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   Author  Topic: CH history, genetic link and nicotine  (Read 15088 times)
Annette
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Re: CH history, genetic link and nicotine
« Reply #25 on: May 6th, 2008, 9:37am »
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on May 6th, 2008, 8:38am, Paul98 wrote:

 
I wonder if it is possible for the Pineal gland and the Hypothalamus to become chemically "uncoupled" ?  Severe sleep deprivation (5+ days of absolutely no sleep) has been reported to brake a cycle.  Perhaps this resets the clocks.
 
.... but at the same time I could easily see a CH sufferer looked upon as being posessed.  I'm sure headbashing was done back then like some do today.  
-P.

 
 
I have not looked into sleep deprivation stopping a CH cycle. I am currently looking into REM sleep and CH activies. Melatonin affects REM sleep and it seems to stop some night hits in a number of CHers, so there must be a strong link there.
 
Regarding head bashing CH being looked upon as a mental illness instead of a physical illness, I would say thats likely for a kip 9 or 10, but I would argue that how often does a CHer get those in relation to lower kip hits? The majority of CH hits are kip8 or lower, kip 10 are rare thank God. I would say someone with a kip 6 or 7 pacing the room squeezing his head with a red teary eye would not look anymore crazy than one lying in bed crying in pain with a migraine.  
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Re: CH history, genetic link and nicotine
« Reply #26 on: May 6th, 2008, 9:39am »
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What a fantastic conversation going on here!!!!
 
Annette's proposition is interesting and certainly doesn't seem as though it is as far-out as some "chaos theory".  The idea that our ingestion of tobacco at sustained daily/hourly levels that probably exceed that which mayans and native americans would have ingested during special ceremonies may be a case of too much of a good (or bad) thing.
 
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Re: CH history, genetic link and nicotine
« Reply #27 on: May 6th, 2008, 10:13am »
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I am personnal happy to see Annette pursue anything that might have caused this terrible thing happen to us. We might not all agree, but at least something to think about.
 
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Re: CH history, genetic link and nicotine
« Reply #28 on: May 6th, 2008, 10:22am »
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Hypocretin can reduce melatonin production, and nicotine does the same.  This interaction is definitely worth considering and may explain some of the dysfunction. An interaction between nicotine and caffeine might be even worse - there is research that shows that caffeine in the evening can be pretty disruptive of melatonin.  
 
As far as  what the space guy is talking about with Lysenkoism:  putting the phrases 'abnormal reactions' and 'over generations' together the way you did implies an interaction between phenotype and genotype that is not there.  Maybe not what you meant, but it could be interpreted that way.  
 
Before the 1600s, the medical literature is pretty sketchy and can't be counted on to document the prevalence of rare conditions. Even in 'modern' countries, diagnosing it is not always straight-forward and consistent.  
 
Other things to consider as circadian disruptors over this same time period include the shift to artificial lighting and clocks.  
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Re: CH history, genetic link and nicotine
« Reply #29 on: May 6th, 2008, 10:24am »
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Great thread and I shall try to keep this short.  Great reference to Christopher Colombo too Annette.  Wasn't he the fictional detective who solved murders in brilliant, if unorthodox ways, and smoked cigars incessantly? Wink Grin
 
I've been looking at the role of smoking and nicotine in CH for quite some time, but don't tend to shout about it very much given the inherent controversy involved.  However, on the history thing, I reckon that the reason why it hadn't been reported upon until Nicolaas Tulp did so, was because of its relative rarity and lack of distinction with other [primary] headaches given the paucity of shareable information available all those moons ago.  Even Hippocrates may have got it wrong because symptoms such as aura, nausea etc. can also be associated with what we now know as trigeminal autonomic cephalalgias.
 
All the evidence, albeit scant, does suggest that people have probably been suffering from headaches from the dawn of time.  Apparently, the earliest account of headache appeared in literature during the 7th century BC:
 
Headache roameth over the desert, blowing like the wind.
This man it hath struck and
Like one with heart disease he staggereth
Like one bereft of reason he is broken,
Like that which hath been cast in the fire he is shrivelled
Like a wild ass... his eyes are full of cloud...

