What Are The Risk Factors of Thyroid Eye Disease?

Reviewed by: HU Medical Review Board | Last reviewed: October 2021

Health risks are everywhere and can sometimes be confusing. Risks can make you feel like everything can lead to disease. You may wonder how these risks apply to you and your family. Knowing your risks can help you find ways to avoid different health problems.1

Identifying thyroid eye disease (TED) early before serious damage is crucial. Being aware of the risks for TED can help you and your doctor make informed decisions about your care.2


People who smoke are 8 times more likely to develop TED. If you already have TED, smoking can make your symptoms worse. One study showed smoking worsened TED in up to 4 out of 10 people.2

If you smoke, ask your doctor about ways to stop. Stopping smoking will greatly decreases your risk for TED.2

Graves’ disease

Graves’ disease is an autoimmune disease that results in an overactive thyroid (hyperthyroidism). Graves’ disease affects 1 out of every 200 people in the United States.3,4

In Graves’ disease, the body makes an abnormal antibody that tricks it into thinking it needs more thyroid hormones. Too much thyroid hormones leads to hyperthyroidism.3,4

The harmful antibody in Graves’ disease begins to attack normal cells and proteins in the thyroid. The tissues in and around the eye are also targeted, which leads to the symptoms of TED.3,5,6

Up to half of those with Graves’ disease develop TED. Despite this link, TED and Graves’ disease are different conditions requiring different treatment.7

Family history

Having a family member who has a thyroid disorder increases your risk of developing TED. About 4 to 5 out of every 10 people with thyroid disorders report a family history of thyroid problems.2


If you have Graves’ disease, your risk of TED increases the older you were when Graves’ first started.8


Like other autoimmune diseases, women get TED at a much higher rate than men. Women are about 5 times more likely to get TED than men. However, men do get TED. Studies have shown that when men get TED, disease symptoms are often more severe.2,5

Radioactive iodine therapy

Radioactive iodine (RAI) is a therapy used to treat Graves’ disease and other thyroid disorders. About 2 in 10 people who have RAI treatment will develop TED or RAI will worsen their symptoms of TED.2

Studies have shown that thyroid hormone levels after RAI treatment impact the overall outcomes of TED. If low thyroid function (hypothyroidism) occurs after treating Graves’ disease with RAI, the risk for new or worsening TED symptoms greatly increases.2,8


Having type 2 diabetes may make TED worse. One study found 7 to 8 out of every 10 people with severe TED also had type 2 diabetes. The study also showed those with type 2 diabetes had worse symptoms than people without diabetes.9

Like TED, type 1 diabetes is also an autoimmune disease involving harmful antibodies. Those with type 1 diabetes are more likely to have thyroid disease, increasing the risk for TED.5

Studies have linked diabetes to problems with the thyroid. If your thyroid is not working properly, your risk of TED is increased.5

High cholesterol

Studies have found a link between TED and high cholesterol levels. Statins are drugs used to lower cholesterol levels in the blood. They may be prescribed to help lower cholesterol and reduce the risk of developing TED. Talk to your doctor about the risks and benefits of these drugs.10

Other autoimmune diseases

About 5 out of every 100 people have an autoimmune disease. While doctors do not know the exact cause of autoimmune disease, a mix of genes and environment are thought to be the cause.11

Autoimmune diseases linked to increased rates of TED include:12

  • Hashimoto’s thyroiditis
  • Rheumatoid arthritis (RA)
  • Psoriasis
  • Vitiligo
  • Lupus
  • Type 1 diabetes

Understanding your risks for TED can help you make decisions about your lifestyle and treatments. Start by talking to your doctor about your own risks and how these may impact your risk for TED.1

By providing your email address, you are agreeing to our privacy policy.