Evaluation of the Relationship Between Thyroid Dysfunction and Menstrual Migraine in Adult Females

Abstract

Aim: Menstrual migraine (MM) is a condition linked to sudden estrogen withdrawal, however, changes in vascular system and neurotransmitters and several hormones are thought to be the underlying causes. Thyroid function affects both menstrual cycle and headache, however, the relationship between thyroid hormones and MM is still not clear. The aim of the study was to evaluate the relationship of MM with thyroid stimulating hormone (TSH), T3, and T4.Methods: Fifty-six patients without MM (group 1), 34 patients with MM (group 2) and 74 controls who had no migraine (group 3) were included in the study. The mean TSH, T3 and T4 levels were compared between the groups. Age, attack frequency (AF), attack period (AP), visual analog scale (VAS) score, Migraine Disability Assessment (MIDAS) grade, and MIDAS score were compared between group 1 and group 2. Correlation analysis was done for TSH, T3, T4 and each of the variables for the groups. Results:The mean T4 level in group 1, group 2 and group 3 was 1.06±1.74, 0.91±0.22 and 1.35±1.19 (p=0.03), respectively. The mean AF was 5.66±6.37 in group 1 and 3.08±1.81 in group 2 (p=0.02). Conclusion:T4 was significantly lower in patients with MM compared to patients without MM, and this difference became more prominent as compared with controls. We would like to draw attention of our colleagues to the relationship between thyroid function (particularly T4 decline) and MM.

Migraine and thyroid dysfunction: Co‐occurrence, shared genes and biological mechanisms

“…Ibrahimi et al [124] reported a decrease in oestrogen levels throughout the menstrual period with a change in the trigeminal vascular cycle. The role of oestrogen in thyroid dysfunction is unknown; however, a study evaluating the relationship between thyroid dysfunction and MM reported a decrease in fT4 levels associated with MM [123]. Hence, further studies delineating the role of oestrogen in thyroid dysfunction could provide a clearer view.…”

“…A group of healthy patients have shown a significant increase in plasma CGRP levels in women compared to men, with a further increase in CGRP levels in women using combined hormonal contraceptives [122]. In contrast, significantly lower levels of oestrogen have been reported in patients suffering from menstrual migraine (MM), which is the occurrence of migraine in the perimenstrual period that is linked to a drop in oestrogen levels [123,124]. Ibrahimi et al [124] reported a decrease in oestrogen levels throughout the menstrual period with a change in the trigeminal vascular cycle.…”

“…crease in oestrogen levels throughout the menstrual period with a change in the trigeminal vascular cycle. The role of oestrogen in thyroid dysfunction is unknown; however, a study evaluating the relationship thyroid dysfunction and MM reported a decrease in fT4 levels associated with MM[123]. Hence, further studies delineating the role of oestrogen in thyroid dysfunction could provide a clearer view.In addition to future studies examining the interplay of MTHFR, APOE, THADA and ITPK1 variants in large and deeply phenotyped cohorts, statistical genetic analyses examining the genetic overlap across migraine and thyroid-related GWAS at the SNP, gene and genome-wide levels have excellent potential to identify specific genetic risk factors and biological mechanisms underlying the relationship between migraine and thyroid dysfunction.…”