 
Then somewhat later in the 11th century AD, eight different types of headaches - then known as sodas - were identified in literature, accompanied with some often bizarre forms of treatment.  Cluster headache may have indeed been associated with this particular one:
 
Hemicranea: with severe pain extending to the roots of the affected part.  Treated with blood letting and expurgation of the inducing humor; must be brought to the sneeze with aroma of marjoram or oil of bitter almonds at the nostril of the affected side.  Should anoint for head before onset of paroxysm with oil of daffodils or peonies.
 
Some people may find humor in treatment with daffodils and peonies Roll Eyes
 
The gender smoking stats are very interesting and are something I had been meaning to look up for some time.  However, I think that the sex profile prevalence changes in CH are more to do with increased awareness of the condition over time, particularly in primary care, coupled with the fact that the professionals now realise that women do get CH and hence the migraine misdiagnosis is less prevalent.  I'm also interested in the incidence of heavy drinking amongst our population, but have yet to compare it to general trends, but that's probably for another thread.
 
The orexin link has also always perplexed me.  As many here will know, I've always looked at this in relation to the potential importance of sleep, or perhaps more importantly the lack of it (as per Paul's post), but the polymorphisms you mention in this context shouldn't be ignored.  More recently though, they have been looking at potential polymorphisms in CLOCK genes, which may or may not be relevant in CH (watch this space).  Oh, and by the way, we have many more biological clocks than the two you mentioned; don't get me going on chronobiology (especially with reference to the pineal gland) or else I'll never shut up Lips Sealed
 
And whilst we're here: Quote:
Unlike other cells in the body, neurons in the brain dont recover or renew in most instances. Any damage to brain cells is likely to stay, unfortunately.

Fortunately, many neurons do recover or are renewed under certain circumstances, through the action of neurogenesis; something that again I won't go into here as it would warrant a completely different thread.
 
However, I do agree with your overall hypothesis inasmuch as there is definitely a link between smoking and nicotine and cluster headache.  Many years ago, Flo's stance was that nicotine (which stimulates the nicotinic acetylcholine receptors) can trigger the release of calcitonin gene related peptide (CGRP), which is associated with the central mechanism theory of cluster headache pathogenesis.
 
He also believes that all this is tied in with an acetylcholine problem in CH patients.  We as sufferers tend to have low levels of choline, which can limit the formation of acetylcholine. Acetylcholine is a neurotransmitter that, amongst many other things, has anti-inflammatory properties.  Perhaps we have a natural deficiency of acetylcholine (that may be genetically based) that increases our risk of nicotine addiction, or perhaps smoking causes a malfunction of our choline system, which increases the risk of cluster headache to those more predisposed (as you suggest)?
 
Also, nicotine phase-advances the circadian neuronal activity rhythm in suprachiasmatic nuclei explants (in the rat anyway), which suggests a hypothalamic role.  The suprachiasmatic nucleus is THE master clock in the human body and is housed within the hypothalamus and is probably the area which shows activity during attacks and where there is increased cell growth (Goadsby et al).
 
Finally, I also subscribe to Bob P's theory that CH sufferers have a higher likelihood of addiction; particularly smoking and drinking, which is possibly fuelled by the possible abnormality within the hypothalamus.  The hypothalamus has also recently been linked with addiction.  I would bet at least a fiver that CH sufferers also have an above average population profile in terms of gambling Wink
 
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Re: CH history, genetic link and nicotine
« Reply #30 on: May 6th, 2008, 10:26am »
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This is a bit side tracked but this is what I have wondered.
 
What would happen if the words spread out there that CH can be caused by cigarette smoking ?
 
If that is proven, there will be potential class actions against tobacco companies for compensation since they have failed to warn people of this risk, just as it has happened with tobacco links to lung cancer.  
 
Will that be a bad thing ? I dont think so, because firstly it may allow CHers who smoke to gain monetary compensation that will be very helpful in many cases. Secondly it may scare the tobacco companies enough to see them pouring money into researches to prove that CH is caused by something else, not tobacco. One of the biggest problem with researches on CH is the lack of funding since the condition is so rare. How good would it be if companies with billions of dollars in profit wanting to pour money into CH research?  
 
