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

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


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.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Female
  • Headache Disorders / epidemiology*
  • Humans
  • Hypothyroidism / epidemiology*
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Ohio / epidemiology
  • Proportional Hazards Models
  • Retrospective Studies
  • Risk Factors
  • Self Report
  • Young Adult