I know there are lots of threads on oxygen, but I couldn't think where this should go and found it to be some really cool info..so here it is.  I started looking into whether or not Lots of straight O2 could be bad for you ....my somewhat paranoid friend told me too much would give me "bubbles in my brain".  I did not find anything about "bubbles" but did find out that for most people lots of straight O2 is not too good for you.  Turns out it causes a cascade of reactions, with the end result being "Several brain areas responded to 100 percent oxygen by kicking the hypothalamus into overdrive"  Hell yeah!  Bad for most people, Friggin awesome for us cluster sufferers and our underactive hypothalamus!  Maybe it's not actually the vasoconstriction
doing all the work!
                    
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On a completely different O2 note...I've seen lots of warnings about the fire risk associated with O2, but none about the thing I really worry about...Torpedoes.  I'm a brewer, and I know of another brewer in the area, used to make hard cider.  Unfortunately he knocked his CO2 tank over, busted the regulator off, and the tank shot across the room exploding his head and killing him instantly.  Not trying to scare anyone, but BE CAREFUL!

Oxygen is the safest abortive in our arsenal.  If you are a noob and reading this discount it.

            Potter

Sorry if my point got lost here....What I took from this article was that 100% O2 is not the best thing to take for non-cluster sufferers...but for us that deal with the beast it's probably doing a lot of good things that have nothing to do with vasoconstriction.  And I agree that O2 is probably the safest thing we have...unless you pop your head open like a watermelon.  We tell people about the risk of fire, just thought we should be mentioning that too.

I'm sticking with Batch's research into astronauts and pilots.

I've seen this article before.  It was discussed previously.  I can't recall exactly where and in which thread, however.

Everything's a trade-off, I think.  There is risk associated with every treatment we use, but my (admittedly non-professional) sense of the thing is that any risk associated with using oxygen the way we use it is very small indeed.

And when you get down to the nub, I doubt whether getting hit is good for us either. 

Best wishes,

George

Ricardo's link is worth reading. It's just over one page and written for non-professional eyes. If you want to see the source document in PLOS Medicine, go to their site and search for the aricle by date--May,2007. It's a slog to read except for a couple of sections which have been translated by the editors.

Interesting that there has been some research on this question in Japan, but I haven't bothered to dig it out.

Until we have some research involving adults, we ought to, at least, be watchful for the basic physiology of the human body is pretty stable over age. Blowing off this study because it was done on young children is not the best route to knowledge.

Very interesting article.

Great article Ricardo, I took it the same way you did. Not great for non CH'ers to be horsing around with, but it's possible us CH'ers are missing the point, it's not the vaso constricting but the effect the pure 02 has on the hypothalamus. Either way, it's sure been a God send for me.

And the dangers of the tanks tipping over and breaking off the head, it is an important safety consideration. Apria now gives me a big steel rack for my garage that holds 8 E-Tanks securely so they don't tip. ;)

Joe

Ricardo,

Harper's observations and more importantly his conclusions are apples and oranges when it comes to using oxygen therapy to abort a cluster headache.  His main point centered on using oxygen to treat a child who is either not breathing spontaneously or who is unconscious. A person suffering from a CH attack is neither of the above.

Moreover, he assumes because his neuroimaging indicated less blood flow in the brain while breathing oxygen that there is less actual oxygen perfusion in the brain tissue.  I don't think that is a correct conclusion as there are several studies that monitored venous blood flow coming from the brain during hyperoxia and the oxygen content of the venous blood indicated the brain tissues were receiving more oxygen than breathing normal air with no indications of ishemia noted using similar neuroimaging techniques.

The bottom line here is simple.  If you're going to cite a study relevant to CH, it's best to do just that and don't try to editorialize too much.

For the new folks reading this link, oxygen therapy is very safe, very effective if used properly at high enough flow rates ≥15 liters/minute, and it has no real side effects.  That cannot be said for verapamil, depakote, or sumatriptan succinate. 

Over 150,000 Navy and Marine Corps pilots have been breathing 100% oxygen on every flight from takeoff to landing since 1941 with an average mission length of 2 hours.  They continue to do this today flying the F/A-18s and they'll continue to do this when they start flying the Joint Strike Fighter.  Our Astronauts have been breathing 100% oxygen every time they suit up since Alan Shepard made the first US manned space flight in 1961.

