What organs in the body can cause eye bags? A Comprehensive Guide

September 21, 2025 •

5 min read

While a late night or high-sodium meal is often blamed, a surprising number of people with systemic issues experience puffy eyes due to underlying organ dysfunction. This authoritative guide addresses what organs in the body can cause eye bags, exploring the deep connections between systemic health and under-eye puffiness that are often overlooked.

Quick Summary

Persistent or unusual eye bags and puffiness can indicate issues with vital organs like the kidneys, heart, thyroid, and liver, which regulate fluid balance and metabolism. This swelling is caused by underlying medical conditions, differing from temporary or cosmetic puffiness.

Key Points

Kidney Dysfunction: Impaired kidney function can lead to fluid and waste buildup, causing noticeable swelling around the eyes due to low protein levels.
Thyroid Conditions: Autoimmune diseases like Graves' disease and hypothyroidism can cause inflammation and fluid retention in the eye area, leading to puffiness and bulging.
Heart Failure: An inefficient heart can cause blood to back up, leading to widespread fluid retention (edema) that includes facial and under-eye swelling.
Liver Issues: Severe liver disease can disrupt fluid balance and decrease protein production, which can cause fluid to leak into tissues and result in puffiness.
Allergies and Sinus Problems: Chronic inflammation from allergies or sinus infections can cause localized fluid retention and congestion around the eyes.
When to See a Doctor: If eye bags are persistent, severe, or accompanied by other systemic symptoms, it's a critical indicator that warrants a medical evaluation to identify and treat the underlying cause.

The Link Between Organ Health and Eye Bags

Under-eye bags, or periorbital edema, are commonly associated with sleep deprivation or aging. However, the delicate tissue around the eyes is highly susceptible to fluid retention and inflammation, making it a tell-tale sign of deeper systemic problems. The body's major organs, particularly those responsible for filtering waste, regulating hormones, and managing circulation, play a critical role in maintaining fluid balance. When these systems malfunction, excess fluid can accumulate in the tissues, manifesting as puffiness and swelling in various parts of the body, including the face and under the eyes.

Kidney Dysfunction and Periorbital Edema

Kidneys are essential for filtering waste and excess fluid from the blood. When kidney function is impaired, it can lead to fluid and waste buildup in the body, a condition known as edema.

Proteinuria: Kidney disease can cause the loss of significant amounts of protein (albumin) in the urine. This loss lowers protein levels in the blood, which reduces the osmotic pressure that helps keep fluid within the blood vessels. Consequently, fluid leaks into surrounding tissues, causing swelling, most noticeably in the face and around the eyes.
Waste and Toxin Buildup: In more advanced kidney failure, the kidneys can no longer efficiently remove waste products. This can contribute to systemic inflammation and other metabolic changes that worsen edema and affect overall skin appearance.

Signs of Kidney-Related Eye Bags

Eye bags resulting from kidney issues are often accompanied by other symptoms that indicate a broader problem. These can include foamy urine (a sign of excess protein), swelling in the ankles and feet, fatigue, and changes in urination habits. If these symptoms are present, it is crucial to consult a healthcare provider for diagnosis.

Thyroid Conditions and Eye Bags

Thyroid disorders, both overactive (hyperthyroidism, commonly Graves' disease) and underactive (hypothyroidism), can cause eye-related issues. The eye bags caused by thyroid conditions are often due to inflammation and fluid accumulation in the muscles and fatty tissue surrounding the eyes.

Thyroid Eye Disease (TED): This is an autoimmune condition associated with Graves' disease. The same autoimmune response that attacks the thyroid can target the fat and muscles behind the eyes. This leads to inflammation, which pushes the eyes forward (exophthalmos) and can also cause significant swelling and puffiness in the eyelids.
Hypothyroidism: An underactive thyroid slows down the body's metabolism, which can lead to weight gain and overall puffiness, particularly in the face. While less dramatic than TED, fluid retention is a common symptom and can contribute to the appearance of bags under the eyes.

The Heart's Role in Fluid Retention

Congestive heart failure occurs when the heart cannot pump blood efficiently. This leads to blood backing up in the body's veins and fluid leaking into the tissues, resulting in edema.

Poor Circulation: Inadequate heart function can cause poor circulation and a buildup of fluid throughout the body. While swelling is most common in the legs, ankles, and feet, it can also appear in the face and under the eyes. This is often more noticeable in the morning after lying down all night.
Other Symptoms: Heart-related eye bags are typically seen alongside other serious symptoms, such as shortness of breath, fatigue, chest pain, and high blood pressure.

