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Home»HEALTH»Eyes on Alert: Thyroid Eye Disease Medicines to Beware of
Eyes on Alert
HEALTH

Eyes on Alert: Thyroid Eye Disease Medicines to Beware of

By Tomer JackJuly 20, 2023Updated:July 20, 2023No Comments4 Mins Read
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Thyroid Eye Disease (TED), also referred to as Graves’ Ophthalmopathy, is an autoimmune condition that affects the eyes and is frequently linked to an overactive thyroid gland. It presents with a range of symptoms, including eye pain, swelling, redness, and protruding eyes. 

The incidence rate of the disease is approximately 19 cases per 100,000 individuals each year. While TED is considered a rare disease, its impact on individuals can be significant, and prompt and proper treatment is crucial to prevent the condition from worsening.

Managing TED involves a multidisciplinary approach, including medications that help alleviate symptoms and control the underlying thyroid disorder. However, it is crucial for individuals with TED to be aware of certain medications that may have potential adverse effects on their condition. 

In this article, we will explore some medicines that should be cautiously approached if you have Thyroid Eye Disease.

Corticosteroids

Corticosteroids, such as Prednisone or Dexamethasone, are commonly prescribed for reducing inflammation and managing symptoms in TED. These medications can help alleviate swelling and redness around the eyes. 

However, it is important to note that corticosteroids can have side effects, particularly when used for an extended period or in high doses. These side effects may include increased intraocular pressure leading to glaucoma, cataract formation, and potential exacerbation of other systemic conditions. 

Therefore, individuals with TED should monitor their eye health and work closely with their healthcare provider to determine the appropriate dosage and duration of corticosteroid therapy.

Teprotumumab

Teprotumumab, branded as Tepezza, is an FDA-approved medication specifically indicated for the treatment of Thyroid Eye Disease (TED). 

It is a targeted biological therapy that inhibits the underlying autoimmune process involved in TED, reducing inflammation and improving symptoms. Tepezza has shown promising results in clinical trials, demonstrating its efficacy in reducing proptosis (bulging eyes) and improving overall eye function. 

However, TruLaw notes that there have been reports of individuals experiencing hearing difficulties while undergoing treatment with this medication. 

According to the University of California San Diego, prior to FDA approval, hearing problems were reported in 10% of patients during two clinical trials conducted for Tepezza. However, a recent study suggests that the rate of hearing issues could be as high as 65%, with cases of permanent hearing loss also being reported. 

This concerning situation has led to a rise in Tepezza lawsuit cases, with 34 Tepezza hearing loss lawsuits filed in federal courts so far. If you are using Tepezza for Thyroid Eye Disease, it is crucial to be aware of these developments. 

Close collaboration with healthcare providers and regular follow-up appointments are essential to ensure the safe and effective use of Tepezza while managing TED and monitoring any potential hearing-related complications.

Iodine-Containing Contrast Agents

Iodine-containing contrast agents are commonly used in diagnostic imaging procedures like CT scans or angiograms. However, it is crucial to note that these contrast agents can temporarily disrupt thyroid hormone production, potentially worsening thyroid-related conditions such as Thyroid Eye Disease (TED). 

The Jod-Basedow phenomenon, as highlighted by the National Library of Medicine, is a rare occurrence where TED reactivates after a significant iodine bolus. In light of this, it becomes essential for individuals with TED to communicate their condition to healthcare providers before undergoing procedures involving iodine-containing contrast agents. 

This information enables clinicians to take necessary precautions, recommend alternative imaging techniques, or consider minimizing the iodine dosage to mitigate potential adverse effects and prevent the reactivation of TED.

Lithium

Lithium, commonly prescribed for bipolar disorder, has been found to have a connection with the development or aggravation of Thyroid Eye Disease (TED) in certain individuals. Although the exact mechanisms are not fully understood, caution is advised for individuals with TED or a history of TED who are recommended to take lithium. 

Regular monitoring of eye health becomes crucial, along with close collaboration between the patient, psychiatrist, and ophthalmologist to promptly detect and manage any potential deterioration of TED symptoms.

It is worth noting that while lithium has been associated with goiter (40-50% prevalence) and hypothyroidism (20-30% prevalence), its specific impact on TED requires vigilance and proactive medical attention.

Conclusion

Thyroid Eye Disease can significantly impact an individual’s quality of life, and proper management is critical to minimizing symptoms and preventing complications. If you have TED, it is essential to be aware of medications that may potentially worsen your condition. 

Open communication with your healthcare providers, including endocrinologists, ophthalmologists, and other specialists, is vital to ensure appropriate treatment decisions and minimize any risks associated with medications. 

Remember, each individual is unique, and what works for one person may not work for another, so personalized care and regular monitoring are crucial in managing TED effectively.

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