I can understand the resistant mentality here, like Bill said, as it makes it less comfortable for a CHer to continue to smoke thinking that it may cause the severe suffering in the first place. However, would it make it easier to bear if one can use it to claim thousands if not ten of thousands of dollars in compensation ?
 
I am not saying this will happen for sure, of course. However, as John said, its something interesting to think about.  Smiley
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Re: CH history, genetic link and nicotine
« Reply #31 on: May 6th, 2008, 10:46am »
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on May 6th, 2008, 10:22am, monty wrote:
Hypocretin can reduce melatonin production, and nicotine does the same.  This interaction is definitely worth considering and may explain some of the dysfunction. An interaction between nicotine and caffeine might be even worse - there is research that shows that caffeine in the evening can be pretty disruptive of melatonin.  
 
As far as  what the space guy is talking about with Lysenkoism:  putting the phrases 'abnormal reactions' and 'over generations' together the way you did implies an interaction between phenotype and genotype that is not there.  Maybe not what you meant, but it could be interpreted that way.  
 
Before the 1600s, the medical literature is pretty sketchy and can't be counted on to document the prevalence of rare conditions. Even in 'modern' countries, diagnosing it is not always straight-forward and consistent.  
 
Other things to consider as circadian disruptors over this same time period include the shift to artificial lighting and clocks.  

 
 
Yes, there is also something to be said about the coupling of nicotine to caffeine, but the information I found so far was too confusing for me to post about yet.
 
I appreciate your intepretation on behalf of SpaceGuy but I would still rather wait for him to respond and clarify before I reply to his comment.
 
Regarding artificial light disrupting the circadian clock, that is not so straight forward. In light treatment used for Seasonal Affective Disorder ( SAD ), a condition affected purely by the change of daylight, it has been found that it has to be at least 2500 lux to be affective ( ie strong enough to reset the circadian clock). Most light treatment is about 10000 lux which is a lot higher than a normal room lighting at 400 lux. A bright sunny day may register at 100000 lux.  
 
Although medical record prior to the 1960s did not report much on the prevalence of rare condition, but it is interesting that there had been NO record of a description of any headache with symptoms classical of CH prior to 1641. There had been no record of any headache that occured several times a day at exactly the same times, I would have thought that anyone observing that would find it interesting enough to document.  
 
I would love it if anyone who believes in different theories can actually come up with researched evidences, rather just personal hunches and impression. That way it will make the discussions more interesting and valid.  
 
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Re: CH history, genetic link and nicotine
« Reply #32 on: May 6th, 2008, 10:54am »
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on May 6th, 2008, 7:25am, Bob P wrote:
I contend that clusterheads display an addictive personality.  They smoke a lot, drink a lot, hang around message boards, etc.
 
I think that the condition that causes clusters also effects brain chemistry to cause this addictive trait.
 
Therefore clusters cause smoking, not vice versa.  Or more corectly, the brain disformity that causes clusters, causes us to have addictive personalities which leads to smoking.

One of the few times I can say I agree with Bob.  
 
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Re: CH history, genetic link and nicotine
« Reply #33 on: May 6th, 2008, 10:58am »
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on May 6th, 2008, 10:26am, Annette wrote:
What would happen if the words spread out there that CH can be caused by cigarette smoking ?

My first reaction is that it would be complete and utter conjecture. There is nothing that confirms which came first - the chicken or the egg (i.e., the smoking or the CH), or which causes the other. The tobacco company lawyers would eat this theory for lunch and most likely spit it back up in time for tea.
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Re: CH history, genetic link and nicotine
« Reply #34 on: May 6th, 2008, 11:04am »
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on May 6th, 2008, 10:46am, Annette wrote:
I would love it if anyone who believes in different theories can actually come up with researched evidences, rather just personal hunches and impression. That way it will make the discussions more interesting and valid.

Sorry - That would not be in the storied tradition of my agnostic leanings. If you have a theory, go ahead and prove it. I'll always give it a listen.
 
I have my inklings, but I'm not out to set the world on its ear, so I'll just remain comfortable believing what I choose and leave the rest.
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Re: CH history, genetic link and nicotine
« Reply #35 on: May 6th, 2008, 11:08am »
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Thanks Lee for your post  Smiley  I would hope you will post more on your researches despite potential controversy here or anywhere else. Controversy is good as it makes you think and it makes you have to prepare better to be able to "defend" your hypothesis which is what happens in the real world of scientific/medical researches.  
 
