Graves’ ophthalmopathy, also known as thyroid eye disease, is common in people with Graves’ Disease, and involves the thyroid antibodies attacking the tissues of the eyes. Graves’ ophthalmopathy is clinically relevant in approximately 50% of patients with Graves’ disease, with severe forms affecting 3%-5% of patients (1). In fact, many people consult with me not due to the high pulse rate, palpitations, or the other symptoms associated with Graves’ Disease, but instead are primarily concerned with their eye symptoms. And most people want to know if there are any supplements or herbs they can take to help with this condition.
Before I discuss some natural approaches to help with thyroid eye disease, I’d first like to talk about the conventional medical treatment approach to this condition. Although radioactive iodine is commonly recommended to people with Graves’ Disease, RAI can worsen ophthalmopathy, especially if it is administered to those patients who smoke, have a severe case of hyperthyroidism, or those with high levels of TSH-receptor-binding inhibitory immunoglobulins (2). If the condition is severe then steroids might be given, such as prednisone, but sometimes a wait-and-see policy is recommended in mild Graves’ ophthalmopathy, and the reason for this is because the condition can resolve spontaneously (2).
So if someone with Graves’ ophthalmopathy is looking to take the conventional medical approach, they are essentially looking at 1) taking steroids, or 2) playing the waiting game. Although I’m not opposed to people taking steroids, there are natural options which might help with the inflammation. And while they might not be as potent as the prescription drugs, they of course don’t come with the side effects.
Address The Inflammation and the Autoimmune Component
If someone has Graves’ ophthalmopathy and is looking to follow a natural treatment protocol, the treatment approach won’t be much different when compared to the one given to someone who has Graves’ Disease without thyroid eye disease. In other words, there aren’t any or herbs which are specific for Graves’ ophthalmopathy. Supplements and herbs which are specific for the eyes such as eyebright and lutein usually won’t help with this condition.
On the other hand, taking supplements and herbs which can decrease inflammation may help. The effectiveness depends on the severity of the condition. Pro-inflammatory cytokines are associated with autoimmune conditions such as Graves’ Disease, and studies show that the cytokines of the IL-1 family and Tumor Necrosis Factor (TNF) play a big role when it comes to Graves’ ophthalmopathy (3). So the goal should be to give supplements which have shown to inhibit these proinflammatory cytokines. Here are some supplements which may help to at least ease some of the symptoms associated with Graves’ ophthalmopathy while the cause of the condition is being addressed:
EPA and DHA. Numerous studies show that eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) can inhibit TNF-alpha and IL-1 (4) (5) (6). These are found in fish oil and krill oil. For those who are a vegetarian, some studies have shown that flaxseed oil can also inhibit these pro-inflammatory cytokines (7) (8). The problem is that many people have problems converting alpha-linolenic acid into DHA and EPA, which are responsible for forming the prostaglandins which help with inflammation.
Gamma-Linolenic Acid (GLA). GLA is a type of omega-6 fatty acid. Although you want to be cautious about consuming too many omega-6 fatty acids, studies also show that consumption of GLA rich oils such as Borage oil, Black Currant Seed oil, or Evening Primrose oil can have beneficial effects on inflammatory disorders and can reduce the production of pro-inflammatory cytokines (9) (10) (11).
Turmeric. Turmeric is rich in curcuminoids, and numerous studies have shown that curcumin has anti-inflammatory properties and can inhibit proinflammatory cytokines(12) (13) (14) (15). Turmeric is a wonderful herb, and I’ve written a separate article entitled Turmeric and Thyroid Health.
Resveratrol. Resveratrol is a polyphenolic phytoalexin found in grapes, fruits, and root extracts of the weed Polygonum cuspidatum, and it exhibits anti-inflammatory, cell growth-modulatory, and anticarcinogenic effects (16). Numerous studies have shown that resveratrol has an inhibitory effect on pro-inflammatory cytokines (17) (18). So resveratrol is yet another powerful supplement with anti-inflammatory properties.
Vitamin D. Vitamin D3 also has anti-inflammatory properties (19) (20). And many people are deficient in vitamin D. I recommend for all of my patients to test their vitamin D levels, and if they are deficient I recommend for them to supplement with vitamin D3, along with increasing their sun exposure. So if someone has thyroid eye disease then they without question want to make sure they are not deficient in vitamin D.
I’m not suggesting that those with Graves’ ophthalmopathy need to take all of these supplements I mentioned. At the very least you want to take some type of omega-3 fatty acid, and it’s a good idea to take a form of GLA. If you’re vitamin D deficient then it probably is a good idea to take vitamin D3 to increase the levels. Taking fish oils, a good form of GLA, and making sure you have healthy vitamin D levels will help a great deal with the inflammatory process. Also, keep in mind that there are other supplements and herbs which have anti-inflammatory effects other than the ones I mentioned, but these are some of the more effective ones.
So if you have Graves’ ophthalmopathy, hopefully you understand that the key to overcoming this condition is to address the autoimmune component of Graves’ Disease. Supplements and herbs which might help include fish oils, GLA, vitamin D3, turmeric, and resveratrol. However, keep in mind that the overall goal should be to find out what’s triggering the autoimmune response, and then to remove this trigger while restoring the health of compromised areas of the body.