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  • shakira7
      Post count: 82

      Hi everyone,

      I haven’t been back in this forum for a while. I was diagnosed with Graves disease last fall 2012, and I was on 5 mg methimazole for about 6 months until I became hypo. My endocrinologist told me to stop, as of April 2013. I went back to see him July with another blood test, and my TSH dropped again below the normal range – 0.02. He put me back in methimazole, but 5mgs in 2 days. It’s slowly reaching the normal range, and I have a follow-up in end of October. I also have an appointment with a different endocrinologist at a hospital in Feb 2014 (the earliest they could give me), to seek for a second opinion.

      I started getting under eye bags towards beginning of this year.
      Since July, I’ve noticed that my upper eyelids have become puffy.
      Now, I’m an asian descendant, so my eyelids were always more or less flat, when you look at me from the profile.
      Anyway, I’ve tried Ole Henriksen lift eye gel, frozen spoon, cold tea bags…so far nothing worked. I just ordered a pillow wedge from Sears, so that I can raise the head level of my bed.I compared my profile picture from last year and last night, this morning. Yes, I definitely see the difference of my eyelids.
      However, I don’t see my eyes bulging.
      It’s really the puffy eyelid and under eye bags,
      Is bulging eye and puffy eyelid, two different things?

      One thing I realized that, I started eating a fermented marinated cabbage dish since July, as I’d been craving for it. Then I realized this morning, that this food is heavily soaked in sodium – 37% sodium, according to the nutrition label of this product. Duh…I feel like an idiot.

      Yes, I’ve been eating this fermented cabbage dish with my meal almost every evening, as it is considered “gluten-free”.

      My puffy eyelid started the similar time with my consumption of this fermented cabbage dish, so I decided to stop this diet and see if things get any better.

      Yes, I look like I haven’t slept everytime I look at myself in the mirror.
      This puffy eyelid bothers me a lot.
      Although I’m not the type that cares so much about looks, it bothers me that a medical condition effects my normal look that I used to have.

      I know, that worse comes, there is the “blepharoplasty” surgery where they can remove the excess water on the eyelid, so that the eyes no longer look puffy.

      Please feel free to share with me your input on this, as where I live, it’s so hard to find an opthalmologist. Most of them only take patients that needs a laser surgery for cataract.

      Thank you,

      Shakira7

      SueAndHerZoo
        Post count: 439

        Hi Shakira.
        I can’t relate to the puffy lids but I can relate to the bags and dark circles under the eyes. If you search my posts you’ll see I started a thread about that a few weeks ago.

        I am right there with you with hating the fact that some medical condition is affecting the way I look. I know other people have noticed it and it makes me look tired and “sickly” regardless of how many things I try and how much concealer and make up I use.

        My final hunch is similar to yours… that it’s related to something we’re eating. I tried cutting way back on carbs a week ago and it seems to have helped a lot already… not sure if it’s coincidence or really the cause.

        Then Wednesday we changed my dose of Levothyroxine and the eyes look pretty tired and sunken again so I guess our thyroids and it’s fluctuations are a factor, too.

        Wish I had some answers or solutions for you but at least know that you’re not alone with this frustration.

        Sue

        ChristinaDe
          Post count: 115

          I also can relate to the puffy eyes. This is a symptom that has really bothered me from the start because it’s a constant reminder that I have a “disease”. I kept telling my husband how much I hate the fact that I have an illness that not only affects my mood, mind & body…but my appearance as well. And since the eyes have been called the “window to the soul” – having them change feels even more significant. Plus it feels like I’m wearing a sign that notifies the world that something is off w/ me.

          I’ve been seen by a neuro opthamologist who specializes in Graves’/thyroid pts, and a opthalmic plastic surgeon who does as well. They both told me that since my antibodies are low to almost non-existent that my eye issues are probably related to my thyroid levels and not Graves’. That means that (at this point anyway) they’re not too concerned that they will suddenly bulge out or that I’ll develop double vision. But it also means that whenever my thyroid levels (TSH, T4, T3) rise or fall out of range – or even just move, even when moving toward normal – that I’ll see an increase in this swelling. Apparently the swelling begins w/ fluid building behind my eye & sort of spills out to the surrounding tissues. Once my levels normalize AND then stay there for at least 6 months, but maybe as long as a year, I “should” see the swelling go down. To what degree no one knows yet. I’ve noticed all this to be true so far. So now I wait. But I’m w/ you on this one…it’s not a pleasant experience.

