Eye issues related to hypothyroidism

[Phoenix_24]

Hi all,

I was diagnosed with hypothyroidism in January of this year and started on 50mg levothyroxine. I’m having bloods every six weeks and working on my iron, vitamin D levels, folate and selenium. I’ll add my test results at the end for info.

Overall I am feeling much better but I developed eye pain a couple of weeks ago, it started with intense itching so I thought I had conjunctivitis or maybe allergies though my hayfever doesn’t usually cause me eye symptoms. The itching only lasted a day and then I woke up with eye pain, mostly in the outer corners of my eyes and behind my eyes with the left eye worse than the right. The pain was exacerbated by moving my eyes in any direction. My eyes were not red or waterin. After 3 days of this pain I went to the optician and requested an eye test with an OCT scan.

The tests showed nothing obviously wrong except for extremely dry eyes. However I have had dry eyes for 4 years without this pain so I wasn’t convinced that was the cause but the prescribed more eye drops.

Just as I was about to leave the optician called me back and asked me to look at a grid (Amsler grid) with one eye at a time and focus on the got in the middle. Some of the lines looked distorted and blurry and the optician asked me to repeat the test several times to be sure. She said I am too young at 44 but it could be a sign of macular degeneration and has referred me to an ophthalmologist. I have an appointment in April.

After the initial anxiety I have calmed down and realise it could be due to other things too and even if it is AMD it’s probably at an early stage as I have no distortion when looking through both eyes.

The distortion on the grid and my eye pain are not directly related but I am wondering if one, the other or both could be due to my thyroid condition?

I know TED is related to hyperthyroidism but does hypo cause eye problems other than dry, puffy eyes and under eye bags?

do thyroid eye problems show up on OCT scans? Just don’t understand why if it’s such an advanced test it showed nothing wrong and yet I seem to have dry eyes, pain and distortion.

please share your experiences and wisdom and thank you for reading my rather long story.

July 2023

TSH 0.43 miu/L (0.27-4.2)

T4 not tested

January 2024

Serum TSH level 65.7 miu/L [0.27 - 4.2];

-Serum free T4 level 6.9 pmol/L [10.5 -22];

Thyroid peroxidase Ab <28iu/mL (0-60)

Tissue transglutaminase IgA, 0.6 u/mL

(0-6.9)

February 2024

Serum TSH 4.01 muy/L [0.27-4.2];

Serum T4 level [17.2 pmol/L [10.5-22]

I am on 50mg levothyroxine ( I am 5ft tall and 54kg) and last dose before final tests was 24h before- I followed the protocol. Test was done at 8:15 am fasted.

[PurpleNails Administrator]

You need FT3 tested.

TPO is negative, has TG antibodies ever been tested?

TED does occur with under active thyroid & in those without thyroid function issues & without presence of positive antibodies.

Diagnosis & treatment can be extremely poor.

If professionals dispute potential of TED show them the articles / information in this post.

healthunlocked.com/thyroidu....

[Phoenix_24 in reply to PurpleNails]

thank you for the information that is really helpful.

My TG antibodies have not been tested and the gp won’t test them. She consulted the endocrinologist who said it’s likely autoimmune because there is family history and I had a mild case of vitiligo as a child.

I plan to do a full thyroid panel privately at some point but will probably wait until I’m not Hank g blood tests which the NHS every six weeks.

[Buddy195 Administrator]

Most people who develop TED have an overactive thyroid and Grave’s Disease, whereas some have it with an under active thyroid/ Hashimotos (like myself) and a few have it who are euthyroid (no thyroid condition).

Having optimal thyroid medication & key thyroid vitamins is very important. My eyes improved considerably when this was achieved.

I recommend you take a Selenium supplement, 200ug daily, as this has showed to help in mild/ moderate TED when taken in the first 6 months. Many take a maintenance dose of 100ug daily when the active phase of the condition has passed. Preservative free lubricating eye drops are important, such as HycoSan or Hyloforte. For light sensitivity wear sunglasses (even indoors if needed). If you have any eye pain, my TED ophthalmologist said to take ibuprofen (with food to protect your stomach). Also worth doing is using 2 pillows at night, to elevate your head.

Above all, please don’t overdo it on Google images, as they show ‘worst case’ scenarios.

I also have an (unrelated) retina issue in one eye. This has improved over time and I take lutein & zeazanthin supplements for overall eye health.

Keep posting if you have further questions!

[Phoenix_24 in reply to Buddy195]

Thank you for the info and the tips. I use hycosan dual as recommended by the optician and have been eating a few Brazil nuts a day for selenium but will look into getting a supplement instead.

[Buddy195 Administrator in reply to Phoenix_24]

Do take care with Brazils as they can contain 50-90ug selenium per nut.

[Batty1]

I have been thyroid-less for 7 yrs now and have been experiencing eye issues for 2 years … Pain behind my eyes, dry eyes, vision disturbances and currently vision that bounces when I walk and unable to walk in the dark or drive in the dark anymore …. Seeing a Neuro- Ophthalmologist in May and hoping this person can stop the bouncing vision …. Eye exam showed nothing as usual …. I have constant issues and test never reveal anything until Im so broken I can’t be fixed ….. its sad !

[Phoenix_24 in reply to Batty1]

That sounds awful, I hope the neuro ophthalmologist can help you. It’s awful when they say there’s nothing wrong and clearly there is something going on.

[Batty1 in reply to Phoenix_24]

Yes, it is awful and what’s even worse is I never had this many issues until I had thyroid problems …. Doctors just can’t connect the dots.

[Phoenix_24 in reply to Batty1]

yes I have always been healthy and didn’t have any issues until hypo, now I feel like everything is breaking.