Liver Problems and Facial Swelling

While less direct, severe liver disease can also be a contributing factor to periorbital edema. The liver plays a crucial role in producing important proteins, including albumin, and managing fluid balance.

Low Albumin Levels: Similar to kidney disease, severe liver disease can lead to decreased albumin production. This lowers the osmotic pressure of the blood and causes fluid to leak into surrounding tissues, resulting in swelling.
Impaired Detoxification: A failing liver struggles to filter toxins from the blood. This can cause systemic inflammation and other issues that impact fluid distribution and contribute to facial puffiness.
Portal Hypertension: In cases of cirrhosis, increased pressure in the portal vein can cause fluid to accumulate in the abdomen (ascites) but can also lead to facial edema.

Beyond Major Organs: Other Systemic Causes

Several other systemic issues can contribute to under-eye puffiness, often related to inflammation and fluid retention.

Allergies: Allergic reactions release histamines, causing inflammation and fluid retention. This can lead to swelling and dark circles around the eyes, sometimes referred to as 'allergic shiners'. Managing allergies with antihistamines can often resolve this cause.
Sinus Infections: Chronic sinus infections can cause pressure and inflammation in the nasal passages, which can impede proper fluid drainage and lead to puffiness under the eyes.
Connective Tissue Diseases: Conditions like dermatomyositis, an inflammatory disease affecting skin and muscles, can cause a specific, purplish-colored swelling around the eyes.

Distinguishing Causes: Lifestyle vs. Organ-Related Eye Bags

Lifestyle Factors vs. Systemic Health

While lack of sleep, high salt intake, and aging are common culprits for eye bags, persistent or severe swelling that doesn't resolve with lifestyle changes should be investigated. Lifestyle-related puffiness is often temporary and fluctuates based on daily habits, whereas organ-related edema tends to be more constant or accompanied by other systemic symptoms.


Feature	Lifestyle-Related Eye Bags	Organ-Related Eye Bags
Timing	Often worse upon waking, improves during the day	Can be persistent and present throughout the day
Associated Symptoms	Fatigue, dehydration, temporary swelling	Systemic symptoms like fatigue, shortness of breath, or changes in urination
Cause	Lack of sleep, high salt, alcohol, genetics	Kidney, heart, thyroid, or liver disease
Appearance	Mild to moderate puffiness	Can be more severe, persistent, and noticeable

Conclusion: When to Seek Medical Advice

Persistent or worsening eye bags that are accompanied by other symptoms like swelling in other body parts, shortness of breath, or unexplained fatigue should be evaluated by a healthcare professional. A thorough medical history, physical exam, and potential diagnostic tests can help determine if the puffiness is merely cosmetic or a sign of a serious underlying organ issue. Prompt diagnosis and treatment of the root cause are key to addressing the problem effectively and protecting your overall health. For more information on symptoms that could indicate kidney or heart problems, consult authoritative sources such as the National Kidney Foundation.

Frequently Asked Questions

Yes, kidney problems can absolutely cause eye bags. When the kidneys fail to properly filter waste and fluid from the blood, excess fluid can build up in the body. This fluid accumulation, known as edema, often appears as puffiness around the eyes and face, particularly in the morning.

Thyroid Eye Disease (TED), an autoimmune condition often linked with Graves' disease, can cause significant eye bags by causing inflammation and swelling of the fat and muscles behind the eyes. In severe cases, hypothyroidism can also cause overall facial puffiness due to fluid retention.

Yes, puffy eyes can be a symptom of congestive heart failure. When the heart's pumping is compromised, fluid can accumulate in the body's tissues. This edema can lead to swelling in the legs and feet, but also in the face and around the eyes, especially after lying down.

Severe liver disease can disrupt the production of albumin, a protein that helps keep fluid in your blood vessels. Low albumin levels cause fluid to leak into surrounding tissues. In addition, an impaired liver cannot effectively filter toxins, leading to inflammation that can contribute to fluid retention and puffiness around the eyes.

Yes, it's possible. While lifestyle factors like lack of sleep and high sodium intake cause temporary or fluctuating puffiness, underlying organ problems can cause persistent, more severe edema. A medical professional can help differentiate the cause based on your symptoms and medical history.

You should be concerned if your eye bags are persistent, severe, and don't improve with lifestyle changes. Look for other symptoms such as swelling in your ankles or feet, shortness of breath, unexplained weight gain, extreme fatigue, or changes in urination. These signs warrant a medical evaluation.

Allergies can cause puffy eyes, sometimes called 'allergic shiners,' due to inflammation and fluid retention. However, this puffiness is usually temporary and resolves with allergy treatment. Organ-related eye bags typically do not fluctuate with seasonal allergies and are often accompanied by other systemic symptoms.