          Also, I was told to make sure that I wait this out before doing any surgery since there is no way to know if it’ll completely resolve on its own, or just partially & to what degree. Ughh – hate the waiting, but it makes sense. And when the swelling gets worse, they don’t just bother me in the mirror. They ache a bit, they’re dry & gritty, that sort of thing. But they assure me there is hope. Whatever is left after all this can be surgically dealt with! ;) But I was also told to call if I developed any vision changes cuz this could mean that a nerve is involved & I’d need to be seen (although they’re not expecting this).

          In the meantime, the thing that seems to make the most difference in mine is keeping my head elevated as much as possible. For example, the swelling tends to worsen for several hrs after a yoga class. Also, staying hydrated seems to make the swelling swing up & down a little less (but I’m not entirely sure if they’re related or if that’s just in my head). Seems like you may be onto something w/ the sodium thing as well. I’ve thought the same thing. Would love to hear if you notice any improvement after decreasing your sodium intake!

          snelsen
            Post count: 1909

            Hi Shakira7
            You had some good comments from others, already.

            I think the high sodium content is very relevant. I think you will see improvement when it is less. Give it a couple weeks, though.
            Pretty sure this will be the easy answer! I hope so.
            Do write again.
            Shirley

            shakira7
              Post count: 82

              Hello SueAndHerZoo, ChristinaDe and Shirley,

              Thank you all 3 of you for getting back to me.
              @SueAndHerZoo – yes, I am really glad that I found this forum and to realize that I am not alone in this. It really upsets me, too, that I have to live with this “illness” for the rest of my life, however, I try reminding myself that I can still work, I can still live a life just like others who do not have thyroid issues.

              @ChristinaDe – Thank you for sharing me the info. Tomorrow, I’m going to call an opthalmologist (my friend gave me her dr’s number), and see if I can get an appt – if I’m lucky, I’ll get one in december and if not, it will be probably in jan 2014. If he doesn’t specialize in TED area, then I’ll ask him where I can go and get my eyes checked. I saw a video on YouTube from a patient who has undergone an eye surgery somewhere in Virginia area. Wow, her doctor really did a great job. I wish I have the $$ and the time off from work to fly over there to have her doctor fix my issue.

              @Shirley, Christina, and SueAndHerZoo – I realized that it’s not just the fermented cabbages that are high in sodium but the buckwheat noodle also has 38% of sodium / the rice noodles come with 18% sodium…OMG. I have been living off on these noodle and fermented cabbage salads since July on a daily base. On wkends, this would be my lunch and dinner…then I’ve been making roast beef, chicken, ground turkey dishes using a barbecue marinade which has 38% sodium, for my daily lunch menu, since july.
              In another words, I’ve been doing a sodium-diet for the past 2 months. Ah, I don’t know what I was thinking, and not checking on sodium level on the nutrition labels. I wanted to save some $$ from grocery bills, which is one of the reason why I’ve been living off on these food.

              Anyhow, I completely changed my diet since Saturday – no more marinades and fermented cabbages. No high-sodium food on my plate.
              I should be getting the pillow wedge from Sears on Wednesday.
              I will give myself a few weeks and see if there’s any change in my eyelids.

              @ everyone,
              I was so depressed yesterday dealing with this issue, but I reminded myself to not spend my day locked inside my appt and worrying. Staying like that won’t do any good to my soul, so I went to gym to work out and then I went to see a movie. This morning, I went to try a dance class that my friend teaches. I felt so good, and I’m glad I didn’t remain inside my appt all wkend over this puffy eyelid issue. However, I can totally see how TED can really effect one’s mood and mind, since I’m already freaking out with puffy eyelids with no signs of bulging eyes. I hope, with all these medical technology developing, that there will be a solution to treat, not just reduce symptoms of Graves disease and also a way to cure TED before eyes get puffy / before eyes start to bulge. That is my wishful thinking.

              Thank you everyone for your support.

