Hypothyroidism And Headaches

No one likes headaches but someone with hypothyroidism may experience more than their fair share of them!  According to the International Headache Society around 30% of people with hypothyroidism experience headaches to go with their underactive thyroid.  So you could almost say that hypothyroidism and headaches go together.

Whilst officially a headache caused by hypothyroidism is described as being

  • bi-lateral (affects both sides of the head simultaneously),
  • non-pulsatile and constant (doesn’t throb)
  • not associated with vomiting or nausea

many hypothyroidism patients do in fact experience headaches that are one-sided, do throb and do come with nausea and vomiting.  However, studies indicate that some of these patients also have a history of migraines.

Hypothyroidism And Headaches – Diagnosis

If hypothyroidism has been diagnosed and the headache generally meets the criteria for a hypothyroidism headache then it can generally be considered one.  However, as with many symptoms and side effects of this disorder, it may well be the headache that triggers the diagnosis of the underlying hypothyroidism.

Hypothyroidism headaches also tend to develop in tandem with the hypothyroidism.  As that condition worsens so too do the headaches.  The reverse is also true – as treatment for the hypothyroidism takes effect the headaches should likewise begin to subside.  If they don’t, your doctor will look for other causes.

Interesting Questions about Thyroid:

How is Hyperthyroidism Treated?

The basic goal of treatment is to return thyroid hormone levels to normal.

Hyperthyroidism makes the body work too fast because there is too much thyroid hormone in the blood. Graves’ disease is the most common cause of hyperthyroidism. Graves’ disease occurs because of a problem in the body’s immune system: antibodies are produced that overstimulate the thyroid gland.

Patients who are hyperthyroid from taking too much thyroid hormone need only to have their dosage properly adjusted.

Patients whose hyperthyroidism is caused by transient thyroiditis usually do not require any of the treatments described below, since their condition gets better on its own.

Treatment for hyperthyroidism from Graves’ disease, toxic autonomously functioning thyroid nodule, or toxic multi-nodular goiter may include one or more of the following:

Radioactive iodine (I131)

Radioactive iodine shrinks an enlarged thyroid or toxic nodule or nodules that are making too much thyroid hormone. This treatment is safe and is widely used in adults with hyperthyroidism.

* Radioactive iodine (I131) is the treatment of choice for the majority of the endocrinologists in this country. It is an effective, simple, safe way to treat patients with Graves’ disease or other forms of hyperthyroidism. Patients often have fears and misconceptions about using radioactive iodine.

* Studies have been done since the 1940’s on patients receiving this treatment. Treated patients, their children, and their grandchildren do not have an increased incidence of cancer, leukemia, etc.

* There are no increased instances of birth defects in children born to mothers who have had this treatment and waited the recommended time before becoming pregnant. (Pregnancy should be avoided for at least six months after the treatment.) As a matter of fact, fertility is often restored to women whose infertility is due to hyperthyroidism. Treating the disease also lessens the chance of miscarriage.

* Pregnant women should not be given radioactive iodine for any reason. If a patient has any doubt as to whether she is pregnant, treatment (and testing) with radioactive iodine should be delayed.

* Hospitalization is not required in order to treat hyperthyroidism with radioactive iodine.

* Radioactive iodine treatment ablates the thyroid gland (turns it into something like a dried-up raisin). Patients wishing to avoid destruction of the gland should know that the thyroid gland frequently “burns out” within 15 years even without treatment.

* Radioactive iodine does not cause a person to gain weight. However, because Graves’ disease increases the metabolism, patients should keep in mind that they cannot continue to eat the way they did while hyperthyroid. Because of changes in the metabolism after hyperthyroidism is treated, many patients will gain weight . This weight can be lost through diet and exercise once the thyroid levels are normalized.

Antithyroid drugs

Propylthiouracil (PTU)
Tapazole®

Antithyroid drugs, such as propylthiouracil (PTU) and methimazole (Tapozole®), are used in patients with Graves’ disease and, less commonly, in other hyperthyroid patients

Surgery (thyroidectomy)

In some cases beta-blocking drugs are prescribed to treat the symptoms of hyperthyroidism while waiting for one of the above treatments to work.

Your doctor will be able to discuss the benefits and risks of each treatment.

