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Menstrual Migraines - Hypothyroid?

I have suffered from menstrual migraines since the birth of my son 12 years ago.  Approximately 7-10 days prior to my period, I get low level migraines. They increase in intensity as I near my period, yet some days I experience low level (2/10) for a few days then nothing fo ra day or two, then back to it. Usually 1-2 big migraines (7-8/10) occur.  

I am working with a doctor using low levels of bioidentical progesterone cream. 5-10 mg/day days 1-13 and 10-20mg days 14-27 of my cycle. I am also exhibiting signs of hyothyroidism (weight gain, fatigue, edema, etc), yet TSH=2.73, Free T-3=3.5, and Free T4=1.27.  I am treating (subclinical) with 1/2 grain of Armour Thyroid and have felt much better - less fatigue.  I have been under quite a bit of stress at work (took on large workload) and through a divorce recently. I have reduced a good majority of the stress, now job and settling into my "new" single mom role. I also attend a yoga class and excercise daily for 30 minutes (running/light weights/pilates).  

I am also following an insulin resistant diet.  Good carbs, linking protein with carbs/veggies.  I am vegetarian (no beef, chicken or pork), but I do eat fish.  I also supplement with Omega3 and 6.  I am also taking a multivitamin with an additional multi-B.  Magnesium, vitamin C also daily.

My doctor and I are at a loss when it comes to treatment of the the migraines.  Is it possibly due to adrenal stress?  Should I take an adrenal support formula? hdrocortisone?  I am a bit stumped as far as where to go next.  I know balancing the endocrine system is delicate to say the least, so I don't want to do more harm than good.  Blood and saliva tests indicate slightly elevated DHEAs, morning cortisol was 7 (low) indicating difficulty sleeping, noon cortisol was 5 (normal), afteronnon and evening levels were in the low normal range.

I have difficulty sleeping through the night, wakening at 2-3 am and then really having to work at getting back to sleep.I have tried a bedtime snack of almond butter on whole wheat crackers and milk to determine if it could be a drop in blood glucose.  This has helped some.Fasting insulin was 6 and fasting glucose was 86.

My doc ran a full serum panel (CBC, lipids, etc.) and my results fall within "normal" ranges. LDL and HDL were normal.  Testosterone was a bit on the high side of normal.Estrodial was normal.

Any thoughts?

2 Responses
Avatar universal

Is the progesterone cream, that you are using, helping your menstrual migraine?
What else have you tried for migraine?
Prophylactic treatment with imitrex for 6 days begining two days prior to the onset of anticipated menstrual migraine is known to cut the chance of getting a migraine attack by half.You can discuss this option with your doctor.
I would suggest you to wait for some time before begining treatment with steroids since they have a lot of side effects and cannot be stopped abruptly. If possible please seek a second opinion. Take all your blood reports with you.
Avatar universal
Hi there.
I hope this reply isn't too late that you forgot that you had even posted this.
Anyway, I am an acupuncturist and was wondering if you ever tried recieving acupuncture treatment for your migraines?
I have treated many women, including myself, with similar problems as yours. They all had intense migraines that came days before their periods. THey were also very stressed women.
Some were taking handfuls of medications to alleviate the excruciating pain, but with several treatments of acupuncture, some were down to just one or two pills while others were completely off of their medications.
you also mentioned that you have hypothyroidism. As an acupuncturist, I see a clear relationship between your migraines and your hypothyroidism. It tells me that your circulation is poor. Exercising does help, but that is not enough. you need to incorporate dietary changes. Try eating soups that are low in sodium and that has a meat base to it (I know you're a vegetarian, but can you at least cook the meat in a broth and then remove it?). You should notice a vast improvement in your overall condition. you will feel warmer and you will feel that things are moving smoothly inside. Also, try adding slices of ginger (maybe 2-3) into your soups. I advise you to drink ginger tea regularly. Your circulation will improve tremendously, which will in turn alleviate your migraines. Also, becuase ginger helps with circulation, you will notice an increase in your energy and because it is also a very warm herb, you will notice an improvement in your digestion and also with your weight loss.
Chinese Medicine is amazing!!! I am so excited for you. I have seen my patients wean off of their medications (with their doctor's permission, of course) and just loving their new lives!
I understand your situation. I had premenstrual migraines and have undergone many stressful situations as well. So, please trust me and try acupuncture. It changed so many people's lives.
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