              Shakira7

              Raspberry
                Post count: 273

                Hi Shakira, I can relate to the eye stuff too – for me the first swelling appeared when my thyroid levels neared the bottom of the range. Whenever they move up a little, the swelling gets better though it’s never been fully gone. It is indeed frustrating to have the illness be so visible to others. At this point my eyes are mismatched, slight proptosis on one eye and mismatched swelling too. Guess I’ll have to give up on the modeling contract, lol. It helps me a lot to read the stories of others on this board battling serious TED to keep perspective and I’m always inspired at how courageous they are.

                shakira7
                  Post count: 82

                  Hi everyone, it’s been exactly 2 weeks since I posted this message, and I’m afraid I don’t see any major change on my puffy eyelid. It tends to look more puffier in the morning, especially when I sleep for long hours. It looks a little better in the evening, however, the puffiness is STILL there. :-(
                  My parents were in town last week, to visit me. My mom even noticed that, from the side, she sees my eyelids are puffy.
                  On Monday, the 16th, I went to see an opthalmologist.
                  He is not a neuro-opthalmologist, but the ratemymd.com has a very good review of him, and some even feels he is the best opthalmlogist in town.
                  He confirmed me that, although he doesn’t know why my eyelids are puffy, he doesn’t see any signs of Thyroid Eye Disorder.

                  I have decreased tremendous amount of sodium in my diet, no more marinated cabbage salad in my dinner menu, and no more of buckwheat noodles. I also picked up the wedge from Sears to lift up my head level of my bed.

                  Yet, my eyelids are still puffy. I don’t see any signs of eye protusion, but I don’t see any improvement of my puffy eyelids either.

                  @ChristinaDe, I think I am in a similar situation as yours. My right side eyelid is puffy since August, and I really hope this goes away eventually. How are your eyelids?

                  Depending on how this puffy eyelid evolves, I am looking into blepharoplasty, to have the fatty part of the upper eyelid removed. They are starting to look like frog’s eyelids. Ugh.
                  I would rather deal with weight issue than to deal with eyelids which I have very little control of.

                  I have a follow-up with my endocrinologist, however, I got another appt with a different endocrinologist, who has an excellent review on ratemymd.com. It’s in February 2014, however, I think it’s worth seeing someone else and get a second opinion.

                  I am trying to keep my mind in peace and trying to be positive, thanks to this forum and the support I am getting from the readers.

                  Shakira7, hoping to get her normal look back.

                  ChristinaDe
                    Post count: 115

                    Shakira ~ My eyes are still in flux. When my levels flatten out after med changes they get a lot better. But then when I need my meds tweaked, they really puff up due to the movement in my thyroid levels (no matter which direction we’re moving them in). They also puff from abnormal levels, but worse w/ low levels than high. My docs have told me that my eye puffiness is not as Graves’ related as it is thyroid related. This means that we’re not worrying about any of the more severe eye issues right now. As for the puffy lids and bags underneath…they say that I really need to wait until I’ve been at the RIGHT level for at least 6 months w/o any movements out of range before I can know exactly how much they will (or will not) improve. If I get surgery now & they’re not finished improving on their own yet – then they could remove too much fat & I could have a bad result later. So their rule (for me) is to wait 6 -12 months after stable levels. I just had another Synthroid increase, so of course they swelled up – the left way worse than the right. But now that I’m stabilizing on the new dose (4 wks later), the swelling is going down some. If this turns out to be the magical dose – then I’m 6 months or so away from knowing if I’ll need bleph or whatever to improve things the rest of the way.

                    I really do hate this part! The waiting! But they can’t put back what they take away if they take away too much. So wait it is!

                    PattiMeg
                      Post count: 42

                      Hi there!
                      I wanted to chime in with my own puffy eyelid experience. It is really really important for your eyes to stabilize before you do any kind of eye surgery. I had really puffy lids, the eye surgeon told me that he thought the disease was stable so he did an upper and lower blepharoplasty. Well, the disease was still active and my eyes continued to worsen to the point where I now have double vision and proptosis. The premature blepharoplasty means that my lids are now retracted and I have to tape them shut at night. I have been 8-10 months now where my eyes seem stable so the surgeon (a different one then the one who did the first surgery!) feels that by early next year I will be ready for a procedure to try and make my eyes close properly.
                      The message I am trying to share with you is to be patient and don’t rush into any surgery unless you and your doctor are certain that the disease is in remission and that your eyes aren’t changing.
                      Patti

                      Kimberly
                      Online Facilitator
                        Post count: 4294

                        I definitely know from personal experience that it is *very* frustrating to have your appearance change like that! But ChristinaDe and PattiMeg are spot on about making sure symptoms are stable before proceeding with any eye surgery…you definitely don’t want to have one surgery done and then have to go back if things shift again.

