Migraine Triggers and Comorbidities: Thyroid Disease – Part 1

Migraine is an often misunderstood and much maligned disease. If I had to pick another that comes close to the misdiagnosis and stigma of Migraine, it would be autoimmune thyroid disease.

Unfortunately, there are probably more undiagnosed people with thyroid disease walking around wondering why they don’t feel well than there are Migraineurs without an appropriate diagnosis.To make matters more confusing, thyroid dysfunction is a frequently co-morbid disease with Migraine, as well as acting as a frequent trigger for Migraine attacks.

When episodic Migraine transforms into chronic Migraine, or a patient presents to a physician with a case of new daily persistent headache (NDPH) a frequent cause or trigger is thyroid disease or dysfunction. Like Migraine, thyroid disease is most often found in women, and can be influenced by levels of reproductive and other hormones.

What is the thyroid?

The thyroid is a small, butterfly shaped gland in your neck between your adam’s apple and collarbone. It is a gland that responds to hormonal instructions by the brain. The part of our brains called the hypothalamus senses the need for thyroid hormone. It secretes TRH (thyrotropin releasing hormone) and the pituitary gland responds by secreting TSH (thyroid stimulating hormone) which turn the thyroid’s hormone production plant on. The thyroid in turn secretes a number of hormones which are vital to the way every single cell in our bodies function. When it underproduces hormone, we say the patient is hypOthyroid. When it overproduces thyroid hormone, we say the patient is hypERthyroid.

The thyroid gland utilizes mainly dietary elements as fuel to create thyroid hormones, especially iodine and tyrosine. The most important of these hormones are called T4 and T3. The T stands for tyrosine and the number stands for the number of iodine molecules attached to it. Knowing these facts are important as we learn how thyroid hormones function and why they can be so important to Migraineurs.

Left untreated, thyroid disease often becomes disabling, and can eventually be fatal. Just 100 years ago, myxedema (hypothyroid) was a frequent cause of death. HypERthyroid conditions often also resulted in death, often by heart attack.

Our knowledge re: thyroid disorders is fluid and changes constantly as we learn more about these problems and get better at testing for them and treating them. It used to be assumed that children rarely if ever had thyroid dysfunction. Most of these children actually suffer through their childhoods without a diagnosis. For them, feeling bad becomes their normal. Although the chance you suffer thyroid dysfunction rises with age, we now know that lab ranges for children vary from those of adults, and that they do suffer thyroid dysfunction. Endocrinologists who specialize in pediatric thyroid care are the best resources for children who may have a thyroid disorder as their diagnosis and treatment may be more difficult. Finding a good doctor is a vital key for these patients.

Thyroid dysfunction can happen at any age, but estimates range from 1/3rd to 2/3rds of women over the age of 50 suffer from some type of thyroid dysfunction, and the percentage of men affected by thyroid dysfunction rises with age as well. More than half are undiagnosed. Why then do very few doctors take the time to screen their chronic Migraine patients for thyroid dysfunction or even have the ability to visually identify a goiter (swollen thyroid gland)?

Indeed, the average physician is not even up to date enough on thyroid protocol to know which tests must be run to find a thyroid condition. Thyroid conditions are sometimes not taken seriously and patients suffer stigma from families, friends and unfortunately, sometimes their physicians. This is why it is very important for Migraineurs — especially chronic Migraineurs — to understand these conditions and be proactive with their doctors so they can receive the right testing to correctly diagnose thyroid dysfunction that may be complicating their Migraine disease.

The most frequent reasons a person may be suffering from a thyroid disorder include:

  • Autoimmune disease
  • Dietary deficiency or malabsorption problem
  • Thyroid nodules
  • Injury or radiation exposure
  • Medications
  • Over-consumption of iodine or goitrogenic foods such as soy, cruciferous vegetables, etc
  • Cancer

There are several things that may put you at increased risk for thyroid dysfunction including:

  • Female gender
  • Having a relative with thyroid disease
  • Having an autoimmune disease
  • Having another endocrine (hormone) disorder
  • Pregnancy or recent childbirth
  • Exposure to radiation, chemicals, certain medications or surgeries
  • Smoking
  • A diagnosis of Fibromyalgia or Chronic Fatigue Syndrome
  • A diagnosis of depression or anxiety

Although there are many tests for thyroid function, many are old, outdated and no longer as useful as current testing. The main and current screening tests include:

  • Free T3 (not total)
  • Free T4 (not total)
  • TSH
  • TPO antibodies
  • TSI antibodies

If you have a nodule (growth, or bump within the gland) or goiter, ultrasound is usually used to locate and measure the gland and any growths found within it. A baseline is usually noted so it can be monitored over time. Nodules may be further tested with a nuclear uptake scan that will determine if it is ‘hot’ (produces too much hormone) or ‘cold’ (produces insufficient hormone). Needle biopsies are usually considered if cancer is suspected.

Next: Migraine triggers and co-morbidities: Thyroid Disease – Part 2

This article represents the opinions, thoughts, and experiences of the author; none of this content has been paid for by any advertiser. The Migraine.com team does not recommend or endorse any products or treatments discussed herein. Learn more about how we maintain editorial integrity here.

