Alokley Alia, ALNasser Maryam N, Alabdulqader Razan Anwar, Aljohni Faisal Abdulhamid, Alqadhib Duaa Hussain, Aljuaid Rose Khalid, Alshik Ali Montather Akeel, Hanbazazah Shahad Shadi, Almaqhawi Abdullah
Departments of Clinical Neurosciences, College of Medicine, King Faisal University, P.O. Box 400, Al Hofuf, Saudi Arabia.
Department of Biological Sciences, College of Science, King Faisal University, P.O. Box 400, Al Hofuf, Saudi Arabia.
BMC Neurol. 2025 May 6;25(1):198. doi: 10.1186/s12883-025-04214-4.
Subclinical hypothyroidism (SCH) is defined by elevated thyroid-stimulating hormone (TSH) levels alongside normal free thyroxine (T4) and triiodothyronine (T3) levels. Emerging evidence suggests a link between SCH and migraine disorders, including both episodic and chronic migraine. Given this association, researchers have explored whether correcting mild thyroid dysfunction with low-dose levothyroxine could alleviate migraine symptoms in affected individuals. This study investigates the potential efficacy of low-dose thyroid replacement therapy in reducing migraine frequency and severity among patients with comorbid SCH and migraine.
A search was conducted on Cochrane Central, Medline, Embase, Web of Science Core Collection, and Scopus to identify randomized clinical trials (RCTs), case-control studies, and cohort research studies evaluating the use of low-dose thyroxine in patients with subclinical hypothyroidism (SCH).
This review analyzed four studies, two of which qualified for meta-analysis. The findings suggest a potential association between (SCH) and migraine. Notably, levothyroxine treatment in hypothyroid patients appeared to correlate with reduced migraine frequency and headache severity. However, while the meta-analysis showed a trend toward migraine reduction with thyroxine therapy, the results did not reach statistical significance - likely due to the limited study sample included in the analysis.
The study highlights the importance of thyroid screening in migraine management, due to the link between hypothyroidism and migraines. It recommends routine thyroid function assessments for migraine patients and suggests personalized treatment approaches. Early intervention can minimize migraine episodes and improve quality of life. Adherence to low dose levothyroxine regimens can reduce migraine frequency. Further research is required to elucidate the underlying mechanisms, optimize treatment protocols, and explore potential comorbidities.
亚临床甲状腺功能减退症（SCH）的定义是促甲状腺激素（TSH）水平升高，同时游离甲状腺素（T4）和三碘甲状腺原氨酸（T3）水平正常。新出现的证据表明SCH与偏头痛疾病之间存在联系，包括发作性和慢性偏头痛。鉴于这种关联，研究人员探讨了用低剂量左甲状腺素纠正轻度甲状腺功能障碍是否可以缓解受影响个体的偏头痛症状。本研究调查低剂量甲状腺替代疗法在降低合并SCH和偏头痛患者的偏头痛频率和严重程度方面的潜在疗效。
在Cochrane Central、Medline、Embase、Web of Science核心合集和Scopus上进行检索，以识别评估低剂量甲状腺素在亚临床甲状腺功能减退症（SCH）患者中应用的随机临床试验（RCT）、病例对照研究和队列研究。
本综述分析了四项研究，其中两项符合荟萃分析的条件。研究结果表明SCH与偏头痛之间可能存在关联。值得注意的是，甲状腺功能减退患者的左甲状腺素治疗似乎与偏头痛频率降低和头痛严重程度减轻相关。然而，虽然荟萃分析显示甲状腺素治疗有降低偏头痛的趋势，但结果未达到统计学显著性——可能是由于分析中纳入的研究样本有限。
该研究强调了甲状腺筛查在偏头痛管理中的重要性，因为甲状腺功能减退与偏头痛之间存在联系。它建议对偏头痛患者进行常规甲状腺功能评估，并建议采用个性化治疗方法。早期干预可以减少偏头痛发作并改善生活质量。坚持低剂量左甲状腺素治疗方案可以降低偏头痛频率。需要进一步研究以阐明潜在机制、优化治疗方案并探索潜在的合并症。
