Subclinical hypothyroidism is associated with migraine: A case-control study

Rubino, Elisa; Rainero, Innocenzo; Garino, Francesca; Vicentini, Costanza; Govone, Flora; Vacca, Alessandro; Gai, Annalisa; Gentile, Salvatore; G, Govone; Ragazzoni, Federico; Pinessi, Lorenzo; Giordana, Maria Teresa; Limone, Paolo Piero

doi:10.1177/0333102418769917

Cited by 29 publications

(42 citation statements)

References 35 publications

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“…In 2018, an Italian case‐control study of 151 patients with subclinical hypothyroidism, reported that prevalence of migraine was higher compared to controls (46% vs 13%, respectively), without statistically significant differences in clinical characteristics of migraine between the 2 aforementioned groups. As for the groups with subclinical hypothyroidism, both with migraine and without migraine, serological differences in thyroid hormone values were not found, while in the group with subclinical hypothyroidism and migraine, the prevalence of other autoimmune disorders was higher (27.1% vs 9.8% respectively).…”

Section: Resultsmentioning

confidence: 99%

“…Rubino et al stated as a limitation of their study the limited number of patients included, while the possibility of volunteer bias could not be excluded in the study by Martin et al Moreover, in 3 studies patients recruitment was made from a specialized headache center, thus making difficult the generalization of their results. Additionally, in 3 other studies patients were recruited from endocrinological outpatient clinics . In contrast, 3 large population‐based studies were included .…”

Section: Discussionmentioning

confidence: 99%

“…Comorbidity in general, refers to the greater than coincidental association of separate conditions . In particular, of a total of 5 studies that investigated the above hypothesis, 3 studies had clearly positive outcomes . A Norwegian study, presented contradictory findings.…”

Section: Discussionmentioning

confidence: 99%

“…Concerning the diagnosis of migraine, the strength of the majority of the studies is that they were based on standardized diagnostic criteria . However, in the study by Le et al diagnosis of migraine and in particular migraine with aura, was based on 2 questions, leading to both false positive and negative reports.…”

Section: Discussionmentioning

confidence: 99%

“…Finally, the study by Moreau et al did not state how the diagnosis of migraine was made. Diagnosis of hypothyroidism was another crucial point, and was based on laboratory measurements in the majority of the studies . However, in the study by Martin et al the diagnosis of hypothyroidism was based either on laboratory measurements or on the initiation of thyroid replacement medications by their treating physician, while serum samples for thyroid antibodies were not analyzed.…”

Section: Discussionmentioning

confidence: 99%

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Relationship of Migraine and Tension‐Type Headache With Hypothyroidism: A Literature Review

et al. 2019

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Background Migraine, tension‐type headache, and hypothyroidism constitute very common medical conditions. Headache is one of the most common symptoms of hypothyroidism, occurring in approximately one‐third of the patients. To date, data about the relationship between migraine and tension‐type headache and thyroid dysfunction, and in particular hypothyroidism have been contradictory, while the underlying pathophysiological basis explaining this association is still unclear. Objective In this review, we investigated the association between primary headaches and hypothyroidism, with the aim of shedding light on its pathophysiological basis. Methods We conducted a systematic search in the MEDLINE database using both subject headings and keywords for headache, migraine, tension‐type headache, thyroid hormones, and hypothyroidism, and we also examined manually the reference lists of all articles that met the inclusion criteria. Included studies were related to headache and thyroid disease comorbidity, with emphasis on hypothyroidism (ideally demonstrated by hormonal measurements), and with the term headache including migraine, tension‐type headache, and headache attributed to hypothyroidism (HAH) based on the International Classification of Headache Disorders IIIb. Quality of studies was assessed by the Newcastle‐Ottawa scale. Results Of a total of 640 identified articles, 9 studies were included. Overall, there was vast heterogeneity across the included studies concerning population, study design and outcomes. Two studies investigated the HAH, with emphasis on the clinical characteristics of headache (time of onset, localization, quality, intensity, and response to hormonal replacement treatment). Five studies investigated comorbidity between migraine and thyroid disorders, especially hypothyroidism, and in the majority of them a positive association was demonstrated. One study found that headache, and particularly migraine, may increase the risk of developing hypothyroidism. Finally, only 1 study on chronic tension‐type headache found coexistence of migraine and hypoactivity of the hypothalamus‐pituitary‐thyroid axis. The strengths and limitations of these studies are analyzed and possible pathophysiological mechanisms are suggested. Conclusions The existing data are considered inadequate to answer with certainty the relationship between headaches and thyroid disorders. According to our analysis, it seems that suggestions for a possible bidirectional association between headaches and especially migraine and hypothyroidism could exist. It hence lays the foundation for further research into the aforementioned association and its pathogenesis via large prospective multicenter studies.

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Section: Resultsmentioning

confidence: 99%