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June 08, 2023 7 min read

Hypothyroidism (underactive thyroid gland), a condition in which the thyroid gland doesn't produce enough thyroid hormones, can send your body into a tailspin. Fatigue, weight gain, and sensitivity to colds are just a few of the many symptoms that can come with it. To manage these symptoms and improve your thyroid function, a common treatment involves taking levothyroxine, a synthetic form of the thyroid hormone thyroxine (T4).

Though levothyroxine can help regulate your body's metabolism and energy levels, some patients have reported headaches as a side effect. And if you're one of them, you're probably wondering if levothyroxine could be the culprit behind your headache. So, let's discuss the possibility, how you can cope, and when it's time to consult a doctor.

The link between hypothyroidism and headache

Before diving into whether levothyroxine might be causing headaches, let's first grasp the possible connection between hypothyroidism and headaches. Although we're not exactly sure how they're linked, studies suggest that people with hypothyroidism could experience headaches. These headaches often show up as pulsating pain on both sides of the head. The study also found a connection between hypothyroidism and migraine headache.

The International Headache Society (IHS), which classifies headaches related to hypothyroidism, has specific guidelines to identify them. You'll likely experience the following if you have a headache attributed to hypothyroidism:

1. You have a confirmed diagnosis of hypothyroidism.

2. You experience pain on both sides of your head that usually gets better or disappears after successful hypothyroidism treatment.

3. You experience at least two of the following signs showing that hypothyroidism may have caused the headache:

  • The headache showed up before getting diagnosed with hypothyroidism or was the reason it was discovered.

  • Both headaches and hypothyroidism get worse at the same time.

  • Headache significantly eased following the improvement of hypothyroidism.

  • The headache occurs on both sides and/or is always there.

Apart from hypothyroidism possibly leading to headaches, migraine and headaches can also be a risk factor for hypothyroidism. A 2016 study discovered that roughly 7% of people with preexisting headache disorders were later diagnosed with new-onset hypothyroidism. Furthermore, having hypothyroidism might raise the risk of developing migraines and increase the chances of experiencing a severe headache or severe migraine episodes.

So, keep in mind this potential connection between hypothyroidism and headaches when thinking about the role levothyroxine might play in causing headaches.

Can levothyroxine cause headaches?

Studies have shown that using levothyroxine to treat hypothyroidism may help alleviate headaches and migraines, especially in cases of new-onset hypothyroidism or subclinical hypothyroidism, where the thyroid hormone levels are low but not low enough to be diagnosed with hypothyroidism.

In a study that involved 17 children with an average age of 11 and diagnosed with subclinical hypothyroidism and migraine, it was discovered that treatment with levothyroxine significantly reduced the intensity and frequency of migraine episodes. After the diagnosis of migraine headaches in patients based on clinical evaluation, free thyroxin (T4) and thyroid stimulating hormone (TSH) serum levels were measured to evaluate thyroid functions in all of the children. According to the Nelson Textbook of Pediatrics, normal values of serum-free T4 levels at ages 3-10 and in more than 10-year-old children are 5.5 -12.8 and 4.2 -13 microgram per deciliter (μg/dL), respectively.

However, some cases show that headaches and migraine attacks can be a common side effect of levothyroxine treatment.

What are the potential causes of headaches while on levothyroxine?

It might be confusing to experience headaches due to levothyroxine, a medication that's supposed to ease your hypothyroidism symptoms. However, there are several potential causes that may explain why it happens:

1. Dosage adjustment period

When initiating levothyroxine treatment or adjusting the dosage, some patients report experiencing headaches. Like any other medication, your body needs to acclimate to the hormonal changes that levothyroxine brings. During this adjustment period, fluctuations in your thyroid hormone levels can lead to temporary side effects like headaches.

It's crucial to understand that this transitional phase is usually short-lived, lasting only until your body adjusts to the new dosage and hormone levels stabilize. This duration can vary from person to person, so remaining patient and open with your healthcare provider about your symptoms can ensure that your treatment plan is tailored to your individual needs.

2. Wrong dosage

Occasionally, a physician might prescribe a dose of levothyroxine that is either too high or too low. An excessively high dose can trigger a thyroid disease called hyperthyroidism (an overactive thyroid), a condition that has the potential to cause headaches. Individuals taking higher dosages of this medication might experience increased frequency or intensity of headaches. On the other hand, if the dosage is too low, the hypothyroidism remains undertreated, and your headache, as a symptom of hypothyroidism, may not see any improvement.

3. Overstimulation

Although relatively rare, certain individuals with hypothyroidism might have a heightened sensitivity to thyroid hormone replacement therapy, like levothyroxine. In such cases, the medication can inadvertently cause overstimulation, giving rise to symptoms that closely resemble hyperthyroidism. These symptoms can include headaches, as well as other discomforts like insomnia, irritability, increased heart rate, and palpitations.

4. Interaction with other medications

Headaches may also arise as a consequence of levothyroxine interacting with other medications. Some patients require various medications for different conditions, and their combined use can lead to undesirable effects. For instance, some antidepressants, blood thinners, and anti-seizure drugs can interfere with levothyroxine. To minimize the risk of drug interactions, always inform your healthcare provider of all the medications and supplements you are currently taking.