I've 3000 hours in Navy fighters and all of that flight time was spent breathing 100% oxygen at flow rates up to 50 liters/minute.  I've also used oxygen therapy at flow rates that support hyperventilation since 2005.  I'm still here at age 67 and in great health.

Moreover, all military pilots must pass an annual flight physical to remain on flight status and astronauts get one before every space flight.  If there was a problem associated with breathing 100% oxygen... we would have known about it back in the early 1940's.

Finally, you might want to ask yourself...  Would the Navy or NASA make us breathe 100% oxygen for several hours at a crack if it was harmful?

Take care,

V/R, Batch

I think some may have mis-interpreted the original post. I re-read it to make sure! He's not knocking 02 for use in CH, in fact he's strongly supporting it. His friend was saying 02 would give him "bubbles on the brain." His research showed no such effect, but he stumbled accross an article that views how 02 may or may not affect the hypothalamus. But ends by saying:

Friggin awesome for us cluster sufferers and our underactive hypothalamus!  Maybe it's not actually the vasoconstriction
doing all the work!

I am one of the biggest cheer leaders for 02, and am the first to jump someone knocking it, I don't think that was the case here! ;)

I just KNEW you were a cheerleader!

Joe,

I agree...  and therein lies the problem.  Too easy to mis-interpret with the predicates swinging back and forth.  Moreover, a statement that oxygen is "Bad for most people" is not true and an over generalization that could easily be taken out of context by CH'ers considering oxygen therapy and that statement alone could sway them away from a very effective abortive.

Take care,

V/R, Batch

So....I posted this being a science guy who loves to know how things are really working, especially in the brain.  I thought this was really cool, thinking that the O2 is going to kick start my brain to start making it do what it should.  Maybe I should have thrown some disclaimers out there...When I looked at it again later and saw the title alone, I admit it doesn't sound like a great article for us.

Sorry if it's a little late but here's my two cents....Most of us know O2 can't be THAT dangerous if they've been giving people this stuff for as long as they have without noticing ill effects.  I completely believe that the media is blowing the whole thing out of proportion and making mountains out of molehills.   Something important to consider when reading it too--when it's saying the scary sounding " The hypothalamus overreacted by dumping a massive flood of hormones and neurotransmitters into the bloodstream. These chemicals interfere with the heart's ability to pump blood and deliver oxygen the opposite effect you want when you're trying to resuscitate someone."  This WOULD be true if you DIDN'T have an underactive hypothalamus (I think...) My guess is your underactive hypothalamus isn't producing enough of ANY of those hormones or neurotransmitters, so they're really just getting back to a more normal level-- NOT interfering with your heart's abilty to pump blood or deliver oxygen.   

RECAP---------OXYGEN IS GOOD FOR US!!!!!!!!!! :D
Friends again?

Ricardo wrote on Mar 14^th, 2011 at 10:07pm:

I completely believe that the media is blowing the whole thing out of proportion and making mountains out of molehills.

I agree with that!  The article was interesting, but I really didn't want to see newcomers confused and not try O2.
Ricardo, there was never any doubt about our friendship! :)

You da man Ricardo! ;)

joe

My friend told me to be careful that my body doesn't start going rusty, because oxygen is what causes oxidisation = rust.

Seriously.

But on the torpedo thing...... When I first got my O2, and I was bringing a tank in to work in the car, I got a bad hit and was trying to attach the regulator while I was in the car, so I could hook up the mask as soon as I got to the car park. I accidentally undid the valve.... and man, the burst of O2 that came out scared the life out of me...... I can see how that would cause a torpedo if that pressure had been aimed against a wall!!!

Melby29 wrote on Mar 14^th, 2011 at 11:01pm:

I accidentally undid the valve.... and man, the burst of O2 that came out scared the life out of me...... I can see how that would cause a torpedo if that pressure had been aimed against a wall!!!

MythBusters did a great episode on that... the tank went through a cinder block wall!!

Sounds like we're in violent agreement regarding the substance of the article and study...  I happen to have found parts of the article and study results interesting as well if I parse my way around what I consider to be some of the generalized and misleading statements.

I also happen to believe in the science behind publishing the results and conclusions of studies like this. 

The scientific method involves the observation of phenomena, the formulation of a hypothesis concerning the phenomena, experimentation to demonstrate the truth or falseness of the hypothesis, and a conclusion that validates or modifies the hypothesis ultimately resulting in a Theory.