Many patients treated for hyperthyroidism become hypothyroid. They will need to take thyroid hormone pills for the rest of their lives. In addition, they will need to see their doctor at least once a year.

® Tapozole is a registered trademark of Jones Medical Industries.

What Are the Main Types of Thyroiditis?

Chronic thyroiditis

Called Hashimoto’s thyroiditis, it is by far the most common form. It begins so slowly that most people don’t know anything is wrong. Over time, the disease destroys thyroid tissue until permanent hypothyroidism results. Some patients with Hashimoto’s have normal thyroid functions (euthyroidism) with a goiter.

Subacute thyroiditis

It’s a less common form, with far fewer cases than in chronic thyroiditis. Often caused by a viral infection, the disease lasts for several months. Subacute thyroiditis is painful, causing a tender, swollen thyroid gland with pain throughout the neck. The pain usually responds to treatment with aspirin or other anti-inflammatory drugs. At first, gland destruction causes the release of stored thyroid hormones, inducing temporary hyperthyroidism. A month or two later, the patient may become hypothyroid, because the thyroid has been damaged and its hormone reserves used up. Most patients return to normal within six to nine months, but the hypothyroidism could be permanent.

Painless thyroiditis

It causes a painless swelling of the thyroid gland. When this disease occurs after pregnancy, it is called postpartum thyroiditis. The course of painless thyroiditis is otherwise similiar to painful subacute thyroiditis.

Acute thyroiditis

A rare disease, is caused by an acute infection. Patients with the disease become very sick and have a high fever. The neck is red, hot, and very tender. Acute thyroiditis is a medical emergency and must be treated with antibiotics and surgery.

What About Thyroid Cancer?

Are all thyroid lumps cancerous? How common is thyroid cancer?

Thyroid lumps (also called nodules) are growths in or on the thyroid gland. They occur in 4%-7% of the population. A thyroid nodule might cause your voice to become hoarse, or it could make breathing or swallowing difficult. However, it usually produces no symptoms and is discovered incidentally by you or your physician

More than 90% of these lumps are benign (not cancerous) and do not need to be removed. Thyroid cancer is found in only about 15,000 people each year and causes about 1,210 deaths per year. The most common form (papillary cancer) moves very slowly, and treatment is almost always successful when the cancer is detected early. A less common form (follicular cancer) also moves relatively slowly. Two less frequent forms of thyroid cancer (undifferentiated, or anaplastic, and medullary) are more serious.

Who can get thyroid cancer?

Anyone can get thyroid cancer. However, one group in particular has a higher risk: people who have had radiation to the head or neck. From the 1920s to the 1960s, x-ray treatments were used for an enlarged thymus gland, inflamed tonsils and adenoids, ringworm, acne, and many other conditions.

At that time, doctors thought the x-rays were safe. About 1 million Americans received the treatment, and some of these people will get thyroid cancer up to 40 or more years after receiving the treatment. We now know that radiation therapy to the head or neck increases the chance of developing thyroid cancer later in life. (Radioactive iodine treatments and x-rays used for testing do not increase the risk of cancer.)

Others at higher risk include a child or elderly person with a lump (nodule) in the thyroid. If a man has a thyroid nodule, it is more likely to be cancerous than if a woman has one.

Have more questions? Need more answers? Check our Full Thyroid FAQ

Treating Your Hypothyroidism And Headaches

In most cases treatment of your hypothyroidism should also sort out most of your headache problems.  That’s IF the headaches are being caused solely by the hypothyroidism and not some other cause.   For instance, in rare cases hypothyroidism and headaches can be an indication of a pituitary tumor.  Other types of headaches though, notably tension headaches and migraines, will not respond to thyroid treatment and may even get worse with treatment.  Therefore it’s clear that there really is no one-size fits all approach to treating hypothyroidism and headaches and that each patient should be assessed on an individual basis and treatment regimes planned accordingly.

Furthermore, speaking of migraines, this study looked at the association of hypothyroidism with migraines.  The authors found that when they compared their own headache clinic results with a population based study on the incidence of hypothyroidism in the general public, hypothyroidism was 3 times more prevalent in patients they’d treated for migraines than was found in the population-based study.

Donna Morgan

Donna Morgan

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