5. Additives and fillers in the medication

For some people, the additives and fillers used in the formulation of levothyroxine tablets can cause headaches. Different brands may have different additives, and your body might react negatively to some of them. If this is the case, your healthcare provider may suggest trying another brand with different additives or consider prescribing a different form of thyroid hormone replacement medication.

6. Levothyroxine is not for you

Another reason levothyroxine may cause headaches is that the medication simply might not be suitable for you. This could be due to your body's inability to effectively convert the T4 hormone, provided by levothyroxine, into the more potent T3 hormone. This conversion process is vital for the proper regulation of thyroid hormones in the body. When an individual has difficulty or inefficiency in this conversion, it can result in an imbalance of these hormones, potentially leading to headaches.

In such cases, despite taking levothyroxine as prescribed, the body might not fully benefit from it since your body doesn't receive the active T3 hormone, leading to persistent hypothyroid symptoms, including headaches. It's important to address this conversion issue to properly manage and treat hypothyroidism-related headaches effectively.

7. Non-thyroid related causes

It's important to consider other potential factors unrelated to levothyroxine that could be contributing to your headaches. Stress, tension, dehydration, or eyestrain can all lead to headaches. Additionally, various underlying medical conditions, like uncontrolled hypertension, sinusitis, or sleep apnea, might also be responsible. As you work with your healthcare provider to address your headaches, it's essential to explore all possible causes and not solely focus on levothyroxine as the culprit.

Dealing with the side effects of levothyroxine: headaches.

How to deal with headaches caused by levothyroxine

Experiencing headaches while taking levothyroxine, a medication intended to improve your health can feel disheartening, but it's important to understand that there are numerous ways you can cope with it. Here are some things you can do:

1. Monitor and report

Keep a record of the frequency, severity, and duration of your headaches, as well as any potential triggers such as medication dosage adjustments, diet, or situational stress. This log can help you and your healthcare provider pinpoint the cause of your headaches and develop a tailored treatment or lifestyle plan to mitigate them.

2. Hydrate

Adequate hydration is essential for overall health and well-being. Many individuals experience headaches as a result of dehydration, so make sure to drink plenty of water throughout the day.

3. Develop a consistent sleep schedule

Poor sleep quality or an irregular sleep schedule can exacerbate or cause hypothyroidism and headaches. Establish a consistent sleep routine and create a bedtime environment that promotes relaxation to improve your sleep quality. Consider incorporating techniques like soft music, aromatherapy, or a comfortable sleep mask to block out light.

4. Manage stress

Chronic stress can contribute to headaches and make the ones attributed to levothyroxine use worse. Engage in stress-relieving activities like deep breathing exercises, progressive muscle relaxation, meditation, mindfulness, or yoga to alleviate your headaches while boosting overall mental and emotional well-being.

5. Exercise

Engaging in regular aerobic exercises, such as walking, swimming, or cycling, can help reduce the frequency and intensity of headaches. Exercise increases blood flow to the brain while also promoting the release of endorphins, which can act as natural painkillers.

6. Dietary adjustments

If your headaches are triggered by certain foods or dietary patterns, consider making adjustments to your diet to avoid personal triggers and maintain a balanced intake of nutrients. For example, limiting caffeine, alcohol, or high-sugar foods might help alleviate headache-inducing inflammation.

7. Use medications and supplements wisely

Be cautious when using over-the-counter pain medication for headaches, as long-term or overuse may result in medication overuse headaches. Consult your healthcare provider regarding the appropriate use of pain relievers or supplements, like magnesium, riboflavin (vitamin B2), or coenzyme Q10, which have been shown to help some individuals manage headaches.

8. Consider switching your thyroid hormone replacement

Sometimes, the problem is that levothyroxine is not the right treatment option for you. In this case, you might consider other alternatives.

Natural Desiccated Thyroid (NDT) is an alternative and effective treatment for hypothyroid patients who are not responding well to levothyroxine. Unlike levothyroxine, which contains only one form of the thyroid hormone, NDT contains all of the hormones that a thyroid gland would normally produce, such as Thyroxine (T4), Triiodothyronine (T3), and Diiodothyronine (T2).

If you want to try NDT such as Armour Thyroid, it might be a bit frustrating because some doctors don't want to prescribe this medication. Plus, it can be hard for you to find it on the market. But thankfully, NDT is also available in supplement form, which you can buy without a prescription. 

VitaliThy, a natural desiccated thyroid you can buy online, is a great option. It contains Thyroid (USP), just like Armour Thyroid. Plus, it's free from common allergens like lactose, gluten, fish, shellfish, and eggs, as well as artificial coloring and flavoring.

Conclusion: Levothyroxine can be the culprit behind your headaches

Though levothyroxine is a standard and effective treatment for hypothyroidism, it's essential to be aware of potential side effects like headaches and communicate with your healthcare provider. Your comfort and well-being are crucial for successful treatment, and working together with your doctor can help ensure that you're feeling your best as you journey toward improved thyroid health.

Patients who continue to experience headaches despite dosage adjustments may consider natural desiccated thyroid (NDT) as an alternative option. The NDT supplement VitaliThy can be a great place to start if you want to try this natural alternative.

Wojciech Majda
Wojciech Majda

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