Hypothyroidism and Migraines: Understanding the Link

migraine, hypothyroidism
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Migraine is a headache disorder that involves recurrent headaches, ranging from moderate to severe. Migraines can last up to 72 hours, and in addition to pain, can cause nausea, vomiting, and sensitivity to smells, sounds, and light. Around the world, an estimated 12 to 15 percent of the population is affected by migraines.

Research has shown that if you have migraines, you have a significantly increased risk of being hypothyroid.

A University of Cincinnati College of Medicine study published in Headache: The Journal of Head and Face Pain found that people with migraine and other headache disorders actually have a 41 percent increased risk of developing hypothyroidism. The risk was higher in women, those who were obese, and those who were of more advanced age.

The study looked at a large group of more than 8,400 people. Within that group, researchers tracked people with migraines—known as migraineurs—as well as those with other headache disorders, such as cluster headaches and tension headaches, for 12 years on average. Thyroid levels were measured at various points over time.

The University of Cincinnati researchers have several theories to explain the relationship between migraines and hypothyroidism:

  • Migraine and headache disorders activates the immune system, which in turn can trigger hypothyroidism.
  • Stress that results from chronic migraine and headache disorders triggers hypothyroidism.

    Another study published in the journal Headache Pain also found a high prevalence of hypothyroidism—3 percent—in migraine, much higher than the general population’s prevalence of 84 percent. For more than half the patients studied, there was a significant worsening of migraine symptoms after the onset of hypothyroidism.

    Subclinical Hypothyroidism and Migraine

    If you have migraines along with subclinical hypothyroidism, research also shows that treatment for your thyroid condition can reduce the number and severity of your headaches.

    A study, conducted by Kapodistrian University of Athens Medical School and Eginition Hospital, Athens, Greece, recommended that patients with migraines should have a complete thyroid panel for evaluation. The researchers also recommended that treatment of subclinical hypothyroidism be considered in migraineurs.

    The study’s lead author, Antonasia Bougea, PhD, summarizes the key finding:

    To the best of our knowledge, this is the first study showing that treatment of subclinical hypothyroidism was effective in reducing both the frequency and severity of migraine attacks and improved the quality of life in patients.

    For the purposes of the study, subclinical hypothyroidism was defined as a thyroid stimulating hormone (TSH) level above 4.5 mU/L and normal thyroxine (T4) levels of 4.5 to 13 µg/dL. In the group studied, the mean TSH level was 10.6 mU/L, a level characterized as overt hypothyroidism by most healthcare providers.

    The patients with migraines were treated with 50 to 100 mg per day of levothyroxine, and the researchers evaluated the frequency and severity of migraine.

    The findings:

    • The severity of migraines was significantly reduced from a level of 6.5 – on a 1-10 scale to around 1
    • The monthly migraine frequency was reduced from around 14 migraine episodes to 2
    • The length of migraines was reduced from around 186 hours to around 1.5 hours

    The study included a control group of patients with migraine and subclinical hypothyroidism who were not given thyroid treatment. According to the researchers, this group had significantly worse migraine parameters, such as severity, frequency, and length of migraine episodes.

    The link between subclinical hypothyroidism and migraines in children is also well known.

    A 2012 study in the journal Child Neurology found that treating subclinical hypothyroidism in children with migraine can reduce the frequency of migraine episodes. As a result, regular thyroid evaluation, including blood testing, is already recommended as part of the workup for children with migraines.

    A Word From Verywell

    While there clearly is an established relationship between migraines and hypothyroidism, the mechanism behind that relationship is still not understood. There’s no evidence that migraines cause hypothyroidism, or that hypothyroidism causes migraines. Further research is needed to explore the benefits of treating subclinical hypothyroidism in migraineurs, before such treatment becomes standard clinical practice.

    But when untreated, hypothyroidism clearly makes migraine disorder worse, and treating hypothyroidism—even a mild, subclinical case—appears to reduce the number and severity of migraine attacks.

    Given this knowledge, if you have migraine disorder:

    1. Be sure that you periodically have a complete diagnostic thyroid examination and blood test panel.
    2. If you have untreated subclinical hypothyroidism, discuss the benefits of thyroid treatment with your physician.

    Sources:

    Congress of the European Academy of Neurology (EAN) 2017. Abstract O4111. Presented June 27, 2017. https://www.ean.org/amsterdam2017/fileadmin/user_upload/00_EAN_Journal_2017_Book.pdf

    Lisotto C, et. al. “The comorbidity between migraine and hypothyroidism.” The Journal of Headache and Pain. 2013;14(Suppl 1):P138. doi:10.1186/1129-2377-14-S1-P138.

    Martin, Andrew et. al. Headache Disorders May Be a Risk Factor for the Development of New Onset Hypothyroidism. “Headache: The Journal of Head and Face Pain.” 2016; DOI: 10.1111/head.12943

    Mirouliaei, M et. al. “Efficacy of Levothyroxine in Migraine Headaches in Children with Subclinical Hypothyroidism.” Iranian Journal of Child Neurology. 2012;6(4):23-26.

     

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