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. 2017 Jan;57(1):21-30.
doi: 10.1111/head.12943. Epub 2016 Sep 27.

Headache Disorders May Be a Risk Factor for the Development of New Onset Hypothyroidism

Andrew T Martin  1 , Susan M Pinney  1 , Changchun Xie  1 , Robert L Herrick  1 , Yun Bai  1 , Jeanette Buckholz  1 , Vincent T Martin  2
Affiliations

Headache Disorders May Be a Risk Factor for the Development of New Onset Hypothyroidism

Andrew T Martin et al. Headache. 2017 Jan.

Abstract

Objective: To determine whether headache disorders are a risk factor for the development of new onset hypothyroidism.

Background: Past studies have reported associations between headache disorders and hypothyroidism, but the directionality of the association is unknown.

Methods: This was a longitudinal retrospective cohort study using data from the Fernald Medical Monitoring Program (FMMP). Residents received physical examinations and thyroid function testing every 3 years during the 20 year program. Residents were excluded from the cohort if there was evidence of past thyroid disease or abnormal thyroid function tests at the first office visit. A diagnosis of a headache disorder was established by self-report of "frequent headaches," use of any headache-specific medication, or a physician diagnosis of a headache disorder. The primary outcome measure was new onset hypothyroidism defined as the initiation of thyroid replacement therapy or TSH ≥ 10 without thyroid medication. A Cox survival analysis with time dependent variables were used for the model. Headache disorders, age, sex, body mass index, income, smoking, narcotic use, and hypothyroidism-producing medications were independent variables in the model.

Results: Data from 8412 residents enrolled in the FMMP were used in the current study. Headache disorders were present in about 26% of the residents and new onset hypothyroidism developed in ∼7%. The hazard ratio for the development of new onset hypothyroidism was 1.21 (95% CI = 1.001, 1.462) for those with headache disorders.

Conclusions: Headache disorders may be associated with an increased risk for the development of new onset hypothyroidism.

Keywords: headache; hypothyroidism; migraine.

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Conflict of interest statement

Conflicts of Interest: Andrew T. Martin, BA: no conflicts; Susan M. Pinney, PhD: no conflicts; Changchun Xie, PhD: no conflicts; Robert L. Herrick, PhD: no conflicts; Yun Bai, PhD: no conflicts; Jeanette Buckholz, RN, MSN: no conflicts; Vincent T. Martin, MD: Depomed: speaker, Neuroscion: consultant, Allergan: speaker, Teva: speaker, Lilly: research, consultant, Avenir: speaker.

Figures

Fig. 1.—
Fig. 1.—
Flow of patients through study.
Fig. 2.—
Fig. 2.—
Model predicted cumulative incidence of hypothyroidism in persons with and without a headache disorder stratified by years from baseline exam.
See this image and copyright information in PMC

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