Can Migraines Be a Symptom of Hypothyroidism?

Migraine headaches are common in people with hypothyroidism (an underactive thyroid). In fact around 30% of people with hypothyroidism have a history of headaches.

It is not clear exactly what is responsible for the association, but some research suggests that a history of headaches can predispose someone to hypothyroidism.

This article explains the correlation between migraine headaches and thyroid disease, symptoms, and treatment options.

migraine and thyroid
Verywell / JR Bee

What Is a Migraine?

A migraine is a type of severe headache that typically comes with many other symptoms, such as nausea, extreme sensitivity to light and noise, and visual changes (called an aura). A migraine headache usually involves throbbing or pulsating pain, often on one side of the head. It is different from other types of headaches.

Are Migraines a Symptom of Hypothyroidism?

Migraines are often a symptom of hypothyroidism, and people with migraines may be more likely to develop hypothyroidism.

In a 2016 study published in the journal Headache, researchers medically monitored 8,412 people over 20 years. They excluded anyone with a prior history of thyroid disease or an abnormal thyroid reading at the start of the study.

The study found that those with pre-existing headache disorders had a 21% increased risk of new-onset hypothyroidism compared to people with no history of headaches. In addition, compared to the general population, people with a history of migraines (as opposed to tension-type headaches) had a 41% increased risk of new-onset hypothyroidism.

Thus far, there is no research that explains a definitive reason for the association. Another study done in 2017 suggested that headache disorders may activate the immune system, predisposing someone to develop hypothyroidism in the future. Stress, environmental, and genetic factors might play a role as well.

Treatment and Management of Migraines

For people with hypothyroidism as well as migraines, thyroid hormone replacement therapy, most typically in the form of levothyroxine, can help minimize hypothyroid symptoms, including migraines. A study published in 2016 found that people with both subclinical and overt hypothyroidism reported a similar relief from headaches with levothyroxine treatment.

It is also important to note that headache is a common side effect of levothyroxine use. In people with moderate to severe hypothyroidism, which would require higher doses, the drug could potentially trigger headaches or worsen existing symptoms.

Treatments for migraines in general (whether or not they exist in conjunction with hypothyroidism) include medications such as:

  • Triptans, such as Zembrace SymTouch (sumatriptan)
  • Gepants, such as Qulipta (atogepant)
  • Ditans, such as Reyvow (lasmiditan)
  • Nasal sprays, such as Trudhesa (dihydroergotamine mesylate)
  • Non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen

Preventive treatments include neuromodulation devices (Cefaly) and monoclonal antibody infusions such as Vyepti (eptinezumab) that can be self-administered as an injection or delivered via an intravenous infusion.

When to See a Healthcare Provider

If your migraines seem to be getting worse or more frequent, talk to your healthcare provider, who may want to adjust your treatment plan.

Seek emergency care if you experience:

  • Unusually severe migraine symptoms
  • Confusion
  • Fever
  • Vision changes
  • A stiff neck
  • Numbness or weakness
  • Trouble speaking

Summary

Headaches are common in people with hypothyroidism. It is unclear whether headaches are a side effect of an underactive thyroid or a risk factor for developing the condition. If you have hypothyroidism and migraines, the thyroid hormone replacement medication levothyroxine may reduce the frequency of migraines.

A Word From Verywell

Migraines can be debilitating in some cases. If levothyroxine does not improve your headaches or if it makes them worse, you may need to treat your headache separately as a distinct disorder. Talk to your healthcare provider, who may want to refer you to a headache specialist.

7 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. International Headache Society. Headache attributed to hypothyroidism.The International Classification of Headache Disorders. 3rd ed. Phoenix, Arizona: IHS.

  2. Martin A, Pinney S, Xie C. et al. Headache disorders may be a risk factor for the development of new onset hypothyroidism. Headache. 2017;57(1):21-30. doi:10.1111/head.12943

  3. Martin AT, Pinney SM, Xie C, Herrick RL, Bai Y, Buckholz J, Martin VT. (2017) Headache Disorders May Be a Risk Factor for the Development of New Onset Hypothyroidism. Headache: The Journal of Head and Face Pain, 57: 21-30. doi:10.1111/head.12943

  4. Garber JR, Cobin RH, Gharib H, et al. Clinical practice guidelines for hypothyroidism in adults: Cosponsored by the American Association of Clinical Endocrinologists and the American Thyroid Association. Endocr Pract. 2012;18(6):988-1028. doi:10.4158/EP12280.GL

  5. National Library of Medicine. Medline Plus. Levothyroxine.

  6. American Migraine Foundation. New treatments for migraine.

  7. American Migraine Foundation. Understanding migraine treatment in the emergency room.

By Colleen Doherty, MD
 Colleen Doherty, MD, is a board-certified internist living with multiple sclerosis.