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CC BY-NC-ND 4.0 · Arq Neuropsiquiatr 2020; 78(11): 695-699
DOI: 10.1590/0004-282X20200070
Articles

Primary headache subtypes and thyroid dysfunction: Is there any association?

Subtipos de cefaleia primária e disfunção tireoidiana: existe alguma associação?

Authors

  • Ioanna SPANOU 

    1   National and Kapodistrian University of Athens, Medical School, Aeginition Hospital, Athens, Greece.

  • Foteini CHRISTIDI 

    1   National and Kapodistrian University of Athens, Medical School, Aeginition Hospital, Athens, Greece.

  • Georgios LIAKAKIS 

    1   National and Kapodistrian University of Athens, Medical School, Aeginition Hospital, Athens, Greece.

  • Konstantina RIZONAKI 

    1   National and Kapodistrian University of Athens, Medical School, Aeginition Hospital, Athens, Greece.

  • Anastasia BOUGEA 

    1   National and Kapodistrian University of Athens, Medical School, Aeginition Hospital, Athens, Greece.

  • Evangelos ANAGNOSTOU 

    1   National and Kapodistrian University of Athens, Medical School, Aeginition Hospital, Athens, Greece.

  • Evangelia KARARIZOU 

    1   National and Kapodistrian University of Athens, Medical School, Aeginition Hospital, Athens, Greece.
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ABSTRACT

Background: Primary headaches, and particularly migraine and tension-type headache (TTH) as well as hypothyroidism are common medical conditions. To date, numerous studies have suggested a possible bidirectional relationship between migraine and hypothyroidism, although certain studies had contradictory results. Objective: To investigate whether there is any association between primary headache subtypes and thyroid disorders. Methods: A retrospective study of consecutive patients aged ≥18 years referred to the Headache Outpatient Clinic of Aeginition Hospital and diagnosed with primary headache and any thyroid disorder. Results: Out of 427 patients (males/females=76/351), 253 (59.3%) were diagnosed with migraine without aura, 53 (12.4%) with TTH, 49 (11.5%) with migraine with aura, 29 (6.8%) with medication-overuse headache, 23 (5.4%) with mixed-type headache (migraine with/without aura and TTH), nine (2.1%) with cluster headache, and 11 (2.6%) with other types of primary headaches. The prevalence of any type of thyroid disorder was 20.8% (89/427 patients). In the total sample, 27 patients (6.3%) reported hypothyroidism, 18 (4.2%) unspecified thyroidopathy, 14 (3.3%) thyroid nodules, 12 (2.8%) Hashimoto thyroiditis, 12 (2.8%) thyroidectomy, three (0.7%) thyroid goiter, and three (0.7%) hyperthyroidism. Further statistical analysis between categorical variables did not reveal any significant association between headache subtypes and thyroid dysfunction. Conclusions: No specific association was found between primary headache subtypes and specific thyroid disorder. However, a high prevalence of thyroid dysfunction in general and specifically hypothyroidism was demonstrated among patients with primary headaches, which lays the foundation for further clarification in prospective longitudinal studies.

RESUMO

Introdução: Cefaleias primárias e, particularmente, enxaqueca e cefaleia do tipo tensional (CTT), bem como hipotiroidismo, constituem condições médicas comuns. Até o momento, vários estudos sugeriram uma possível relação bidirecional entre enxaqueca e hipotireoidismo, embora alguns estudos tenham resultados contraditórios. Objetivo: Investigar se existe associação entre subtipos de cefaleia primária e distúrbios da tireoide. Métodos: Estudo retrospectivo de pacientes consecutivos com idade ≥18 anos encaminhados ao Ambulatório de Cefaleia do Hospital Aeginition, com diagnóstico de cefaleia primária e qualquer distúrbio da tireoide. Resultados: De 427 pacientes (homens/mulheres=76/351), 253 pacientes (59,3%) foram diagnosticados com enxaqueca sem aura, 53 (12,4%) com CTT, 49 (11,5%) com enxaqueca com aura, 29 (6,8 %) com cefaleia por uso excessivo de medicamentos, 23 (5,4%) com cefaleia mista (enxaqueca com/sem aura e CTT), nove (2,1%) com cefaleia em salvas e 11 (2,6%) com outros tipos de cefaleias primárias. A prevalência de qualquer tipo de distúrbio tireoidiano foi de 20,8% (89/427 pacientes). Na amostra total, 27 pacientes (6,3%) relataram hipotireoidismo, 18 (4,2%) tireoidopatia não especificada, 14 (3,3%) nódulos de tireoide, 12 (2,8%) tireoidite de Hashimoto, 12 (2,8%) tireoidectomia, três (0,7%) bócio da tireoide e três (0,7%) hipertireoidismo. Uma análise estatística posterior entre as variáveis categóricas não revelou qualquer associação significativa entre os subtipos de cefaleia e disfunção tireoidiana. Conclusões: Não encontramos associação entre subtipos de cefaleia primária e distúrbio específico da tireoide. No entanto, foi observada prevalência elevada de disfunção tireoidiana em geral e especificamente hipotireoidismo entre pacientes com cefaleia primária, o que estabelece base para maiores esclarecimentos em estudos longitudinais prospectivos.

Keywords:

Headache - Migraine Disorders - Tension-type Headache - Thyroid Diseases - Hypothyroidism

Palavras-chave:

Cefaleia Primária - Transtornos de Enxaqueca - Cefaleia de Tipo Tensional - Distúrbio da Tireoide - Hipotireoidismo

Authors’ contributions:

IS and EK: conception and design. IS, GL, KR and AB: acquisition of data. IS, FC and EK: analysis and interpretation of data. IS and EK: drafting the manuscript. IS, FC, GL, KR, AB, EA and EK: revising it for intellectual content and final approval of the completed manuscript.


Disclosure:

An earlier version of this work has been presented as an abstract at the 13th European Headache Federation Congress.




Publication History

Received: 03 May 2020

Accepted: 17 May 2020

Article published online:
07 June 2023

© 2020. Academia Brasileira de Neurologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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