Although there’s no cure for thyroid eye disease (TED), effective treatments and lifestyle changes can help you manage symptoms, such as double vision, eye pain, and dry, irritated eyes. These measures can also help reduce inflammation, slow disease progression, help preserve your vision, and protect your quality of life.
Here are some strategies you’ll want to have on your radar as you manage TED:
1. Quit Smoking
If you’re a smoker, kicking the habit should be the first thing on your to-do list. “Smoking is the only real modifiable risk factor that patients have control over,” says Allison Coombs, DO, director of oculofacial plastic, reconstructive, and orbital surgery at Manhattan Eye, Ear & Throat Hospital in New York City. Smoking causes tissue to be ischemic, meaning it doesn’t receive enough oxygen, due to impaired blood flow. This makes the disease more severe, she explains.
Don’t assume it’s okay if you’re smoking something other than cigarettes. You also need to avoid vaping. And do your best to stay away from secondhand smoke.
2. Stick to Your Treatment Plan
If you’ve been prescribed thyroid medication, take it as directed by your doctor. Keeping thyroid numbers within a certain range helps keep symptoms under control, says Dr. Coombs. There are also many treatment options, such as steroids, that can help dial down symptoms. “Steroids can be given in eye-drop form, via high-dose oral steroids, or even through an IV,” she says. “These don’t really change the course of the disease or the duration, but they help with symptoms.”
Another treatment option is orbital radiotherapy, which your doctor might recommend along with high-dose steroids to reduce disease activity and prevent TED from getting worse.
3. Eat Healthy
An anti-inflammatory eating plan, such as a Mediterranean diet, can be beneficial when you’re dealing with thyroid eye disease. This diet focuses on eating whole foods and avoiding processed foods and drinks, such as commercial baked goods, deep-fried foods, processed meat, and soda, which contribute to inflammation. “Patients who are really strict with adhering to an anti-inflammatory diet tend to have less severe disease,” says Coombs, who also notes that it can help lower cholesterol, which is associated with TED. She also recommends eliminating alcohol from your diet.
To find the best way to adapt an anti-inflammatory diet to your life, try meeting with a nutritionist for a session or two to help you strategize the best food choices.
4. Ask About Your Selenium Levels
This mineral may not be on your radar, but it’s essential in making thyroid hormones and could have an effect on the disease. Research has shown lower levels of selenium may be linked to higher severity of thyroid eye disease. For this reason, Coombs has her patients with mild-to-moderate TED take a selenium supplement. Talk with your doctor about whether this should be part of your treatment plan.
5. Manage Stress
While it’s not clear if emotional stress can trigger the development of a thyroid disease, it can worsen symptoms. And because thyroid eye disease can increase your risk of anxiety and depression, it’s a good idea to have strategies in place to help deal with stress.
Coombs recommends consulting a mental health professional and regularly engaging in activities that calm you, such as meditation or yoga.
6. Wear Sunglasses
If you have severe TED symptoms, such as bulging eyes or eyelids that don’t close all the way, shades are crucial. “You should be wearing sunglasses outside from a safety perspective,” says Coombs. “You can’t protect your eyeballs if your eyelids don’t close completely.” If symptoms are mild, you don’t necessarily have to wear sunglasses, but Coombs says it’s a good idea, because they can reduce your risk of skin and intraocular cancers.
7. Choose Your Medical Team Carefully
“Self-advocacy is essential, and it’s so important to find an interdisciplinary team you like,” says Coombs. You’ll likely want to enlist the help of a neuro-ophthalmologist, an endocrinologist, a dietitian, and a mental health specialist, if possible. “I tell my patients, ‘I’m not the solution. I’m one factor in this.’ We need to utilize every option we have, because it’s a complicated disease to have and complicated to manage,” she says. When you take the time to find doctors you like and trust, you’ll be more inclined to reach out to them when symptoms change or if you have other concerns.
The Takeaway
Managing a chronic condition such as thyroid eye disease may seem overwhelming, especially when you’ve just been diagnosed.
There are treatments and measures you can take to help reduce symptoms and feel more like yourself.
Habits such as eating healthy, sticking to your treatment plan, and working with your thyroid eye disease medical team can help you optimize management of TED.
EDITORIAL SOURCES
Everyday Health follows strict sourcing guidelines to ensure the accuracy of its content, outlined in our editorial policy. We use only trustworthy sources, including peer-reviewed studies, board-certified medical experts, patients with lived experience, and information from top institutions.
Sobel RK et al. Orbital Radiation for Thyroid Eye Disease. Ophthalmology. April 2022.
Foos W et al. Selenium Supplementation in Thyroid Eye Disease: An Updated Review From a Clinical Ophthalmic Perspective. Orbit. December 2024.
Lee TC et al. Evaluation of Depression and Anxiety in a Diverse Population With Thyroid Eye Disease Using the Nationwide NIH All of Us Database. Ophthalmic Plastic and Reconstructive Surgery. May/June 2023.
He earned his medical degree from Dartmouth. He completed an ophthalmology residency at the NYU Grossman School of Medicine, where he was chief resident, followed by a fellowship in uveitis and ocular inflammatory disease at the Francis I. Proctor Foundation for Research in Ophthalmology at the University of California in San Francisco.
Dr. Tsui is committed to advancing the field of ophthalmology. His research focuses on utilizing state-of-the-art ophthalmic imaging technology to improve the diagnosis and monitoring of uveitis. He is a co-investigator in several multicenter clinical trials investigating therapeutics for uveitis. He is the author of over 80 peer-reviewed publications and has given talks at national and international conferences.
Along with his clinical and research responsibilities, Tsui teaches medical students and residents. He is on the Association for Research in Vision and Ophthalmology's professional development and education committee, as well as the advocacy and outreach committee, which seeks to increase funding and awareness of vision research. He also serves on the editorial board of Ophthalmology and the executive committee of the American Uveitis Society.
Laurel Leicht has been a writer and editor for nearly two decades. A graduate of the College of William and Mary and the master's program at the Missouri School of Journalism, she covers a wide range of health and fitness topics, including breast cancer, various chronic conditions, mental health, and cardiovascular health.
