Hashimoto's and Migraines - Synthroid worsens Migraines?

Health Professional

Full Question:

My 11-year-old girl Hashimoto's hypothyroid. 1 month on Synthroid start on 75mcg many changes and holding dt tolerated poorly. Now migraines with aura. Had migraines before but never this bad or with aura. She taken Fioricet twice it was so bad it was scary I thought she was going to have a stroke. Pedi knows she took Fioricet. What are her non sedative options for medication? I'm not crazy about tricyclics or anticonvulsants as I do not tolerate them for my migraines. I can barely articulate a sentence on them. She has exercise asthma so beta blockers are probably out. When we are holding her Snythroid they go away. Seems her migraines are probably from hypothyroid as they started only this last year. Suzanne.

Full Answer:

Dear Suzanne;

Thyroid issues can be a Migraine trigger, so it's very important to resolve your daughter's problems with her thyroid treatment and keep it will managed. Not treating the Hashimoto's isn't a viable solution, as you know. It's also important to know that migraine is a neurological disease and classified as a primary headache disorder. That means that it is not caused by any other disease or disorder. Your daughter's Hashimoto's can be triggering Migraine attacks, but it cannot cause her to have the disease in the first place. Sometimes, people with Migraine disease don't start experiencing Migraine attacks until they're older than your daughter. It could also be that she doesn't have many triggers, so her migraines have been few and mild and were thought to be "normal" headaches.

Fioricet is not a good choice for treating Migraine. Research has shown that it can actually make Migraines worse because any use of opioids or barbiturates (the butalbital in the Fioricet) increases the risk of Migraines becoming chronic. Maxalt, a triptan medication that works to stop the Migraine's process, thus stopping the symptoms as well, is approved by the FDA for children as young as six-years-old. Axert, another triptan, is FDA approved for children as young as 12- years-old. These are options you can discuss with her doctor. As for preventives, it may be possible to get her Migraines managed without them. If she does need them, there are many to choose from. Periactin, an antihistamine, has shown success with children. Verapamil and other calcium channel blockers are also an option that don't present problems with asthma. In addition, there ar some supplements that can be helpful for Migraine prevention - coenzyme Q10, magnesium, and ribovlavin (Vitamin B2), for starters.

Your best course of action at this point is to have an endocrinologist, hopefully one who specializes in thyroid, work with you on the Hashimoto's. There are medications other than Synthroid that can be used. Also, timing of when the medication is taken and / or taking smaller doses more frequently might make a big difference. Have that doctor consult the doctor who is treating her for Migraines.

mIf her doctor isn't able to help with the migraines, it may well be time to consult a Migraine and headache specialist. It's important to note that neurologists aren't necessarily Migraine and headache specialists. Take a look at the article  Migraine and Headache Specialists - What's So Special? If you need help finding a Migraine specialist, check our listing of ** Patient Recommended Migraine and Headache Specialists**.

Good luck,
John Claude Krusz and Teri Robert

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