Medical Causes of Headaches

There are many conditions associated with headache, but I will review the more common ones here. These headaches are generally different from migraine.

They tend to be dull, diffuse headaches and may or may not go on to trigger a migraine.

Anemia

Anemia, no matter what is causing it, results in either damaged red blood cells or a lower count. This means less oxygen gets to the brain as this is one of blood's function is to carry oxygen to organs.

Less oxygen means headache. Indeed in cases of acute hypoxemia (low oxygen to the brain) we can see the damage to the brain on an MRI.

If you suspect this might be contributing to your headaches, ask your doctor to do some basic bloodwork. He or she will take it from there.

Hypothyroidism

Low thyroid production may also cause a dull headache. This type of headache may tend to come and go as the thyroid fluctuates.

Occasionally, this will provoke a migraine if you already have migraines.

If you have a family history of thyroid disorder, and you are having symptoms of hypothyroid (depression, weight gain, cold intolerance, fatique) in addition to headaches, again ask your doctor to do some bloodwork.

Hypoglycemia

Low blood sugar is an easily preventable cause of headache. Again this dull headache may further provoke a migraine if not treated.

This is why I recommend to headache patients that they must eat three meals a day. Many migraineurs tend to skip breakfast, eat a light lunch and wonder why they are starting to get a headache by the afternoon.

Sure, other people can do this, but you can't. If you have headaches, you already have a "sensitive" brain and it doesn't take much to push it over the edge into a severe headache.

Sleep Apnea

Well, I could devote a whole website on this one. And I am sure others have!

Sleep apnea is on the rise in the US due to the rise in obesity. It is often accompanied by snoring, daytime sleepiness and fatigue.

The headache usually occurs upon awakening in the morning and is diffuse and dull. It is caused by less oxygen to the brain during sleep.

As you progress through the morning and get more oxygen, the headache usually goes away.

Unfortunately, sleep apnea raises your risk of a heart attack (less oxygen to the heart too!) so if you suspect this, talk to your doctor about testing and treatment.

Infectious Diseases

Many times infections will cause migraines, and sometimes the migraine is the herald for the infection! I have seen cases where the migraine comes first and then the next day the patient comes down with a bad cold or a GI flu.

Many infections can cause headaches. Patients with Hepatitis C or B that is chronic will have dull diffuse headaches that wax and wane as the virus does.

The same holds true for teenagers and young adults who come down with mononucleosis and after they recover, they start to have headaches. This is actually known as post-viral syndrome.

If it is a straight forward migraine, we treat the headache as just that.

Post viral syndrome headaches may require a short course (one or two weeks)of a low dose of steroids, but may also respond well to low doses of Elavil.

Autoimmune Disorders

Many times there is an overlap so to speak in diseases and syndromes that are associated with each other. Migraine is one of them and can be associated with flares in autoimmume diseases.

Some of the more common that have migraine with them are lupus, multiple sclerosis and Hashimoto's thyroiditis.

Although the autoimmune disorders are treated with various medications, these particular medications do not control migraine, so overall, it is best to rely on the migraine meds that work best for you.

Surgery

In the context of headaches, any surgery is considered a stressor on the body and as a result could cause a migraine. More often than not the migraine occurs within 24 hours after the surgery.

Unfortunately, most surgeons dismiss the pain of a migraine and give the patient Lortab or another opiod for the headache, with poor results.

I encourage my patients to talk to the surgeon BEFORE surgery and explain their headache condition. Many times a surgeon will allow a patient to bring their medication, such as Imitrex to the hospital in case a migraine results.

This might be a good option for you, as by the time the hospital pharmacy gets the medication to you, the headache is full blast!

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