Are Headaches A Symptom Of Hashimoto’s Disease?

Hashimoto’s disease is an autoimmune thyroid condition that often leads to hypothyroidism. There are thought to be 0.3 to 1.5 Hashimoto’s cases per 1,000 people worldwide¹, and the incidence rate is around 2%² in the US. The condition is ten times² more likely to affect women than men.

Although Hashimoto’s disease signs and symptoms can vary from person to person, headaches are common in people with thyroid conditions. Besides headaches, there are other Hashimoto’s symptoms to watch out for, and you should know when to speak to your doctor.

What is Hashimoto’s disease?

Hashimoto’s disease, also known as Hashimoto’s thyroiditis and autoimmune thyroiditis (AIT), is an autoimmune disorder commonly linked to hypothyroidism (underactive thyroid).

The thyroid is a butterfly-shaped gland at the front of your neck which produces hormones that control many functions in your body.

In Hashimoto’s disease, the immune system attacks the thyroid gland because it believes it’s a threat to your body. This damage can lead to hypothyroidism, where the thyroid doesn’t produce enough thyroid hormone.

Both Hashimoto’s disease and hypothyroidism can lead to dangerously low production of thyroid hormones.

Risk factors for Hashimoto’s disease

Three common risk factors increase your chance of developing Hashimoto’s disease:

1. Being female: Women are more affected by the disorder than men. Annually, there are around 3.5 incidences per 1,000 women and only 0.8 per 1,000 men.

2. Family history and genetics: Research³ suggests you are more likely to develop Hashimoto’s disease if a close family member has the condition.

3. Other autoimmune disorders: You are more likely to develop Hashimoto’s if you have another autoimmune disorder, such as diabetes.

Hashimoto’s disease symptoms

Hashimoto’s disease symptoms often occur gradually, spanning months or even years. Some symptoms are similar to those caused by other conditions, so they may go unnoticed for some time.

Research² suggests physical signs of Hashimoto’s disease may include slow speech, brittle nails, cold and dry skin, and swelling around the eyes and in the feet and hands.

Other common symptoms include:

• Depression

• Constipation

• Fatigue

• Weight gain

• Cold intolerance

• Hair loss

• Joint pain

• Memory loss

• Neck pressure from goiter (enlarged, swollen thyroid)

Hashimoto’s disease diagnosis and treatments

Hypothyroidism is usually diagnosed through thyroid-stimulating hormone (TSH) and thyroxine hormone (T4) testing, followed by antibody tests to pinpoint Hashimoto’s disease or another condition that’s causing your thyroid dysfunction.

The presence of thyroid peroxidase (TPO) in your blood and anti-thyroglobulin (Tg) antibodies suggest you may have Hashimoto’s disease. Tests will also look at your anti-thyroid-stimulating hormone receptors (TSHR).

Hashimoto’s disease treatment often includes hypothyroid medication, although some very mild cases may not need treatment at all. Instead, your doctor will monitor you closely for any signs of progression.

Most Hashimoto’s disease treatments include thyroid hormone replacement, with a standard dosage of 1.6 to 1.8mcg/kg per day². Titrated levothyroxine is the most commonly prescribed drug to treat Hashimoto’s.

Complications and prognosis

Hashimoto’s disease prognosis is often very positive among patients who receive early treatment and ongoing care. Many patients living with Hashimoto’s disease can lead a normal life, but complications can develop when Hashimoto’s disease isn’t treated quickly enough.

Common Hashimoto’s disease complications include depression and other mental health problems, pregnancy complications, and in rare cases, myxedema coma (severe symptoms caused by multiple organs slowing down). In serious cases, Hashimoto’s can lead to death.

Are headaches a Hashimoto’s disease symptom?

Nearly 30%⁴ of patients with an underactive thyroid suffer from headaches, but they must fit two or more of the following criteria to be linked to the condition:

• The headaches developed around the time of diagnosis

• The severity of the headaches mirrors the severity of the condition (for example, when hypothyroidism improves, so do your headaches)

• The headaches are bilateral (affecting both sides of the head) and/or constant

It is unknown whether headaches are a symptom or cause of Hashimoto’s disease and hypothyroidism. Research results have not yet been conclusive and more research is needed.

However, one study⁵ identified a link between headache disorders and the development of new-onset hypothyroidism.

Can medication help with headache pain?

Thyroid hormone medication can reduce headache frequency by 78%⁶.

The most common and effective drug used for Hashimoto’s disease and hypothyroidism is levothyroxine; however, headaches are listed as a side effect.

On the other hand, levothyroxine has been linked to a decrease in severity and frequency⁷ of headaches in children with chronic thyroid headaches.

Research on the topic is limited, so work closely with your doctor to figure out whether your medication or your condition is causing your headaches.

You might be taking too much levothyroxine, and the headaches might be a side effect. Alternatively, your headache might be caused by your condition, and a severe headache could suggest the condition is also severe.

Always consult your doctor about any concerns before making changes to your treatment.

The lowdown

Headaches are common in patients with low thyroid hormone production, as is the case with Hashimoto’s disease and hypothyroidism. Although more research is required on the topic, there is a clear link between an underactive thyroid and headaches.

Doctors typically prescribe levothyroxine to increase and stabilize thyroid hormone production, but this drug has been linked to headaches as a side effect.

There are many potential underlying causes of your headaches, including medication, the severity of your condition, or causes unrelated to hypothyroidism. Consult your doctor to find out what’s causing your headaches as they can pinpoint the problem and determine the best treatment.

If you haven’t yet been diagnosed with Hashimoto's disease, but you have one or more symptoms, have a close family member with the condition, and you are female, talk to your doctor to discuss the condition and get a diagnosis.

Getting treatment early can help you manage the condition and enjoy a normal life, as long as you get ongoing medical care. Severe, untreated Hashimoto’s disease cases can lead to mental health complications, problems during pregnancy, myxedema coma, and, rarely, death.