Hello, I am new to the site and am hoping to get some advice from you lovely people.
I have had treatment for uveitis (inflammation of the middle layer of the eye), over the past 3 months, using Pred Forte (steroid) eye drops. The steroid drops do not seem to be working properly, my Ophthalmologist said that I might have an underlying autoimmune disease that is causing the on-going uveitis.
Having just been told I have hypothyroidism, I wonder whether this might be causing an autoimmune issue or unbalance and is this a reason for the uveitis not responding to treatment?
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GeorgieandBlu
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There is some linkage, in that individuals with autoimmune-based hypothyroidism are twice as likely to get uveitis. a useful commentary is below (downloadable)
Presumably you have been started on Levothyroxine?
Standard starter dose is 50mcg. Bloods should be retested 6-8 weeks after each dose increase in Levothyroxine
For full Thyroid evaluation you need TSH, FT4 and FT3 plus both TPO and TG thyroid antibodies tested.
Also EXTREMELY important to test vitamin D, folate, ferritin and B12
Low vitamin levels are extremely common, especially if you have autoimmune thyroid disease (Hashimoto's) diagnosed by raised Thyroid antibodies
Ask GP to test vitamin levels and antibodies if not been done yet
Recommended on here that all thyroid blood tests should ideally be done as early as possible in morning and before eating or drinking anything other than water .
Last dose of Levothyroxine 24 hours prior to blood test. (taking delayed dose immediately after blood draw).
This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip, best not mentioned to GP or phlebotomist)
Private tests are available. Thousands on here forced to do this as NHS often refuses to test FT3 or antibodies or all vitamins
Medichecks Thyroid plus ultra vitamin or Blue Horizon Thyroid plus eleven are the most popular choice. DIY finger prick test or option to pay extra for private blood draw. Both companies often have special offers, Medichecks usually have offers on Thursdays, Blue Horizon its more random
If antibodies are high this is Hashimoto's, (also known by medics here in UK more commonly as autoimmune thyroid disease).
About 90% of all primary hypothyroidism in Uk is due to Hashimoto's.
I had previously requested a full blood analysis because of the on-going issues with my uveitis, joint pain etc and this is where my doctor was able to see that my thyroid wasn't working properly. He put me onto Levothyroxine 50 micrograms once per day. I can't say that I have noticed any changes or side effects, in time I am sure.
I will of course contact my GP and discuss having the above tests done and see whether it is possible to have these done on the NHS, as I am a student at present and funds are incredibly low.
It is interesting to note that 90% of cases in the UK are due to Hashimoto disease, I wonder why this is the case?
Thank you again. This has been most useful and gives me an opportunity to delve into this subject and make the necessary adjustments to further improve my health.
The aim of Levothyroxine is to increase the dose slowly in 25mcg steps upwards until TSH is under 2 (many need TSH significantly under one) and most important is that FT4 in top third of range and FT3 at least half way in range
NHS guidelines on Levothyroxine including that most patients eventually need somewhere between 100mcg and 200mcg Levothyroxine.
I don't know, but believe I was undiagnosed hypothyroid for very many years, but after being assaulted by a work colleague in 2003, I was diagnosed with Graves Disease, an overactive thyroid and treated in 2005 with RAI and now manage Graves, thyroid eye disease and hypothyroidism.
Looking back, in my 40's in 1990's I was diagnosed with iritis, by Moorfields Hospital.
I was told I had tears and holes in both retinas and ultimately had to have laser treatment in both eyes. I have an open appointment should I ever need to go back, and experienced a few " flares " over the next 10 years which were treated with steroid drops.
Moorfields couldn't give me an explanation as to what caused my original issues. I was living with extreme bouts lower backache and sciatica and " inflammation on the spine " was then offered as a possible cause.
I tend to think that maybe there is some correlation :
Thank you for sharing. It is always interesting to reflect on what was going on at the point when you had a uveitis flare up. I think unless an individual has bloods investigated to cover all possibilities, it is difficult to know exactly what is setting things off.
I think when you are ill and in shock you trust the hospital do all they can to help you, and true to form my initially symptoms were relieved by the laser treatment.
