Migraine and Pregnancy

When you suffer from headaches, including migraine, your expectation should be that your headaches will improve when you get pregnant, especially after the first trimester. If your headaches do not improve, something is amiss and it certainly does not have to be serious. Common medical conditions that can develop during pregnancy are anemia, hypertension, hypothyroidism, and diabetes. Of these four conditions, diabetes tends to be protective of headaches, while the other three tend to make headaches worse or cause them. Anemia is the most common, usually from iron deficiency, and is often not recognized. Get it checked and make sure your hemoglobin (Hg) is around 13.5 and your ferritin level (iron reserve) is at least 80. Slow Fe® is a great over-the-counter iron preparation to take if your numbers are not as good as indicated. However, be sure to treat the constipation that may result from taking iron with docusate (Colace®). If your constipation is particularly bad, combine the docusate with Senna or take magnesium citrate instead. The magnesium citrate comes in 200-mg tablets and can be bought in health-food stores. Hypertension refers to elevated blood pressure and is readily picked up at prenatal care visits. It is a different story with hypothyroidism, which, like anemia, needs a blood test. The blood test is called TSH, which stands for thyroid stimulating hormone. Its level increases with the development of hypothyroidism. During pregnancy, the TSH should be 3 or less. Treatment is with thyroid hormone, which is available in tablet form. It can only be obtained by prescription. The prescription thyroid hormone will bring your TSH down and a good value is around 0.5.

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