK-HU-TED1

You might find something of use/interest.

Rod

[AmandaK in reply to helvella]

Many thanks Rod, I've had a quick skim over the pubmed articles and there does seem to be some evidence there. Will take a more leisurely look shortly.

[HarryE in reply to AmandaK]

I have had loads of eye problems and am a patient at a specialist eye Hosp. I am going for a checkup on Weds so I'll ask too. I am hypo & have very swollen eyelids & sore eyes, both of which I didn't have prior to thyroid issue. Will let you know what they say

[AmandaK in reply to HarryE]

That's great - much appreciated.

[Fruitandnutcase]

Many years ago I was tested (more than once!) for being under active and I remember my doctor saying that I wasn't under active, that in fact I was borderline over active. I should have seen that as a warning but I didn't. Many years on I now have full blown Graves so although I looked under active for a while I obviously wasn't.

My eyes felt terrible for quite a while before I was found to have Graves. I used to get what felt like stiff, aching muscles plus blurred vision when watching TV or reading for too long, my eyes were incredibly dry too, so dry they watered a lot and stung.

Interestingly enough the consultants I have seen all look at me and say ' your eyes are fine' what they mean is they look fine, they do but inside they feel awful. I think they say that because they have radio active iodine in mind if the block and replace treatment they use doesn't work and TED complicates that.

Even though you are 'within range' you might not be at your optimal point so don't be fobbed off with 'within range' if you still feel ill. Try to get a print out of your blood test results with the lab ranges used or at least ask what the results are and write them down. Also if you smoke you should try and stop because that is very bad for people with TED.

[AmandaK in reply to Fruitandnutcase]

Your story goes to show how complicated it all is! I've actually provided my results and ranges in an earlier post; I didn't want to repeat it here, although suffice to say that when they were redone recently the TSH and FT4 were nearer the middle of the range than the ones I posted. Having said this, the test was carried out late afternoon, so not the optimal time. When I see the endo I'll make sure the bloods are drawn in the morning.

[Fruitandnutcase in reply to AmandaK]

I was lucky , I always had mine taken first thing in the morning - more by accident than design though.

[AmandaK in reply to Fruitandnutcase]

Hi I've just come across a case which sounds similar to yours: tinyurl.com/nmwfn4l though here the person developed primary hypothyroidism (having been sub-clinical hypothyroid). It does seem a rare case though.

[Fruitandnutcase in reply to AmandaK]

Interesting isn't it. Not sure I know what it means when you see people are sub-clinical hypothyroid or even sub-clinical hyperthyroid.

[AmandaK]

Many thanks for this - in fact I found out today that my paternal aunt had exactly the same - bulging eyes, goitre, yet severely overweight, which suggests thyroid resistance. How strange!