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Dr. Andrew Rynne

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Exp 50 years

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Suggest treatment for intermittent headache

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Dr. Dariush Saghafi

Neurologist

Practicing since :1988

Answered : 2024 Questions

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Posted on Wed, 21 Oct 2015 in Headache and Migraines
Question: Dear Doctor,
I am 42 year old male. over last few weeks i get
headaches intermittently.
location -middle portion,right side,top of brain . intensity -sometimes mjld sometimes slightly sharp, but never debilitating.
duration -sometimes few seconds to 1 hour. cannot see any pattern in the time or days when i get these headeaches. sometimes there is a gap of 2-3days ,sometimes multiple times in same day.
No accompanying symptoms. no problem in sleep or appetite. what could be the problem ? should i consult a doctor ? consult an eye specialist?neurologist ?
since i never had thia problem earlier so i am botheredand keep thinking about the worst possibilities ? the informatiom given by ne is not very detailed ,but is it possible to indicate something ? what problems can be ruled out ?
Best regards
XXXX
doctor
Answered by Dr. Dariush Saghafi 39 minutes later
Brief Answer:
Recommend you see an adult neurologist or headache specialist

Detailed Answer:
The characteristics you are describing of the headaches that you're having typify a type of problem referred to Trigeminal Autonomic Cephalgia. Such headaches frequently come on multiple times per day, have durations from seconds to minutes or up to several hours, and are difficult to predict as well as treat.

However, I also would recommend that you consider seeing a specialist as in neurologist or if possible headache specialist because getting seen by a doctor and having some testing done, in my opinion, is a good idea in this case to be sure that there isn't some other explanation to your condition.

I don't see where an eye specialist would be quite as helpful in making a good diagnosis in this case compared to a neurologist or headache specialist.

I hope I've satisfactorily responded to your statements. If so, may I ask your favor of a high star rating with some written feedback?

Please send me more comments or inquiries in the future by going to my web address at:

bit.ly/drdariushsaghafi

I would be honored to answer you quickly and comprehensively.

This query has required a total of 15 minutes of physician specific time to read, research, and compile a return envoy to the patient.


Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Dariush Saghafi 43 minutes later
Dear Doctor,
Thank you for your prompt and informed reply.
1. I was asking about eye specialist, as I have heard that at my age the headache may also be caused by worsened eye-sight and need for glasses (I do not wear any so far). I think I will need to settle for a neurologist, since in a XXXXXXX II city like XXXXXXX a good neurologist itself may be a difficult find, what to talk of a headache specialist ?
2. How will it be confirmed that my problem is Trigeminal autonomic cephalagia ? if it is difficult to treat, how can I manage it or control it ?
3.Can serious issues which lead to tumour or haemorrhage be ruled out at this stage ? Will the neurologist suggest a CT or a MRI Scan ?

Yours Sincerely
XXXX
doctor
Answered by Dr. Dariush Saghafi 19 hours later
Brief Answer:
You appear to be hypothyroid

Detailed Answer:
I reviewed your lab results and you have a highly elevated TSH of >11 with the upper limit of normal at about 5 according to this laboratory. That is over twice the limit. At the same time your thyroxine is just barely above the lower limit of normal at 4.6 with the lowest limit of normal of 4.5.

I know your symptoms don't seem to be very significant aside from the headaches but the following is a list of symptoms associated with the condition of hypothyroidism:

Weight gain, Fatigue, Dry skin, Hair loss, Intolerance to cold, Constipation

New onset headaches (especially for your age) is also known to be caused HYPOTHYROIDISM. Treatment of the headaches is directed at the thyroid abnormality and awaiting at least 4-6 weeks following normalization of the hormone profile before assuming headaches are not being affected or caused by the glandular imbalance.

If I were your primary doctor I might consider sending you to an endocrine specialist if I were unclear on what to do next. If I were to send more labs I might go ahead and do an FULL PANEL of thyroid function testing to include:

1. FREE T3
2. FREE T4
3. Thyroid stimulating hormone receptor antibodies
4. Thyroglobulin
5. Thyroglobulin Antibody
6. Thyroid binding inhibitory immunoglobulin

These tests can help define the state of HYPOTHYROIDISM a bit more in terms of the mechanism by which it may be occurring.

I hope I've satisfactorily responded to your statements. If so, may I ask your favor of a high star rating with some written feedback?

Please send me more comments or inquiries in the future by going to my web address at:

bit.ly/drdariushsaghafi

I would be honored to answer you quickly and comprehensively.

This query has required a total of 43 minutes of physician specific time to read, research, and compile a return envoy to the patient.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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