Migraines - overmedicated?

[cazzaleo]

Hi

I have Hashi’s, currently taking 50mcg/day levo and 15mcg/day liothyronine - is is an increase from 25mcg levo (still 15mcg liothyronine) after blood tests in Jan showing the following:

TSH 5.39 (0.27 - 4.2)

FT3 2.2 (3.1 - 6.8)

FT4 5.7 (12 - 22)

I had a migraine yesterday - haven’t had one since October when I had 4 in 5 days and it turned out the Hashi’s had caused a release of thyroid hormones as my results swing as follows (this was on 25mcg/day T4 and 15mcg/day T3):

TSH 0.04 0.27 - 4.2)

FT3 7.9 (3.1 - 6.8)

FT4 13.5 (12 - 22)

So I was wondering if anyone had experienced if migraines when levels swing high and if things settled and there wasn’t a need to think about changing dose (unless levels very high of course, and I will have more blood tests next week).

I realise there are plenty of other possible triggers for yesterday’s migraine but would be good to hear others’ experiences.

Many thanks!

[cazzaleo]

Or maybe the migraines are related to Hashi’s flares?!

[greygoose]

You are horribly under-medicated to have a TSH over 5. It should be brought down to 1 or under. And, your Frees are below range. It's probably your continuing hypothyroidism that is causing your migraines.

[cazzaleo in reply to greygoose]

Thanks greygoose - those results were from when I was on 25mcg T4 and 15mcg T3, I’m due blood tests next week to see where I am after the increase in T4 to 50mcg (keeping T3 at 15mcg)

[greygoose in reply to cazzaleo]

Given how low your Frees are there, it's unlikely that an increase of 25 mcg has made much difference - unless, of course, you've had another Hashi's 'hyper' swing.

[cazzaleo in reply to greygoose]

I wasn’t sure if it’d be enough to make a difference and did wonder about the possibility of another swing 🤔 Thanks greygoose. So you think I’ve either had another swing or still undermedicated, either of which could be causing migraines?

[greygoose in reply to cazzaleo]

That's right, yes. And, the blood test will show either way.

[cazzaleo in reply to greygoose]

Thanks!

[greygoose in reply to cazzaleo]

You're welcome.

[Lovecake]

Hi cazzaleo, I get migraines too.

Have you had your vitamin D tested?

When mine was first done it was down at 21 (range 50-199). I’ve found that when my vitD is over 80, my migraines are less frequent and less severe.

I also found that I don’t absorb vitD tablet form well. So I either take liquid capsules (as per GP when on loading dose) or sublingual spray.

If you are not on any blood thinning meds (inc aspirin) then it is recommended on here that you take k2. (BetterYou do a spray with and without k2). Also taking magnesium (I use a lotion so it doesn’t mess up when I take my thyroid meds).

You should take vitD and magnesium 4hrs away from thyroid meds.

The National migraine centre recommend magnesium too.

Anyway, I have found the above to really help with the migraine issue.

I get a bad head if I’m changing meds up or down too. That seems to be my body’s way of warning me if something’s not quite right. (More issues with adding T4 than T3 though).

[cazzaleo in reply to Lovecake]

Hi Lovecake!

Sorry to hear you’re a migraine sufferer too, great that you’ve got it under control though!

I haven’t had my vit D tested for a while but was planning too with my next thyroid tests. I do supplement (with K2), and magnesium too.

There are many possible triggers for the other day really - I might’ve overdone it with a bit of walking (my exercise tolerance levels are very poor, I’ve been diagnosed with ME/CFS but of course not sure if it’s just thyroid issues really!), I sat in the sun for a while, I had an osteopath treatment in the morning with some work on my head and my periods due on Sunday. So could be any of that - or maybe Hashi’s swing/thyroid levels too high 🤔

[Lovecake in reply to cazzaleo]

Sounds like a busy day. Think I’d be suffering too after that.

A sunny day can be torture for someone with migraine issues.

I also have Imigran (sumatriptan, can’t tolerate generic) which kicks a migraine into touch if I need it.

I find it frustrating that on top of the low energy from the thyroid issues (it can suddenly drop to zero) and the triggers for migraines I seem to lead a rather sedentary life compared with many others.

I teach ballroom dancing, but have had to reduce to one night a week and a very small class. They are all older than me and I can tell you, put me to shame when I hear one (70 yr old) say he was up at 6am playing golf! And then he’s still at a dance class at 7.30pm!

Oh well, such is life. I do get the odd few days of feeling ok, so I shouldn’t be ungrateful. ☺️

[cazzaleo]

Ahhhh Imigran, I used to get that when you could still get it OTC, was really good, don’t know why I didn’t think to ask the Dr for it! They gave me something else which I felt made me feel worse.

I know, its frustrating isn’t it?! I did way more the other day than I usually would should’ve known I’d suffer for it in one way or another.

Yup, I always try to look at the good points and be grateful for that too 😃

[blondpalomino]

Hi cazzaleo,

I too have suffered a lot with migraines.You mentioned your period being due shortly, I know that a lot of my migraines were due to hormones.I also found that if I got several triggers together - one of mine is stress ,another tiredness, then I would be more likely to get a migraine.Thankfully I gave up work - which was the stress one- and am just about through the menopause - the hormonal one - so am now a lot better,only getting the occasional one. I also would take Imigran, or one of the other similar migraine drugs prescribed by the doctor, which helped in the short term and would get me through the day, but I found they had a rebound effect and the next day the migraine would come back and I would need another tablet, which became a vicious circle, and I found I was taking them nearly every day.I managed to wean off them when I gave up work, and now just take paracetomol/codeine which I get over the counter. I think it's your body's way of telling you you are doing too much, and need to rest.If you get a migraine you can't do much else! Kind regards.

[cazzaleo in reply to blondpalomino]

Hi blondpalomino

They are tricky things to navigate, aren’t they?! I think sometimes I can forget to be careful of my triggers because it might be months since my last (but then I can also end up with multiple migraines in a very short space of time).

[Hidden]

Hi, I used to get migraines pretty bad till the menopause. The only thing that did any good for me was Migril, but these days the migraines are much less and a couple of co-codamol tablets, or half a Migril tablet at most, usually settle any symptoms.

Since starting on Levothyroxine last year, I've had headaches when needing an increase, but they mostly feel different from migraine, though can also lead to a migraine. I think they are a hypo symptom in my case.

[cazzaleo in reply to Hidden]

Hi Jnetti

Thanks, I’ll look into Migril.

I can definitely tell the difference between a migraine and headache, apart from the difference in pain and nausea etc I get aura before my migraines

[Hidden in reply to cazzaleo]

Migril (the main active ingredient is called ergotamine) is pretty powerful and doesn't suit everyone, but it might be worth a try if the doctor agrees. I would try half a one to begin, just in case you get a reaction. They are quicker to kick in than ordinary painkillers. They can cause sleepiness though, so wait till the effect wears off before trying to drive or anything.

[cazzaleo in reply to Hidden]

Thanks for the tips 😃 I hadn’t heard of it before

[Hidden in reply to cazzaleo]

I hope it helps and is available, I've had a couple of problems with supply. But don't be surprised if doctor is reluctant to prescribe, it doesn't seem popular!

[cazzaleo in reply to Hidden]

Ha - never feel optimistic when I go to my GP with a request!!

[Hidden in reply to cazzaleo]

Maybe if you just explain that your present migraine meds don't help much and that someone told you about Migril…?

[cazzaleo in reply to Hidden]

I’ll give it a go!