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Effectiveness of low dose thyroxine in patients with subclinical hypothyroidism and migraine; systematic review and meta-analysis

A. Alokley, Maryam N. ALNasser, R. Alabdulqader, Faisal Abdulhamid Aljohni, Duaa Hussain Alqadhib, R. Aljuaid, Montather Akeel Alshik Ali, Shahad Shadi Hanbazazah et al.

BMC Neurology, 2025

3 citations

Abstract

Background: 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.

Methods: 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).

Results: 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.

Conclusion: The study highlights…

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