{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T08:49:46Z","timestamp":1791622186118,"version":"4.3.4"},"reference-count":52,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T00:00:00Z","timestamp":1784073600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T00:00:00Z","timestamp":1784073600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["headachejournal.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Headache"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To evaluate whether thyroid dysfunction, including hypothyroidism and hyperthyroidism, is associated with migraine across racial and age groups using a large, multinational electronic health record database.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Thyroid disorders are highly prevalent worldwide, with hypothyroidism affecting over 200 million individuals and hyperthyroidism affecting approximately 2.5% of adults. Migraine is a leading cause of disability globally. Prior studies have suggested potential links between thyroid dysfunction and migraine, but evidence has been limited by small sample sizes, restricted population diversity, and inadequate control of confounding. Whether associations differ by thyroid subtype, race, or age remains unclear.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We performed two parallel retrospective cohort analyses within the TriNetX Global Collaborative Network, comprising over 200 million patients across 21 countries, using patient records from January 2004 to December 2024. Adults aged 18\u2013100\u2009years with hypothyroidism or hyperthyroidism, defined by \u22653 clinical encounters within 20\u2009years, were identified. Individuals with psychiatric disorders (including mood, anxiety, and stress\u2010related disorders), sleep disorders, epilepsy or recurrent seizures, or known migraine\u2010related genetic mutations were excluded. Each thyroid cohort was compared with a control group without thyroid disease, with groups balanced on key demographic and clinical characteristics including age, sex, and hypertension; beta\u2010blocker use was additionally considered in the hyperthyroidism cohort. The primary outcome was diagnosis of migraine (International Classification of Diseases, 10th Revision, code G43) within 5\u2009years of index date. Subgroup analyses were conducted by race (Caucasian, African American\/Black, Asian) and age (18\u201340, 40\u201365, 65\u2013100\u2009years). Sensitivity analyses assessed robustness to alternative visit thresholds and expanded covariate adjustment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 33,327,750 patients were included in the hypothyroidism analysis and 28,182,377 in the hyperthyroidism analysis. Baseline differences between groups were minimized after cohort balancing. Hypothyroidism was associated with higher odds of migraine across all racial groups, strongest among African American\/Black (odds ratio [OR] 2.04; 95% confidence interval [CI] 1.91\u20132.17), followed by White (OR 1.93; 95% CI 1.89\u20131.96) and Asian (OR 1.83; 95% CI 1.69\u20131.98). Hyperthyroidism was similarly associated with increased migraine odds, most prominently among White (OR 1.64; 95% CI 1.59\u20131.70), with smaller but significant associations in African American\/Black (OR 1.28; 95% CI 1.14\u20131.44) and Asian (OR 1.18; 95% CI 1.07\u20131.29). Elevated odds were observed across all age strata, generally increasing with age. Findings were consistent in sensitivity analyses.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In this large, multinational real\u2010world study, both hypothyroidism and hyperthyroidism were independently associated with increased migraine prevalence across diverse racial and age groups. These results highlight thyroid dysfunction as an important comorbid condition in migraine and support further prospective and mechanistic investigation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/head.70173","type":"journal-article","created":{"date-parts":[[2026,7,16]],"date-time":"2026-07-16T05:58:51Z","timestamp":1784181531000},"page":"2020-2031","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Thyroid dysfunction and migraine across racial and age groups: A multinational cohort study"],"prefix":"10.1111","volume":"66","author":[{"given":"Isaac","family":"Bai","sequence":"first","affiliation":[{"name":"Brown University  Providence Rhode Island USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Niki","family":"Mascarenhas","sequence":"additional","affiliation":[{"name":"Department of Family Medicine Brown University Warren Alpert Medical School  Providence Rhode Island USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kritika","family":"Maharjan","sequence":"additional","affiliation":[{"name":"Division of Biology and Medicine Brown University Warren Alpert Medical School  Providence Rhode Island USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Han","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Neurology Mayo Clinic College of Medicine &amp; Science  Rochester Minnesota USA"},{"name":"Department of Neurology Mayo Clinic Health System  Mankato Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chien\u2010Chih","family":"Chou","sequence":"additional","affiliation":[{"name":"School of Medicine, College of Medicine National Yang Ming Chiao Tung University  Taipei Taiwan"},{"name":"Department of Ophthalmology Taichung Veterans General Hospital  Taichung Taiwan"},{"name":"Department of Post\u2010Baccalaureate Medicine, College of Medicine National Chung Hsing University  Taichung Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"I\u2010An","family":"Lai","sequence":"additional","affiliation":[{"name":"Department of Family Medicine Brown University Warren Alpert Medical School  Providence Rhode Island USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ching\u2010Heng","family":"Lin","sequence":"additional","affiliation":[{"name":"Department of Medical Research Taichung Veterans General Hospital  Taichung Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0794-1263","authenticated-orcid":false,"given":"Chien\u2010Hsiang","family":"Weng","sequence":"additional","affiliation":[{"name":"Department of Family Medicine Brown University Warren Alpert Medical School  Providence Rhode Island USA"},{"name":"Brown Health Medical Group Primary Care Brown University Health  Providence Rhode Island USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,7,15]]},"reference":[{"key":"e_1_2_9_2_1","unstructured":"World Health Organization (WHO).Migraine and other headache disorders.2025. 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