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Your Guide to Thyroid Eye Disease

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Risk Factors of Thyroid Eye Disease

Medically Reviewed By Leela Raju, MD

As many as half of people with Graves' disease develop thyroid eye disease.

Risk factors for thyroid eye disease (TED) include smoking, some health conditions, and undergoing radioiodine therapy. Self-care and addressing the risks may lower the chance of TED. Some factors may increase the risk of TED, but being aware of your risk and seeking treatment can help protect your eye health.

Read on to learn about TED risk factors and how to address them.

What are the risk factors for thyroid eye disease (TED)?

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Having risk factors does not mean you will develop TED, but they raise your overall likelihood of the condition.

Smoking

Studies say smoking may be the most significant Trusted Source PubMed Central Highly respected database from the National Institutes of Health Go to source risk factor for TED. Having previously smoked cigarettes may also increase the risk of TED. Avoiding or quitting smoking could still reduce the chances of TED, protect your eyes, and support your general health.

Speak with a doctor if you need help quitting smoking. They can recommend smoking cessation programs and other supportive resources.

Learn about treatment options and support for quitting smoking.

Underlying health conditions

Conditions that affect immune function may also increase the risk of TED, such as:

  • diabetes
  • autoimmune conditions Trusted Source PubMed Central Highly respected database from the National Institutes of Health Go to source , such as:
    • rheumatoid arthritis
    • vitiligo
    • psoriasis
    • celiac disease
    • Sjögren disease
    • Crohn’s disease
    • lupus
    • multiple sclerosis

Working with your medical team and following their recommendations may help reduce the risk of TED as a complication. Also, regular eye checkups can detect TED before it damages the eyes.

Radioiodine therapy

Radioiodine or radioactive iodine therapy can help treat hyperthyroidism and thyroid cancer. However, radioiodine therapy may increase Trusted Source PubMed Central Highly respected database from the National Institutes of Health Go to source the chances of TED.

Steroid medication treatment may help prevent TED linked to radioiodine therapy.

If you’ve had or are going to have radioiodine therapy, talk with your medical team about preventing side effects.

See more about radioiodine therapy, including its procedure and effects.

High cholesterol

High total cholesterol levels and high levels of low-density lipoprotein (LDL), or “bad” cholesterol, may increase the risk of TED. However, statins and other treatments for high cholesterol may reduce the risk.

Learn more about how to treat high cholesterol.

Genetics

Some people may have a genetic mutation that increases the likelihood of TED. The condition also appears to by hereditary.

Genetic predisposition is an unmodifiable risk factor, so you cannot change it. However, knowing and managing your other risk factors can help reduce your overall risk.

If a close biological relative has had TED or another eye condition, let your doctor know. They may recommend more regular eye checkups to protect your health.

Sex assigned at birth

People assigned female at birth may be more likely to develop TED, whereas people assigned male at birth may be more likely to have severe TED and may need more treatment.

On average, males may develop TED at an older age than females, according to a 2020 review Trusted Source PubMed Central Highly respected database from the National Institutes of Health Go to source . Researchers are working to confirm these differences and understand what may cause them.

One possible explanation for TED being more frequent in females is that the estrogen hormone may contribute to TED development.

Who gets thyroid eye disease (TED)?

TED usually develops in people who have conditions that cause the thyroid gland to overproduce thyroid hormone, known as hyperthyroidism.

The most common cause of TED due to hyperthyroidism is Graves’ disease. As a result, TED is also called:

  • Graves’ ophthalmology
  • Graves’ eye disease
  • Graves’ orbitopathy

However, less often, TED can occur in people who:

  • used to but no longer have hyperthyroidism
  • have hypothyroidism: The thyroid gland doesn’t produce enough thyroid hormone
  • have typical Trusted Source PubMed Central Highly respected database from the National Institutes of Health Go to source thyroid hormone levels

Read more about hyperthyroidism and hypothyroidism, including their causes, symptoms, and effects.

You may be more likely to develop TED with a thyroid condition if you do not receive treatment. Similarly, following your medical team’s treatment recommendations may help reduce the risks of TED.

Still, not everyone with a history of a thyroid condition will develop TED.

What age does thyroid eye disease (TED) start?

According to a 2017 review, TED often develops between the ages of 30 and 50 years Trusted Source PubMed Central Highly respected database from the National Institutes of Health Go to source . However, TED could occur at a younger or older age.

Summary

Graves’ disease may be one of the most common causes of TED. However, other conditions can contribute to its development.

Other risk factors for thyroid eye disease (TED) include:

  • smoking
  • conditions that affect immune function, such as diabetes
  • radioiodine therapy
  • high cholesterol levels
  • family history of TED

Many TED risk factors can be improved with treatment and self-care. Talk with a doctor for personalized advice about TED risk and how to protect your health.

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Medical Reviewer: Leela Raju, MD
Last Review Date: 2024 Mar 13
View All Your Guide to Thyroid Eye Disease Articles
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