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New Message Board Archives >> Medications, Treatments, Therapies 2003 >> Why does exercise trigger CH?
(Message started by: Marcel on Dec 3rd, 2003, 1:43pm)

Title: Why does exercise trigger CH?
Post by Marcel on Dec 3rd, 2003, 1:43pm
Hi all, my name is Marcel and I live in Northern California.  I've had episodic CH since I was 19, I'm now 45.  I'm into a really bad bout right now and looking for new medication.  Does anyone know why exercise triggers CHs?  I usually get them about 10 minutes after an intense workout, in addition to the usual suspects of alchohol, sleeping, etc.  The only thing I can think of is that exercise causes the blood vessels to dialate but for some reason it triggers the CH response during the episode.

Title: Re: Why does exercise trigger CH?
Post by thomas on Dec 3rd, 2003, 1:45pm
Can't answer that one - exercise clears my head for many hours while in cycle.

Title: Re: Why does exercise trigger CH?
Post by floridian on Dec 3rd, 2003, 1:48pm
I think you are right - it affects the blood vessels somehow.  Exactly how??  Not sure.  Some possible culprits are nitric oxide, serotonin, histamine, VIP, CGRP.  

I think I read that some people use exercise to try to abort a headache - vigorous aerobics as soon as they feel one coming on. That might work along the lines of oxygen.  There is not alot of agreement on what (if anything) can trigger a headache, and people have mixed results with the various preventatives.  Still lots to learn.

Title: Re: Why does exercise trigger CH?
Post by Marcel on Dec 3rd, 2003, 2:45pm
thanks.  What is VIP, CGRP?

Title: Re: Why does exercise trigger CH?
Post by floridian on Dec 3rd, 2003, 3:52pm
VIP = vasoactive intestinal peptide
CGRP = calcitonin gene related peptide

They affect contraction and expansion of blood vessels. CGRP is associated with hot flashes, as well.


Quote:
Expert Opin Ther Targets. 2003 Jun;7(3):377-83.

   New therapeutic target in primary headaches - blocking theCGRP receptor.

   Edvinsson L.     Department of Internal Medicine, University Hospital, S-221 85 Lund, Sweden.

   The primary headaches are among the most prevalent neurological disorders, afflicting up to 16% of the adult population. The associated pain originates from intracranial blood vessels that are innervated by sensory nerves storing several neurotransmitters. In primary headaches, there is a clear association between the headache and the release of calcitonin gene-related peptide (CGRP), but not other neuronal messengers. The specific purpose of this review is to describe CGRP in the human cranial circulation and to elucidate a possible role for a specific antagonist in the treatment of primary headaches. Acute treatment with administration of a 5-HT(1B/1D) agonist (triptan) results in alleviation of the headache and normalisation of the CGRP level. The mechanism of action of triptans involves vasoconstriction of intracranial vessels and a presynaptic inhibitory effect of sensory nerves. The central role of CGRP in migraine and cluster headache pathophysiology has led to the search for small-molecule CGRP antagonists, which are predicted to have fewer cardiovascular side effects in comparison to the triptans. The initial pharmacological profile of such a group of compounds has recently been disclosed. These compounds have high selectivity for human CGRP receptors and are reportedly efficacious in the relief of acute attacks of migraine.

Title: Re: Why does exercise trigger CH?
Post by Prense on Dec 3rd, 2003, 6:54pm
I get the same thing, but only when running...about 7-9 minutes into it.  The one thing that comes to mind is that the VO2 required to run/vigorous workout is higher than at rest or even moderate activity.  The heart rate and breathing increases to keep up with the demand for the O2 so you can keep doing the activity.  The efficiency of the heart is often measured with VO2 intake under a certain workload.  My guess, the intake of O2 vs what is needed by the body to maintain the activity falls short.  Seems to me, this lack of O2 could possibly trigger an attack.  Other than the blood vessel idea, I cannot think of anything else.  

Just a thought...

Chris

Title: Re: Why does exercise trigger CH?
Post by Piglett1969 on Dec 3rd, 2003, 11:05pm
Interesting.  It's weird how exercise seems to help some people but isn't good for others.  I can't do much of anything when I'm in the middle of a cycle.  I've even tried just walking...but sure enough, about 30 minutes after I'm done...BOOM!  My neuro told me that it's probably something to do with changes in blood pressure, as exercise naturally tends to raise it.

Title: Re: Why does exercise trigger CH?
Post by sandie99 on Dec 4th, 2003, 5:55am
Hmm... intresting information. My exercise has so far only relaxed me and not triggered Ch. But hey, perhaps that's  because I'm doing pilates.... ;;D

Best wishes & PFdays,
sandie99

Title: Re: Why does exercise trigger CH?
Post by Marcel on Dec 4th, 2003, 8:26am
Thanks Sandie, maybe I'll start doing Pilates to see if I can make it through without one.   [smiley=laugh.gif]

Title: Re: Why does exercise trigger CH?
Post by Bob_Johnson on Dec 4th, 2003, 8:42am
Some months ago a medical journal report was posted which reported that--for some people--elevated body temperature often triggered an attack.

Several messages followed which confirmed this experience. Personally, for a number of years, I could count on an attack during the summer months when cutting the grass would boost my body temp. enough to fire off a cluster. I'd routinely take Ergomar before starting to work and it usually blocked or reduced an attack.

Title: Re: Why does exercise trigger CH?
Post by kim on Dec 4th, 2003, 2:51pm
Hey Marcel,

I think when you are in a pf state and then excercise vigorously, this releases endorphins which cause a feeling of relaxation - and it is THAT feeling which triggers the attack.

This has happened to me countless times.  AFTER the excercise, when you are chilling out - ya get hit.

Many people who experience an attack, feel compelled to excercise vigorously.  But the attack comes first - not the exercise.  It's the chicken and the egg thing 8)

PFDAN :)

Title: Re: Why does exercise trigger CH?
Post by Paigelle on Dec 4th, 2003, 3:05pm
I do pilates too!   :D  They make me feel good, but I have tried to abort a CH with them.  I crawl alot when I have a CH, it is almost too much effort to walk.

Title: Re: Why does exercise trigger CH?
Post by MAugust on Dec 5th, 2003, 8:45am
When I feel an attack coming, I go outside and run my @ss off until I can't run any more.  Then I walk and I can feel the endorphine kicking the beast out of my head. The whole thing takes about 10 or 15 minutes.

It is indeed strange how this can trigger an attack for some and abort for others.

Try not exercising until an attack comes, then see if you can abort with exercise.



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