It doesn't end there as fact.  The results of experimentation must be open to debate and scrutiny by others.  Moreover the results must demonstrable and repeatable by others or the theory will be challenged.

Otherwise you end up with junk science like the global warming hockey stick where they cooked the numbers to support an ideology and not science.

Take care,

V/R, Batch

Batch wrote on Mar 15^th, 2011 at 10:22am:

Otherwise you end up with junk science like the global warming hockey stick where they cooked the numbers to support an ideology and not science.

Woops there you go again bringing your Sarah Palin fan club hot button issues and ultra right wing viewpoints entirely unrelated to CH into the equation again. Completely unnecessary and uncalled for.

That sort of stuff is devisive and way off topic. I think we need to stay united here and focused on CH.

Democrats have no sense of humor! ;)

Joe

(who is really not political!)

bejeeber wrote on Mar 15^th, 2011 at 12:09pm:

...ultra right wing viewpoints...

Right wing, yes. Ultra, no.


Quote:

I think we need to stay united here and focused on CH.

Perhaps on this, the "Cluster Headache Specific" board. But certainly not on the General board. That's what it's for.

I'd give it to him.  The extrapolation of theories with graphics can seem sensational at times until they get chewed on.  Throwing out any weak links only makes the rest much stronger.



Batch wrote on Mar 14^th, 2011 at 4:03pm:

The bottom line here is simple.  If you're going to cite a study ... it's best to do just that and don't try to editorialize too much.

IMHO, it's fine.   ;)

Nice posting this thread, Batch.

Good People of Clusterville,

Hmm, Hmm, Hmm!  I was waiting for just that kind of reaction to my last post on this thread. 

It just so happens that I reviewed the study by Macy, Woo, and Harper titled "Hyperoxic Brain Effects Are Normalized by Addition of CO2" in 2008 while Royce Fishman, Michael Berger and I were developing the patent for the demand valve method of oxygen therapy.  This study is located at the following link:

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Read it for yourself.

I found the opening paragraph in the discussion section of this study to be centered on a statement that was not substantiated by any observations or measurements taken in study nor in the reference study cited, [6] "Hyperoxia-induced hypocapnia: an underappreciated risk", as that study appeared to be just as flakey in its overly dramatic assertions. 

The discussion section of the Macy, Woo, and Harper study starts out with the following:

"We found that a number of brain areas responded to a hyperoxic challenge, especially neural regions that mediate autonomic and hormonal systems. However, addition of 5% CO2 to the hyperoxic mixture substantially reduced reactions of these neural structures. The perfusion and hormonal changes to 100% O2 could initiate a cascade of central and peripheral injuries through oxidative stress processes commonly reported with high oxygen ventilation.

Since the structures recruited in hyperoxia control output of hypothalamic sympathetic and hormonal regulatory areas, the reduced responses of those structures with the addition of CO2 may diminish injury to central and peripheral organs following hyperoxia alone, a possibility suggested by others [6]."

Pardon me folks, but in my opinion based my understanding of the basic logic used in the scientific method, this smacks of pseudoscience and some kind of agenda against the use of 100% oxygen.  Making a statement with the conditionals "could" and "may" does not constitute a scientific method of proof!

Where are the biochemical measurements and observations (read medical evidence) to substantiate this "cascade of central and peripheral injuries"?  What injuries?  How were these central and peripheral injuries detected? What is the extent of these central and peripheral injuries?

If the study authors can't substantiate the nature and extent of these injuries, then how can they make any claim as to the efficacy of adding CO2 in diminishing them? 

I don't doubt they observed a change in the functional neuroimaging after adding 5% CO2, but that’s where the science ended…  The rest with respect to central and peripheral injuries is little more than subjective fluff and a clear indication, at least to me, that they have an agenda.

The authors of this study also claimed that 100% oxygen caused cerebral ischemia yet they provided no evidence as proof to back up their neuroimaging. 

You might want to read the study by B.F. Matta et. al reported in the Canadian Journal of Anesthesia titled "The influence of arterial oxygenation on cerebral venous oxygen saturation during hyperventilation."  You can download a pdf copy at the following link.  It totally debunks and refutes the assertions made by Macy, Woo, and Harper about ischemia caused by breathing 100% oxygen…  and Matta has the medical evidence on his side.

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While we're at it, "Oxidative Stress" is also a code word for an agenda with a highly probable mission statement that reads: (we've got to restrict the use of 100% oxygen).  A related code for this same agenda is "Reactive Oxygen Species."  Now that's a real spooky phrase, but what does it mean and how do you characterize it?

