Effect of Cannabis Usage on Thyroid Eye Disease

Area of Science:

• Endocrinology
• Ophthalmology
• Public Health

Background:

• Thyroid eye disease (TED) is an autoimmune condition affecting the eyes, often associated with hyperthyroidism.
• While smoking is a known risk factor for TED, the impact of cannabis use remains unclear.

Purpose of the Study:

• To investigate the association between cannabis usage and the development of thyroid eye disease (TED) in patients diagnosed with autoimmune hyperthyroidism.
• To compare TED presentation and treatment outcomes between cannabis users, nicotine users, and non-users.

Main Methods:

• A cohort study utilizing TriNetX electronic health records from December 2003 to December 2023.
• Propensity matching was employed to control for confounding variables in patients with autoimmune hyperthyroidism.
• Relative risk for TED outcomes was calculated at 6-month, 1-year, and 2-year intervals post-diagnosis.

Main Results:

• Cannabis users (n=783) showed a higher likelihood of developing exophthalmos (1.9 times) and any TED presentation (1.6 times) within one year compared to controls (n=18,093).
• These associations were statistically significant at the 1-year mark but not sustained at 2 years.
• Cannabis users were generally younger, male, Black/African American, and more likely to have anxiety or depression.

Conclusions:

• Cannabis users demonstrated a significantly increased risk for thyroid eye disease outcomes within the first year of diagnosis.
• The findings suggest a potential link between cannabis use and the early presentation of TED.
• Further investigation is warranted to guide clinical management of TED in cannabis-using populations.