It was a scary time, and though I asked several different consultants I saw over that period in my life, at 3 and then 6 monthly check ups, no one had any real answer as to why it had happened, and just as importantly, no suggestions were offered as to what I could do in the future to safe guard myself from another attack.
Sounds all a bit of a coincidence to me : since the auto immune aspect of thyroid disease, either Graves or Hashimoto's isn't understood by the NHS, and the treatment options aren't there.
With numerous individuals suffering with these conditions, you would think that more health professionals would be able to offer some assistance or advice. 🙄
Well, yes, since when you are ill, you are generally on the back foot, and , in the first instance rely on the medical professionals for help.
Who would have thought that I would have to become my own doctor in my late 60's, some 4 years ago.
Being dyslexic was difficult enough but then after RAI - which I deeply regret - for the Graves Disease and the resultant thyroid eye disease and hypothyroidism, as well as lingering Graves symptoms, it's been quite a journey.
I'm now self medicating and buying my own thyroid hormone replacement, staying away from the doctor and getting my life back, as best I can, thanks to this amazing website and a couple of books.
I had severe postpartum thyroiditis caused by a massive autoimmune attack in June 2017. Ten weeks later I had eye involvement, it was mild uveitis and went on steroid drops. I still have mild mild trace inflammatory cells in my eyes now but its not enough to for the doctor to treat it. I've been seeing an ophthalmologist on and off for two years since. Everyone seems baffled, but I have systemic symptoms that have never resolved, so I know there's more to the story. My eye doctor said uveitis is more connected with RA Lupus and AS but I don't seem to have those, yet I do have a positive ANA. I do have hashimoto's, but I'm now medicated and I still have body aches, eye discomfort/tightness and grittiness and eyelid swelling. I can't seems to get anyone to give me a firm explanation.
There does seem to be a link in your case. It is unfortunate that the specialists are unable to come to a conclusive answer in resolving your health issues. I wish you luck, in your continuing fight to getting your health in a more manageable state.
I have been given the details of a DNA nutritional specialist, near Reading, who might be able to help. Fingers crossed.
I have asked about psoriatic arthritis but the rheumatologist is not even considering it. I am now on a paleo diet to see if this will help or alleviate any of my conditions. I constantly feel like I’m bashing my head against a brick wall.
Getting diagnosed with psoriatic arthritis took many years because it comes down to symptoms and lots of X-rays of joints and getting a rheumatologist that is a psoriatic arthritis specialist, most rheumatologist don’t seem to know much when it comes to PSA .
If it wasn’t for my Rheumatologist I might be in a wheel chair today!
I have had bloods taken, my doctor won’t give me the results although he said they were within normal ranges and I could stay on 50mg of the Levo. My vitamin d came back normal although the nutritionist I am seeing said it was very low! I give up, one person says one thing and another says something different.
My eye specialist wants me to consider immunosuppressants because my steroid drops are not having the desired effect. I am looking into this, as immunosuppressants can have devastating effects on other parts of the body.
Normal is an opinion and not a result ! How low is low ? Your VitD needs to be around 100+. VitD is a steroidal anti-inflammatory pro-hormone - so much more than a vitamin. An optimal level may even help your eyes.
I would also check B12 - Folate and Ferritin. Low B12 can affect the optic nerve. I have issues so have done my reading - sigh.
You do not have to involve your GP for your results - ring Reception to request them for the last year and say you will be along in a few days to collect. No reason need be given. Also check if your surgery has on-line access to view records. Take ID. Start a Wellness File and write your own notes on your results pages 🥰
Pred Forte is a strong medicine to be on for 3 months. Unless necessary, the suggested time is 10 days. medicines.org.uk/emc/produc... Could your doctor suggest an alternative?
My experience with drops taken for eye inflammation was when I had a filtration surgery on my eye to reduce eye pressure. I was taking Tobradex, a corticosteroid. The longer I took the drop, the more irritated my eye was and I also experienced systemic effects (low pressure). This is a common rebound effect with this category of drops.
I was switched to B-12 eye drops, used in France as a complementary treatment for corneal healing problems. Within a week I had less redness and no side effects.
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