I agree with you that it is possible that CH was simply "missed" prior to 1641, but personally I think its highly unlikely.  Although it does have similar symptoms to migraine and hemicrania but it also has quite different characteristics which should be peculiar enough to raise attention to itself. For now, until someone comes up with a record of some type of headaches with classic symptoms of CH prior to 1641, we simply have to accept that this is the only information we have to work on.
 
Neurogenesis does happen, I am well aware of that but that is rare. Even when new cells are generated there has been evidence that they dont carry out the exact same mechanisms as the ones what died. It is more common for other types of neurons to mutate and take over the functions rather than a brand new cells being regenerated. Have you got any evidence to show that cells in the hypothalamus and pineal glands can regenerate ?  
 
With the male:female ratio it is possible that women were just misdiagnosed with migraine more. However, recent studies on CH in Asian countries where women smoke a lot less than men still show a large difference in M:F ratio. In this recent article published in 2004, where 104 CH sufferers were recruited from 2 major headache centres in Taiwan, 90 were men and only 14 were women, giving a ratio of 6.4:1, similar to what was found in European countries back in the 1960s.  
 
http://cat.inist.fr/?aModele=afficheN&cpsidt=15979923
 
 
Please help me along here Lee by posting what else you have found. If you need to, please dont hesitate to start new threads on whatever theories you have come up with.
 
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Re: CH history, genetic link and nicotine
« Reply #36 on: May 6th, 2008, 11:13am »
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on May 6th, 2008, 11:04am, Brew wrote:

Sorry - That would not be in the storied tradition of my agnostic leanings. If you have a theory, go ahead and prove it. I'll always give it a listen.
 
I have my inklings, but I'm not out to set the world on its ear, so I'll just remain comfortable believing what I choose and leave the rest.

 
 
Of course Bill, this is not a religion I am peddling here. No one has to change their mind about anything unless they choose to. I am simply forwarding a thought to be considered.  
 
Regarding tobacco company lawyers chewing the theory and spitting it out, if it can get that far it would have already been a major achievement in my book.  
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Re: CH history, genetic link and nicotine
« Reply #37 on: May 6th, 2008, 11:21am »
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I thought you'd missed my post Annette Grin
 
On the note of CH actually causing smoking, this Kiwi study (although not directly related to CH) is interesting and relatively hot off the press.  If "general" primary headache can increase the risk of daily smoking, I wonder what CH does in this respect?
 
I have a full copy if anyone is interested.
 
Quote:
Headache: The Journal of Head and Face Pain
Volume 48 Issue 4 Page 545-552, April 2008
 
Associations Between Frequent Headaches, Persistent Smoking, and Attempts to Quit
 
Karen E. Waldie, BSc, MSc, PhD; Rob McGee, BSc, PhD; Anthony I. Reeder, BA, PhD; Richie Poulton, MSc, DipClinPsych, PhDFrom the Department of Psychology, University of Auckland, Auckland, New Zealand (K.E. Waldie); Social & Behavioural Research in Cancer Group, Department of Preventive & Social Medicine, University of Otago, Dunedin, New Zealand (R. McGee and A.I. Reeder); Dunedin Multidisciplinary Health and Development Research Unit, Department of Preventive & Social Medicine, University of Otago, Dunedin, New Zealand (R. Poulton).
K.E. Waldie, Department of Psychology, University of Auckland, Private Bag 92019, Auckland, New Zealand.  
Conflict of Interest: None  
 
(Headache 2008;48:545-552)
 
Abstract
Background.—Recent studies have found a strong relationship between tobacco smoking and headache pain. It remains unclear whether smoking behavior leads to headache or visa versa, mainly due to the cross-sectional nature of the majority of this research.
 
Objective.—To help clarify the direction of the relation between smoking and frequent headaches in a representative cohort study.
 
Design and Methods.—Members of the Dunedin Multidisciplinary Health and Development Study (N = 980) were asked about their cigarette smoking and headache history at ages 11 and 13 (childhood), age 15 (mid-adolescence), and age 26 (adulthood). Both cross-sectional and longitudinal associations between smoking and headache status were examined using logistic regression.
 