What is the real impact of Oxidative Stress and Reactive Oxygen Species (ROS) on the human body?  Is it bigger than a breadbox and smaller than a house?  Is the health hazard of ROS greater than or less than the common cold?  What is the real health risk?

Having a degree in Chemistry I do know that ROS refers to a single atom of oxygen or the larger molecule, O3 (ozone) as it breaks down into a molecule of oxygen (O2) and a single atom of oxygen.  Although both of these ROS are chemically active and will bind with other atoms or molecules very rapidly, neither of them is present in medical oxygen in any measurable quantity. 

You'll get a thousand times more ozone walking down the street of any large city in five minutes than you would ever get from breathing the entire contents of a K-size cylinder of compressed 100% oxygen.

Now if you think I'm paranoid about an agenda to restrict the use of 100% oxygen, please consider the following: 

The Centers for Medicare and Medicaid Services (CMS) ruled in October of 2010 that Medicare beneficiaries suffering from cluster headache WILL NOT RECEIVE COVERAGE for medical oxygen as an abortive for this disorder as there is not sufficient medical proof of its efficacy… 

The bureaucrats at CMS basically basically told the Presidents of the American Headache Association and American Association of Neurologists to get stuffed when they asked for a new coverage determination on the use of oxygen therapy as an acute treatment and abortive for cluster headache…  but it backfired and they had to do some "careful reconsideration" after pressure from Speaker Boehner turned up the heat.  Home Oxygen Therapy is NOW COVERED for Medicare beneficiaries suffering from cluster headache. 

I misspoke... but this update makes my concerns even more valid...  Oxygen therapy is only covered for Medicare beneficiaries suffering from cluster headache if they are taking part in a CMS sanctioned study of oxygen therapy...  See the following link:

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CMS has also developed a spend plan that will cut a tad less than $1 Billion in funding for home oxygen therapy for Medicare beneficiaries suffering from COPD.  Here's a copy of their spend plan:

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CMS also mandated a bidding process to hold down the cost of compressed oxygen and it has had the not so unintended consequence of driving most of the Mom & Pop home oxygen providers out of business as they can't compete. 

What's even worse is the cost of home oxygen therapy has actually gone up even with lower oxygen costs because of the increased delivery charges to locations previously serviced by the smaller home oxygen providers.

All for now.  Brew, please move this thread to where you think it belongs.

Take care, and when you read the results of medical studies related to cluster headache...  be critical.

V/R, Batch

Edited to correct the nature of the CMS action on non-coverage for Medicare beneficiaries suffering from cluster headache.

Quote:

Brew, please move this thread to where you think it belongs.

Never. First off, not my decision. Secondly, not my decision.

You know I love ya, Pete. ;)

Wow...the idea that there is a government conspiracy to limit the amount of 100% oxygen that I can get is definitely interesting....but I'm really interested in oxygen and what it's doing to our brain.  IS it activating our hypothalamus?  Or is it really just vasoconstriction at work?  Anybody have any other info on that?

Ricardo wrote on Mar 16^th, 2011 at 11:53am:

Wow...the idea that there is a government conspiracy to limit the amount of 100% oxygen that I can get is definitely interesting....but I'm really interested in oxygen and what it's doing to our brain.  IS it activating our hypothalamus?  Or is it really just vasoconstriction at work?  Anybody have any other info on that?

  It works,  let's not over think it.

          Potter

I like to know as many pieces of the puzzle that I can , that's all.  I'm a neurology nut...And one of my strong points has always been to be able to take small parts of information and put them together to come up with a more complete idea of what's going on.  I 100% believe that the more knowledge I have about the beast, what keeps it here and what makes it go away (and why), the better.  You might just be surprised at the info you can come up with when you put a whole lot of small stuff together.

Hey Ricardo,

I applaud your quest for knowledge in the pathophysiology of the cluster headache and the oxygen therapy abort mechanism, but you're asking questions that the brightest minds in neurology who study the cluster headache syndrome on a near daily basis have been grappling with for years.  If the answers to your questions were at hand, these experts would likely be a lot closer to understanding the real cause or our disorder.

The reality of the situation is this, we suffer from an orphan disorder and there will never be enough money to do the kind and number of studies needed to answer your questions and many others that desperately need answers. 

We're fortunate to have as many as one clinical study related to cluster headache a year and that's still not enough to answer the mail, but it's better than no studies at all.

