Investigation of the relationship between headache and vitamin D levels in patients who are 7 to 17 years of age with migrene and tension type headache diagnosis

A headache is one of the most common types of complaints in the world and one of the most common reasons to seek medical care. A migraine and tension-type headache (TTH) is the most common types of a headache in childhood and adolescence. The aim of this study was to determine the clinical and laboratory characteristics of patients with a migraine and TTH. The study was conducted between May 2017 and September 2017 at Fırat University Medical Faculty Hospital. The study included 100 migraine, 30 TTH children, aged between 7-17 years, diagnosed according to the International Classification of Headache Disorders (ICHD)-3 beta criteria, whom applied to the Pediatric Neurology Outpatient Clinic. The control group consisted of 100 healthy children admitted to the General Pediatric Outpatient Clinic. Hemoglobin, hematocrit, MCV, MCHC, MCH, RDW, serum iron, iron binding capacity, ferritin, vitamin B12 and vitamin D levels of the study groups were determined. There was no statistically significant difference between a migraine and TTH patient groups in terms of headache attack frequency. There was a statistically significant difference between the patient groups regarding the shape, severity, and duration of the pain (p <0.05). Increased headache with daily physical activity was higher in patients with a migraine than in patients with TTH. A headache triggering factors such as stress, internal distress, hunger, insomnia, and mental work was found to be the most common causes of migraine and TTH patients. In addition, insomnia, cold air, and exposure to smoking were caused more headaches in migraine patients (p <0.05). There was a decrease in ferritin (p = 0.021, p = 0.003, respectively) and vitamin D levels (p = 0.004, p = 0.002, respectively) as the duration of disease and headache attack frequency increased in patients with migraine. As the severity of headache increased, serum iron (p = 0.010) and transferrin saturation (p = 0.009) were decreased. In addition to, as the duration of headache attack increased vitamin D levels were decreased (p = 0.034). In patients with TTH; as the duration of disease increased, MCHC (p = 0.021) and ferritin (p = 0.012) levels were decreased. As the incidence of headache attacks increased, Hb (p = 0.011) and Hct (p = 0.016) were decreased. There was no statistically significant relationship between Hb, Hct, MCV, MCHC, MCH, RDW, serum iron, TIBC, transferrin saturation, ferritin, vitamin B12 and vitamin D with headache severity and attack duration. In migraine patients, 48% of cranial magnetic resonance imaging (MRI) was normal and 52% were benign changes. Similarly, 46.7% of cranial MRI was normal and 53.3% were benign changes in TTH patients. In conclusion, although the pathogenesis of migraine and TTH is not yet fully understood, it is aimed to emphasize that the decrease in serum iron, ferritin and vitamin D levels may be related to the frequency and severity of headache. There is a need for controlled studies involving a large population. Keywords: Migraine, tension type headache, iron deficiency anemia, vitamin B12, vitamin D