Results.—During mid-adolescence, the likelihood of frequent headaches doubled for smokers relative to nonsmokers (OR: 2.16, 95% CI: 1.39-3.35). Smoking did not increase the risk of developing headaches in adulthood, however. In contrast, individuals who suffered from frequent headaches during mid-adolescence were 2 times more likely to smoke in adulthood than those without headache (OR: 2.20, 95% CI: 1.3-3.7), after controlling for sex and family socioeconomic status. Attempts to quit smoking were significantly more difficult for migraine sufferers with a history of headache than for those with tension-type headache.
 
Conclusions.—Frequent headaches during mid-adolescence appear to increase the risk of daily smoking in adolescence and adulthood. These individuals also have a more difficult time quitting than their headache-free peers.

 
I could murder a fag and I don't even smoke Grin
 
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Re: CH history, genetic link and nicotine
« Reply #38 on: May 6th, 2008, 11:23am »
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Regarding tobacco companies...I have no interest in the theory with regard to pointing out some fault or responsibility. I smoked. I knew it was stupid when I did it. Generations before smoked - no one knew any better - no one much cared. Average life span and a series of wars didn't really point toward the need to have a healthy vessel into your 80's.
 
 
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Re: CH history, genetic link and nicotine
« Reply #39 on: May 6th, 2008, 11:51am »
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on May 6th, 2008, 11:08am, Annette wrote:

However, recent studies on CH in Asian countries where women smoke a lot less than men still show a large difference in M:F ratio. In this recent article published in 2004, where 104 CH sufferers were recruited from 2 major headache centres in Taiwan, 90 were men and only 14 were women, giving a ratio of 6.4:1, similar to what was found in European countries back in the 1960s.

 
As they say at the end though Annette, racial and geographical factors might contribute to these discrepancies.  Also, epidemiologic surveys have often been poo-poo-ed, methodologically speaking, in non-western societies.  Not saying they're right, of course, but a population based study conducted in China in 1985 reported only 14 CH cases of 246,812 inhabitants (0.0006%).  In this study, the prevalence of migraine (0.7%) was also markedly lower than was to be expected, which is somewhat spurious.
 
Don't get me wrong though, I still think there's a link.
 
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Re: CH history, genetic link and nicotine
« Reply #40 on: May 6th, 2008, 11:51am »
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on May 6th, 2008, 11:13am, Annette wrote:
Of course Bill, this is not a religion I am peddling here. No one has to change their mind about anything unless they choose to. I am simply forwarding a thought to be considered.

What I said has nothing to do with religion. Merely consider the Greek roots of the word "agnostic."
 
a = against or not
 
gno = know or knowledge
 
agnostic = not knowing
 
A lot of what you have posited is something I'll never know, nor do I care to. I have a tendency to use anecdotal evidence when I evaluate things. That's what I've done here. All I'm saying is, you have a theory - knock yourself out trying to prove it. I'll always consider the evidence. I don't have any for my beliefs (namely that the same set of circumstances that cause CH also cause sufferers to have more highly addictive personalities).
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Re: CH history, genetic link and nicotine
« Reply #41 on: May 6th, 2008, 11:59am »
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I believe the national average for smokers is around 20%.
 
A survey of 12,000+ clusterheads shows a smoking prevelance of 50%.  So they do definitely smoke more.
 
Of course, that leaves 50% of clusterheads who don't smoke.
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Re: CH history, genetic link and nicotine
« Reply #42 on: May 6th, 2008, 12:03pm »
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on May 6th, 2008, 10:26am, Annette wrote:

This is a bit side tracked but this is what I have wondered.
 
What would happen if the words spread out there that CH can be caused by cigarette smoking ?
 
If that is proven, there will be potential class actions against tobacco companies for compensation since they have failed to warn people of this risk, just as it has happened with tobacco links to lung cancer.  
 

 
In the case of lung cancer, it wasn't simply that they failed to warn people. It was that the companies knew and conspired to mislead the public so they would not be motivated to quit. When the nature of the conspiracy was exposed, the companies settled. Although it sounded like a large dollar amount, it was small enough in terms of the companies revenue and profits to keep them in business.  
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Re: CH history, genetic link and nicotine
« Reply #43 on: May 6th, 2008, 12:08pm »
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I wonder what the percentage of CH suffers born to mothers who smoke is?  Also those exposed to smokers in the home while growing up.
 
