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Nearly 30% of hypothyroid patients have headaches. Half of the population who live with headaches and hypothyroidism report migraines. However, the relationship between hypothyroidism and migraines is relatively new to the medical community. While there is a substantial crossover between hypothyroidism and migraines, the relationship between the two is poorly understood.   

The majority of people with migraines attributed to hypothyroidism are women. According to the American Thyroid Association, women are five to eight times more likely to have a thyroid condition compared to men. Similarly, women are nearly three times more likely to suffer from migraines compared to men. Furthermore, many women experience migraines during their menstrual periods. While these statistics suggest a hormonal component, a hypothyroidism diagnosis often comes after the age of 60 - well into the menopausal years for most women. 

Recent studies have found that a history of headaches and migraines may increase your risk for hypothyroidism. While there is still a lot to learn, studies show that people with both conditions report improvement of migraines when their hypothyroidism is under control. Similarly, people with uncontrolled hypothyroidism report a worsening of migraine frequency and severity.   

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Optimize thyroid medication dosage

Thyroid hormone replacement treatment can help manage the symptoms of hypothyroidism. It is essential to work with a trustworthy thyroid specialist to find the right dose of thyroid medication. Dialing in the correct dosage for you can take time, as your body will need to adjust to the presence of the synthetic hormone in your system.

People who have the right treatment and dosage of hormone medication report a significant decrease in the frequency of migraines, as well as a reduction in the severity.  

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Assess your diet

Food may be a trigger for migraines. While the data is inconclusive, there are certain foods commonly identified as triggers for migraines:

Aged cheese

Foods that undergo an aging process contain tyramine, a compound that forms when bacteria break down the amino acid tyrosine. People with chronic migraines may have higher levels of tyramine in their blood compared to people without migraines. 

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Processed meat

Tyramine is also found in processed meat. Nitrates found in processed meat, such as bacon, hot dogs, and deli meat, have also been associated with migraines. Some people report having a migraine within minutes to hours of eating processed meat.  

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Alcohol

Many people who suffer from migraines find alcohol to be a trigger. Histamine may be the culprit in alcohol. Indeed, histamine is particularly high in red wine. Interestingly, histamine is also in aged cheeses and processed meats. 

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Chocolate

Although there is little evidence for why chocolate may cause migraines, about 19% of people with migraines identify chocolate as a trigger.

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Gluten-laden foods (wheat, barley, rye, etc.)

People with gluten sensitivity and celiac disease can trigger migraines by eating foods containing gluten. 

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Artificial sweeteners

Some people report an increased frequency in migraines with ingesting aspartame and sucralose.

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Citrus fruits

Lemons, oranges, and limes are some of the citrus fruits that may trigger migraines.

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Monosodium glutamate (MSG)

There is some evidence that MSG triggers migraines. 

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Reduce caffeine

We live in a world with influential coffee culture. Most of us start our day with something warm in hand, and some find respite in a cold soda in the afternoon. However, research points towards caffeine as one of the biggest culprits driving headaches and migraines in our population.

Caffeine has a complicated relationship with migraines. On one level, caffeine consumption can trigger migraines in some people. However, it is also one of the active ingredients in some migraine medications as it also demonstrates therapeutic properties. If caffeine consumption is a habit, and you skip your daily drink, withdrawing from caffeine can lead to a caffeine withdrawal migraine. We suggest lowering your consumption gradually over a few weeks.   

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Consider magnesium supplements

Magnesium is an essential nutrient for overall health. Indeed, it is necessary for numerous biochemical reactions in the body. Many people with hypothyroidism, especially the autoimmune condition Hashimoto’s, may be deficient in certain micronutrients. This deficiency may be related to gut inflammation, imbalance in your gut bacteria, effects of certain medications, and difficulty breaking down and absorbing nutrients.

Adding a magnesium citrate supplement at night may improve symptoms of hypothyroidism. Along with reducing migraine frequency and severity, taking magnesium at night time may improve insomnia, constipation, and anxiety. If you think you want to add support supplements to your lifestyle, meet with a doctor to determine the right kind and dosage for you.

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There are many recommendations available for migraine and hypothyroid-friendly diets. The National Headache Foundation recommends a low-tyramine diet to help eliminate dietary triggers containing tyramine. This diet involves removing processed meats, aged cheeses, fermented vegetables such as sauerkraut, fermented soy products, and tap beer.

People on a low-tyramine diet should limit their intake of:

• Cheese - particularly cheddar and swiss
• Tofu 
• Citrus
• Wine and domestic canned beers
• Chocolate-based products
• Foods with artificial sweeteners, MSG, and nitrates.

The low-tyramine diet can be beneficial for other symptoms of hypothyroidism, such as weight gain. This diet encourages people to eat fresh foods, as well as aims to limit eating foods high in sugar. 

A low-histamine diet may also be beneficial for managing migraines and hypothyroidism. A low-histamine diet removes foods that contain high levels of histamine to help improve digestive health, which is closely linked to thyroid health.

Foods that contain high levels of histamine include:

• Fermented dairy products (yogurt, some cheeses, sour cream, buttermilk, etc.)
• Fermented vegetables
• Pickled vegetables
• Kombucha
• Fermented soy products
• Fermented bread products (sourdough bread, for example)
• Fermented or cured meat (sausage, salami, etc.)
• Nightshade vegetables (tomatoes, eggplants, etc.)
• Salted of canned fish (sardines, anchovies, etc.)
• Vinegar

Finally, certain foods may improve thyroid function. Consider eating a diet rich in omega-3’s, which proves to improve thyroid hormone production. Similarly, make sure you are eating an appropriate amount of iodine to support thyroid function. Iodine is a vital nutrient in the body and is essential for thyroid hormone production. 

While we know very little about the interconnectedness between our digestive system and overall health, we do know that our diet plays a significant role in wellbeing. Therefore, if you experience migraines and hypothyroidism, it may help to try an elimination diet to determine if certain foods cause aggravate your symptoms. 

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There are many strategies to try to improve your migraines when you have hypothyroidism. The most important step you can take in managing migraines is to determine the best thyroid medication and dosage for you. For your overall health, it is vital to maintain a healthy lifestyle, reduce stress, get plenty of sleep, and eat a healthy diet. If you feel that your migraine headaches may be linked to hypothyroidism, meet with your thyroid doctor to get your life back.

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