Lupus and Thyroid Eye Disease

Getting a diagnosis of an autoimmune disease like thyroid eye disease (TED) can leave you with some unanswered questions. Your doctor will likely tell you that the disease does not have a cure but is manageable. However, you may not have been told that having 1 autoimmune disease, such as TED, raises your chance of developing another.¹

It is hard for doctors to know how many autoimmune diseases may be linked. Because TED and other autoimmune diseases might be misdiagnosed or take longer to identify, certain illnesses can go undetected. However, doctors have found that some conditions occur more often in those with TED.²

Lupus can increase the risk of thyroid problems. Understanding autoimmune conditions like lupus or TED is still largely a mystery. However, knowing what each of these conditions is, along with possible reasons for their connection, can help you better understand symptoms and possible treatment options for both.³

What is TED?

Like lupus, TED is an autoimmune condition. Also like lupus, symptoms of TED result from the body's immune system attacking itself. In TED, healthy tissues of the eye are attacked and cause symptoms of the disease. These symptoms greatly vary from person to person, with some having mild signs and others having severe impairment.²

Swelling and irritation of the fat, muscles, and tissues behind and around the eye lead to symptoms, such as:²

• Redness and irritation
• Swelling and misalignment of the eyes
• Watery or dry eyes
• Eye bulging from the socket
• Eyelids not closing fully
• Vision problems, like blurred or double vision

Most people with TED have an overactive thyroid gland (hyperthyroidism). Some people with TED may have an underactive thyroid (hypothyroidism). TED can even occur in those with a normal-functioning thyroid (euthyroid). However, this only happens in about 1 out of every 100 people with TED.⁵

The most common cause of hyperthyroidism is Graves' disease, which is another autoimmune condition. Graves' disease damages healthy tissue in the thyroid, causing thyroid problems. Up to half of those with TED also have Graves' disease. However, it is important to understand that 1 disease does not cause the other. TED and Graves' are separate conditions and have different treatments.^6,7

Understanding autoimmune disease

The exact cause of different autoimmune disorders remains unknown. However, doctors do know that the body's immune system mistakenly attacks itself. Inflammation, swelling, and pain are common among autoimmune disorders. Where symptoms occur depends on the target of the body’s attack.¹

Many factors likely contribute to developing autoimmune disease. Your genes, immune system, and your environment all play a role.¹

What you need to know about lupus and TED

Lupus can increase your chances of having thyroid problems, which can lead to TED. Lupus, Graves' disease, and TED are all autoimmune conditions. Having 1 of these diseases may increase your chance of having another. However, this is not always the case.¹

People who have been diagnosed with lupus should be aware of the symptoms of thyroid disease, such as:⁸

• Unexplained weight loss or gain
• Joint pain
• Fatigue
• Hair loss
• Dry skin

Many of these symptoms may overlap lupus symptoms. This can make diagnosing thyroid problems difficult. Keeping track of your symptoms and talking to your doctor about them can help.⁸

If you have lupus and have been diagnosed with a thyroid disorder, you should be aware of TED. If you notice any eye symptoms that are out of the ordinary or that cause irritation, talk to your doctor. Because TED can have a gradual onset, you and those who see you every day may not notice your symptoms.

Living with autoimmune diseases can be challenging. It is important to remember that both lupus and TED can be managed with different treatments. If you notice symptoms of TED, talk to your care team. Your doctor can help you find the best treatment for both lupus and TED. Partnering with your doctor can help you best prepare to face these challenges and live a happy and productive life.