Comments

View Comments (22)
  • Judy H
    2 years ago

    I have hypothyroidism (as well as migraine) and I just plain don’t feel like the levothyroxin does anything to alleviate the symptoms. I also remember reading that extended of propranolol was a cause of hypothyroidism. I took propranolol for quite some time as a migraine suppressant. Sometimes you just can’t win…

  • Anne
    4 years ago

    thank you for this information. I recently had blood work done. Had my thyroid tested, twice, along with T3 and T4 – all within normal. BUT, because I was able to ask for blood work to be done and think of my incredible fatigue, paleness and weakness as something more than just chronic migraines, I found out that I am very deficient in Vitamin D, which also has similar symptoms to hypothyroidism. I’m on my first week of a large dose of vitamin D and my energy is starting to come back – as is the color in my face. I haven’t had a migraine in 4 days (which is good for me). I am so grateful for migraine.com and the sharing of information!!! My neurologist and regular doctor never suggested that I look into other causes for fatigue – I would have just gone on feeling more and more depleted. Thank you so much!!!

  • Corena
    4 years ago

    I’ve had my thyroid checked a few times and have been told it’s “functioning within the normal range”. Barely!!! Symptoms be damned, the chart says I made the cut.

  • Shane Stephens
    7 years ago

    My mom has Graves disease and had her thyroid treated with radioactive iodine in the early 90’s and is on lifelong meds to regulate. She has migraine disease as well with it becoming chronic and each episode longer and more frequent. She also has Celiac disease and has a strict diet. She is so sick all of the time. She has prescriptions medications for everything…she is even now fighting bacteria in her blood stream after skin rashes, dry patches, and even had a staph infection late last year. She is just really sick….it’s sad. She sees specialists for everything…and is at her Dr’s weekly and we spend hundreds of dollars per month on prescriptions for the known issues and those that just keep popping up. Just wanted to vent…we are looking at chiropractors, family counseling, massage therapy…anything to get her relief but sadly she doesn’t feel like she will ever be “normal” again….

  • Judy H
    2 years ago

    God bless your mother. I will pray for her and you.

  • Michele Ott
    7 years ago

    I’ve had migraines ever since being diagnosed with Thryoid cancer at 16 yrs old. All my neuro’s and primary care dr’s tell me that my tsh levels are in the “normal” range but I suffer with migraines 3-4 times a month. I know its related, but no matter how much I talk, you get brushed off. Here, try this med, here try that med. What it has a side effect, well try a lower dose. Logically, I understand that everyone is different and react differently to different medications, but emotionally? Its hard not to throw in the towel.

  • Janice Worden Lamb Clemens
    7 years ago

    I feel your pain…have had migraines since I was 16 also but never diagnosed until about 12 years ago.as well as thyroid disease … Just a couple a year I could handle…until the last 2 years I have what they call the :chronic , daily migraine and no one can figure out what to do about them”…more medication that doesn’t work…I have tried chinese herbs etc with no relief…Acupuncture is the only thing I have found that helps so far and that is only a temporary relief as it is not covered by my insurance and I can’t afford $65. to go 3 x a week…so I am back to square 1…On Topamax and meditation whic I re-started 5 weeks ago and I have not seen any change yet…and I have to keep working , especially as my hubby is going through chemo and barely is able to work 1 day a week if that…good luck to you..if you come up with anything significant that works , let me know…I am open-minded to anything!!!

  • Michele Ott
    7 years ago

    You’re welcome. Its a great resource for migraineurs, get some interesting info off it.

  • Amy Autrand-fragie
    7 years ago

    Thanks for putting that acticle up I’m definitely going talk to my Neurologist about it

  • Drpatty Hagler-Verdugo
    7 years ago

    This is a great article.

  • Cynthia Royse
    7 years ago

    I was diagnosed with hypothyroidism when I was 18. Had it years before that though. I chiropractor was the one who told me I should get tested for it. I was always cold, craved ice, tired and just felt horrible. Now I take pills for my T3 and T4 for the rest of my life. Has helped a great deal.

  • Heather Barber Cummens
    7 years ago

    I was wonderinng about that due to my thyroid problems, I get migraines. I’ve been researching for answers… Is there anything out that can help this particular problem?

  • Teri Robert
    7 years ago

    Heather, I’m not sure I follow. Fluctuations in thyroid levels can certainly make us more susceptible to our triggers or even be one of our triggers. Thyroid problems don’t, however cause us to have Migraine disease. I have thyroid issues too, and know that I’m far more susceptible to my triggers when my thyroid levels aren’t right. So, if you’re asking about thyroid issues making your more susceptible to your triggers or even being a trigger, they only thing that’s going to help that is to work with your doctor to get your thyroid levels where they need to be. Is that what you were asking?

  • Samira SJ
    7 years ago

    The first thing my doctor checked was my thyroid , which turned out normal. : ) but I will go for another recheck though, its been months since the first one.

  • Samantha Price Fischer Kyle
    7 years ago

    I did start back on my thyroid and it helped my headaches tremendously!

  • Berteena Wilson
    7 years ago

    Waiting for diagnosis creates fear while knowing that something is wrong when you’ve had months of migraine, countless doctors, and tests becomes dibilitating. Fear of knowing the undiagnosed.

  • Brandy Riley
    7 years ago

    This little gland has always been a bone in my side, but it is what it is…who knew it was that important! I had to ask my Dr. For the initial (thyroid) testing, because they couldn’t ever figure out why I felt so crummy…

  • Teri Garrett Vanderlaan
    7 years ago

    Migraineur sounds so fancy… Everyone should get their thyroid checked.

  • Robin Wilburn Rains
    7 years ago

    This is very helpful.

  • Allison in Migraineland
    7 years ago

    What if we are already being treated for Hyperthyroidism? My last couple of blood tests have been in the normal range. Should I look more into this more as a possible root to my migraine/CDH?

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