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Re: CH history, genetic link and nicotine
« Reply #44 on: May 6th, 2008, 4:54pm »
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on May 6th, 2008, 12:08pm, Jean wrote:
I wonder what the percentage of CH suffers born to mothers who smoke is?  Also those exposed to smokers in the home while growing up.
 
Jeannie

 
Hi Jean,
 
There isnt any such data, I have looked. However, from the people who frequent this board, I would say high, exactly how high I dont think anyone knows.
 
There isnt any data on the effect of passive smoking and CH either. We can only look to lung cancer and passive smoking for clues and studies there say that it can be worse for passive smokers as their bodies have not built an immunity to cigarette.  
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Re: CH history, genetic link and nicotine
« Reply #45 on: May 6th, 2008, 5:16pm »
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I think it will be very interesting to see what data will emerge from China re prevalence of CH and the ratio between man:woman with CH, in relation to tobacco smoking.
 
China is currently the biggest consumer of tobacco in the world. However, it started way behind America and European countries. The number of smokers ( as in percentage of population ) and the number of cigarette smoked per day have only just caughted up to those measured in the West in the 1950s.
 
http://www.cnn.com/HEALTH/9811/19/china.usa.smoking/index.html
 
For now, as Lee has pointed out, the number of CH cases reported in China is low compared to its huge population. It would be very interesting to see if this number will increase alongside the increase in tobacco consumption in the next 50 years. The increase if there will be, will not be influenced strongly by genetic inheritance due to China's population control policy.  
 
The trend of other medical conditions caused by smoking such as lung cancer has already followed those seen earlier in Western countries, lets see what CH development will be like in China.  
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Re: CH history, genetic link and nicotine
« Reply #46 on: May 6th, 2008, 5:29pm »
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I think China's rate of CH will increase as it gets Bibles, television and western medicine; not all of these factors may be causative.  Wink  
 
« Last Edit: May 6th, 2008, 5:30pm by monty » IP Logged

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Re: CH history, genetic link and nicotine
« Reply #47 on: May 6th, 2008, 6:33pm »
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Simply because my mine works in such a way...
 
I personally feel that the documented cases of CH in any given populatiion is directly related to the amount of knowlege any given physician has about CH and it's diagnostic criteria.
 
We as a population of sufferers know full well that in Western Medicine, few doctors and even skilled neurologists are well versed in CH.  I would imaging that would be the case in other countries as well.  
 
Many doctors can't get past the "features of a Cluster sufferer" being quite tall, with lionine faces, orange peal skin, hazle eyes, MALE, heavy drinkers and heavy smokers.  
 
There is a very great possibility that the Dx of CH was in paret made due to the fact the patient smokes.  Patients not fiitting the above features have been natoriously misdiagnosed with other headache types.
 
With the term CH catching on (thanks in part to OUCH and it work) we see as a CH community the misdiagnosis of CH in persons who's symptoms are clearly not indicitive of CH.  It's almost as if the doctor can't instantly stae for certain it's migrain or tension, then slap this new "Cluster Headache" lable on it.  
 
Either way, my best educated guess would be that any research into a causal relatinship betweennicotine and CH would be scewed at best.
 
Although the incidence of smoking in the CH population is higher than in a general population, it still doesn't account for the nearly half of the CH population of non/never-smoked sufferers.
 
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Re: CH history, genetic link and nicotine
« Reply #48 on: May 6th, 2008, 6:44pm »
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on May 6th, 2008, 6:33pm, Redd wrote:

 
Either way, my best educated guess would be that any research into a causal relatinship betweennicotine and CH would be scewed at best.
 

 
 
And that would be great too ! It took Thomas Edison 1000 tries before he managed to make a light bulb that worked !  
 
Personally I would rather look and not find than not look in the first place.  Smiley
 
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Re: CH history, genetic link and nicotine
« Reply #49 on: May 6th, 2008, 7:15pm »
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Speaking of lights, this one's been burning for 107 years
 
http://www.centennialbulb.org/photos.htm
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