                        shakira7
                          Post count: 82

                          Hello everyone,

                          Thanks so much for replying me with your experience.
                          Yes, I’ve postponed my blepharoplasty until Oct 2014, hoping things would calm down by then. Thanks again for your advice.

                          Question for PattiMeg and everyone
                          Would a Methimazole 2.5mg/day risk a rapid heart rate when a patient goes for a surgery under the anesthesia?

                          @ChristinaDe,
                          Are you on Synthroid or on Methimazole?
                          I am still on Methimazole 2.5mg a day (I actually take 5 mgs every other day.). I question if my Graves Disease treatment needs to be re-evaluated, which is why I have an appointment with an internal medicine doctor in November, in addition to a follow-up with my endocrinologist. My endo wants to treat my Graves Disease with ATD as much as possible and possibly avoid putting me on a Synthroid which I will need for the rest of my life.

                          Given that the RAI treatment puts patients on a higher risk to TED, I am not planning on going with RAI.

                          @PattiMeg,
                          Did you have a RAI treatment before your eye issue began?
                          I’m so sorry to read that you’ll have to go through another eyelid surgery.
                          I really hope your 2nd surgery will also be the last one for you.
                          I have an appointment with an opthalmologist on Wednesday to see if there are any potential signs of TED.
                          My right upper eyelid is puffy as usual and both eyes have under eye bag around.

                          @Kimberly,
                          How long have you been on an ATD for? I’m guessing you do not experience any side effects, am I right?

                          Shakira7

                          ChristinaDe
                            Post count: 115

                            Shakira, I’m on Synthroid. Had my thyroid removed February 1st, 2013. I can tell that my levels have flattened out from my last dose increase (which was back in early September) because my eye bags & swelling have really gone down. Like I said before, every time my thyroid meds are adjusted my eyes swell. That was true while I was on Tapazole as well. And they REALLY swell when I’m hypo. So I’m thinking (fingers crossed) that my levels are pretty close to optimal now since my eyes have not only improved substantially, but so has my mood, energy, etc. I’ll know exactly where I stand in another week or so.

                            Just to give you a little more detail on what my experience has been…they swelled pretty bad while on Tapazole because I just couldn’t stay stable on the stuff and I saw an immediate improvement after thyroidectomy (which lasted a few weeks, until I went hypo). Then they worsened during my 1st Synthroid increase, improved when my levels stabilized at that dose, and worsened again as I sat in hypo-land for a bit. Got another Synthroid increase, worsened for a few weeks until that dose stabilized, then improved a bit once I sat at the new level awhile, and then gradually got a bit puffy as I sat at that very slightly hypo level. My 3rd increase was this last one & as usual I puffed like a blowfish as the thyroid levels moved, and as is customary for me, I improved once I leveled out. I’m so hoping that this was my last increase for awhile because if my eyes improve even slightly from here then I know that I won’t need any eye surgeries. Time will tell.

                            Anyway, for now, my eyes have no upper swelling, just a tiny bit of lower swelling on the left and even less on the right. No dryness or irritation. Good thing I didn’t have any surgery to remove anything from them yet. If I had they’d be sunken now! :) When my eyes swell they SWELL! I can actually see my upper and lower lids as I look out into the room!!! It still amazes me that they can go that far up and then that far down in just 6 weeks.

                            My eyes, hair and muscle/joint areas are my first signs that my levels may be off – no matter what med I’ve been on. So I pay attention, but I try not to panic anymore. I’m convinced these are not permanent symptoms but just signs that my levels are either moving or too low (and in the beginning, too high). I guess that’s why my dr’s have told me that this is not likely Graves’ Eye Disease in my case, but Thyroid Eye Disease associated w/ abnormal levels. Especially since the swelling is unrelated to antibody levels in my case. I know the waiting is miserable – I’ve hated it – but it really is important. The old saying, “time will tell” applies here.

