Migraine

My mother suffered from migraines for years. Turns out she was under-medicated for hypothyroidism for years.

Her old doc liked to keep her TSH at the top of the lab reference range at around 5 or 6. When she switched to a doc that kept her TSH in the lower end of the reference range, below 2, her migraines mostly went away. (A high TSH indicates hypothyroidism, a low TSH indicates hyperthyroidism. Most people without thyroid problems have a TSH between 1 and 2).

She went from having one migraine a month on average, to only having one in one year- and the one only after she neglected to take her thyroid meds for a few days.

Hi, Alanna,

Thanks for the great anecdotal evidence. My TSH has been running around 3, and my free T3 and T4 are in the low end of the range, so definitely, I need treatment. Our goal for my TSH is 1. This is exactly in line with what your mother found.

quote:

Originally posted by alanna:
My mother suffered from migraines for years. Turns out she was under-medicated for hypothyroidism for years.

Her old doc liked to keep her TSH at the top of the lab reference range at around 5 or 6. When she switched to a doc that kept her TSH in the lower end of the reference range, below 2, her migraines mostly went away. (A high TSH indicates hypothyroidism, a low TSH indicates hyperthyroidism. Most people without thyroid problems have a TSH between 1 and 2).

She went from having one migraine a month on average, to only having one in one year- and the one only after she neglected to take her thyroid meds for a few days.

quote:

Originally posted by Teri Robert:
Hi, Alanna,

Thanks for the great anecdotal evidence. My TSH has been running around 3, and my free T3 and T4 are in the low end of the range, so definitely, I need treatment. Our goal for my TSH is 1. This is exactly in line with what your mother found.

You lab values sound like mine before I started thyroid meds. My main symptoms were fatigue, insomnia, and leg pain, which gradually went away after I started thyroid meds.

I felt much better once my TSH was below 2 and my free T3 and free T4 were in the upper half of range. My sis feels best with her TSH just below 1. We both feel crappy with a TSH of 3.

We have a strong family history of Hashimoto's thyroid disease.

It sounds like you have a good doc, and I hope you feel better soon.

Thanks, Alanna,

It's helpful to share experiences. I've given up on my family doctor. My Migraine doctor is treating my thyroid too.

quote:

Originally posted by alanna:
You lab values sound like mine before I started thyroid meds. My main symptoms were fatigue, insomnia, and leg pain, which gradually went away after I started thyroid meds.

I felt much better once my TSH was below 2 and my free T3 and free T4 were in the upper half of range. My sis feels best with her TSH just below 1. We both feel crappy with a TSH of 3.

We have a strong family history of Hashimoto's thyroid disease.

It sounds like you have a good doc, and I hope you feel better soon.

You talk about have various endocrine tests - what are some that we should ask our docs about. A few years ago I had some done - the only one I know is off in me is Free Testosterone. I want to say one of my Thyroid battery were high but can't remember which. Not sure what all of the thyroid tests were done. I think TSH but not sure what else. I am on biorth control to treat the free testosterone - whenever i have been off the estrogen birth control it sky rockets again. Have yet to get a good explanation as to why other than it isn't due to cysts.


anyways... I want to know what I should ask my specialist about next visit.

Thanks

Whenever any part of the endocrine system is off, it can make us more susceptible to our triggers or even be a trigger.

On the thyroid -- TSH, Free T3, and Free T4 should be tested. If there's any family history of diabetes, Dr. Krusz recommends an H1c to test for diabetes. He also tends to test Vitamin D level and sometimes orders an IGF1 to test human growth hormone levels. I spent last week in his clinic in Dallas with him and listened to him talk about these things when taking patient histories and when reviewing labs during follow up visits.

Hope this helps!

quote:

Originally posted by Solta:
You talk about have various endocrine tests - what are some that we should ask our docs about. A few years ago I had some done - the only one I know is off in me is Free Testosterone. I want to say one of my Thyroid battery were high but can't remember which. Not sure what all of the thyroid tests were done. I think TSH but not sure what else. I am on biorth control to treat the free testosterone - whenever i have been off the estrogen birth control it sky rockets again. Have yet to get a good explanation as to why other than it isn't due to cysts.


anyways... I want to know what I should ask my specialist about next visit.

Thanks

Besides getting free T3, free T4, and TSH tested, as Terri mentioned, I recommends getting tested for anti-thyroid antibodies (anti-TPO, anti-Tg) as well.

Pregnancy and estrogen hrt can unmask a struggling thyroid gland, since estrogen increases thyroid requirements. I had to increase my thyroid dose during my last pregnancy, and some women even need their thyroid dose adjusted upwards when starting on the bc pill.

Also have you ever been checked for PCOS or insulin resistance? I have one friend with high testosterone, who has PCOS and hypothyroidism. She gets migraines too, but as long as she sticks to a low glycemic index diet and avoids her triggers she is usually ok.

My sis' testosterone is high also, and she gets a lot of ovarian cysts, my gp thinks she may have PCOS. (Her thyroid labs are all normal).

My other sis also gets ovarian cysts; she has endometriosis and hypothyroidism. Her doc has her on progesterone and thyroid hormone replacement.

I hope this helps.

I was checked for PCOS when I had the symptoms that unmasked the testosterone overload. I was cyst free. Doctor left it at that as I am not trying to get pregnant now. I have to stay on combination birth control pills to keep the testosterone levels in check though.

Ok, I'm glad they checked you out for PCOS.

Make sure when you get the thyroid panel they run *free* T3 and T4, not *total* T3 & T4. Taking estrogen will artificially inflate *total* levels.

I thought that was a really interesting article because I have been dealing with both hypothyroidism and migraine for a long time.

My GP cut back my thyroid meds too much because the labs showed I was almost hyperthyroid. However over the course of two months my head felt worse and worse. Yet I never really made the connection. I had my blood work retested and I was hypothyroid again... adjusting medication is a balancing act sometimes.

To make matter more confusing, some doctors disagree what the normal range TSH range is. I was 5.0, which to me, was off the scale. To my new GP, it was technically normal. After much discussion I got him to work with me and give me more medicine because I know how I feel, basically tired all the time, cold and constipated when I'm not getting enough thyroid supplement.

What I didn't realize though was that maybe my headaches and migraines were getting worse because of this whole experiment of adjusting my thyroid medication.

My thryoid levels are "normal" now, and the daily headaches are getting a bit more manageable.

Christine,

Glad you got your levels back under control and are feeling better. My Migraine doctor is treating my hypothyroidism too. MY GP decided that a TSH of 3.0 is fine even though my free T3 and T4 were low.

keep feeling better!

Teri,

I think everyone is individual when it comes to TSH levels. As you indicated, Mary Solomon is a great resource at about.com. She has pointed out that the American Association of Clinical Endocrinologists like to keep their patients somewhere between 0.3 to 3.0. Mine is now at 0.6. I kind of want to get to 1.0 so I won't get into a situation where I get out of the normal range.

But I don't want to tinker with my medicine until I get my headaches under control. Oh well. It's all good for now I guess. Feeling much better and less tired.