                            I think you’ve made a good decision in putting off any eye surgeries for later & to continue being monitored by specialists. Based on my own experience, the most important thing you can do now is work to stabilize those thyroid levels as soon as possible so that “6 month to a year” clock can begin ticking!!! Hopefully neither of us will need any eye surgeries, but if we do I hear there are some amazing surgeons out there. ;)

                            Kimberly
                            Online Facilitator
                              Post count: 4294

                              Hello – I’ve been taking Methimazole for over 6 years now. I had a couple of scares early on, once with a sore throat and once with my White Blood Cell count dipping just below “normal”. The WBC test came back fine after the sore throat, and my doc was OK with “watching and waiting” during the other episode, since the levels were only very slightly off. I haven’t had any issues since then — knock on wood!

                              PattiMeg
                                Post count: 42

                                Hi Shakira7,
                                I had RAI in February 2011. I recovered from that very well – never went hypo. Started on Synthroid and had to make some minor tweaks but felt pretty good. The eyelid swelling started in the Fall of 2011. It continued to get worse, and then I developed really bad tearing and light sensitivity. In April of 2012 I had the upper/lower blepharoplasty. In hindsight, I see now that the disease was still active and the surgery was premature.

                                shakira7
                                  Post count: 82

                                  Hi everyone,

                                  Hope you’ve all been well.
                                  Oct 23 – I went to see another opthalmologist whom my friend has been consulting for over 20 years. He confirmed me that I do not have a TED symptom so far. He asked me to come back in an year to check again. He also knows my current endocrinologist, who works a few blocks from his clinic.
                                  I asked him about my upper eyelid that is puffy as well as the blepharoplasty. He doesn’t know why they are puffy, but he suggests I wait another 3 years from now. (*I was diagnosed with Graves in Sept 2012 and started Tapazole 5mg/day.) He told me he is conservative, and he said using an incision method (blepharoplasty) while my eyelids are inflammated, is not a good idea. It can possibly delay from healing, and of course, I do not want that either. He said that they should cool down eventually.

                                  Oct 25 – Follow-up with my endo. My TSH is back to its normal range, 1.55
                                  He wanted to stop me from Tapazole 5mg/every other day…however, I reminded him how I went back to hyperthyroid when I stopped the Tapazole in April…relapsed in 3 months, in July. So he told me to stay on Tapazole for another 3 months. I suggested, how about I take 5mg every 3rd day from now and see if my TSH remains normal.

                                  My endo is very pro-ATD treatment and he doesn’t want to go with RAI/thyroidectomy unless I show symptoms.

                                  I asked him about my upper eyelids…and he thinks it’s due to this whole thyroid issue. He said they should cool down eventually. He then joked at me, “You should be an endocrinologist, only for Graves Disease patients. But you won’t be able to make a living out of that. Do you why? Cause in my case, I only get Graves Disease patients, average 1 per week.”

                                  Yes, I feel like we can all be endocrinologist. Don’t you think that way, too?

                                  I also feel like, when it comes to Graves Disease, I feel like I am the endocrinologist for myself.
                                  Is it just me or do you guys feel the same way?
                                  I feel like I tell him how I want my thyroid to be treated.

                                  Today, I went to see my G.P. and she noticed, too, that my upper eyelids are puffy. She actually referred me to an internal medicine doctor in the same clinic (FYI, I’m in Canada, so this is all covered by my provincial health care.). She feels I should get a second opinion with another doctor.

                                  Deep down, this eyelid issue upsets me a lot, however, I try to keep up my sense of humour and try to laugh a lot, both at work and with my friends outside of work. I remind myself, that I am not a covergirl, I do not work for a model agency where my physical appearance will give me a paycheck. I also remind myself that I am a very appreciated employee at my full-time job where I work in an office. My coworkers and my boss appreciate my work ethic and my friendly personality. Therefore, my eyelid looking puffy is not going to put my job at a risk, cause I’m not a fashion model.

                                  Since it’s going to be a long wait until my eyes remain stable, I’ve decided to go on a backpack travel next year during my vacation. That will keep me busy planning my itinerary and doing researches on the cities I will visit.

                                  Thanks again everyone, for your support.

                                  Shakira

                                  Graves Disease since Sept 2012
                                  Tapazole 5mg a day from sept 2012 – march 2013, TSH became 6.4
                                  april – june 2013 stopped Tapazole and became hyperthyroid again, TSH 0.02
                                  Tapazole 5mg /every other day from july – october 2013, TSH returned normal
                                  Tapazole 5mg/every 3rd day since last week of october.

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