I had the opportunity to meet with Prof. Dr. Arne May at the University Hosptial, Hamburg UKE last July for two days.  He's one of the cluster headache experts I spoke of and he specializes in functional and structural neuroimaging.  His work is light years ahead of the study done by Macy, Woo, and Harper. Prof. Dr. May is also the author of the EFNS guidelines on the treatment of cluster headache and other trigeminal-autonomic cephalalgias.

I met with him to enlist his services as the Principal Investigator for a gold standard protocol study of the demand valve method of oxygen therapy for cluster headache with some functional and structural neuroimaging thrown in for good measure. 

He agreed, but there was a small matter of the Million or so USD needed to fund the study...  So, if you've got a line on funding like that, sing out and we'll have what it takes to get you some answers...

Regarding a government conspiracy to limit access to oxygen therapy... That's a bit strong...  Having said that, I'm surprised that with your ability to piece together small parts of the puzzle to get the big picture that you haven't noticed that oxygen therapy is the most over regulated USP in medical history.

I'm surprised you haven't noticed and commented on the fact that someone can go out and get a Hovaround scooter for free in less than a week because they're too overweight to walk, or that doctors can fill your pockets with percocet in less than two shakes of a lamb's tail, but it will take over 30 minutes to fill out all the required paperwork mandated by CMS and schedule tests for oxygen saturation (if you're a COPD sufferer) to go along with the prescription for oxygen therapy...  and that's if you can talk the physician into writing one...

The Centers for Medicare and Medicaid Services have an entire division up in Baltimore dedicated to administering Oxygen DME and they also have a government stooge at every major home oxygen provider's home office to review your prescription.  When you piece together these little facts with what I pointed out earlier in this thread, perhaps you'll see the big picture like I do.

All for now...

Take care,

V/R, Batch

Quote:

I'm really interested in oxygen and what it's doing to our brain.  IS it activating our hypothalamus?  Or is it really just vasoconstriction at work?  Anybody have any other info on that?

A long time ago on the old board here, someone posted on how oxygen works for us, but I've no idea how true it is.  It sounded good, so I just went with it.

The brain of course needs to be supplied oxygen, which it gets through the arteries, but the amount cannot be a totally unregulated amount.  If the brain is receiving a higher amount of oxygen than it normally functions at, there is a built in regulator system.  The brain can somehow, maybe with hormones, use the mechanism it has at its disposal -- constrict the cranial arteries bringing the oxygen.  Perhaps an automatic survival mechanism.

This is an automatic reaction built into our system in an attempt to have oxygen delivered at a regulated rate.  In this way it would be the constricting of cranial arteries that relieves the trigeminal nerve.  Apparently, this reaction can be a stronger natural impulse than what made CH expand them. 

The rare times oxygen seems difficult to relieve a CH, like when it's going strong, the impulse of CH is fighting the brain's natural regulation of constricting the oxygen flow it's receiving, and they are both fighting to a draw. However, this natural method will work most everytime if started early and kept up long enough, but CH will return again later characteristically.

In this way, its the constriction, and it may be that the brain's automatic regulation system to constrict is kicked on by the hypothalamus doing the regulating. 

Sounded ok to me since I haven't heard much else about it.

Kevin, that's what I read too. So even though I try not to believe EVERYTHING I read, it was a simple enough explanation that even if it's not true, it seems to satisfy the people that look at me weird when I tell them that paracetamol and codeine and tramadol and ibuprofen don't work, but chugging pure oxygen does  :D

Hey Kevin,

You're correct, the body and brain do have homeostatic mechanisms that control vasoactivity, respiration rate, heartbeat, and arterial pH.  However, it's carbon dioxide (CO2) levels and not oxygen (O2) levels that acts as the primary stimulus for these homeostatic mechanisms. 

For example, if you do jumping jacks for 30 seconds or climb a couple flights of stairs at a fast pace, you start breathing faster and your heart also starts beating faster.  What you can't see is your arteries dilate as well.  All this happens due to the build up of CO2 in the venous and arterial blood as a result of the increased physical activity. 

As CO2 takes the form of carbonic acid in the blood, this increase in acidity results in a lower pH. There's also a build up of lactic acid that's generated when muscle tissue is stressed without enough oxygen. (If you're a jock, you know this is called anaerobic glycolysis.)  This build up in lactic acid drops the pH of the venous and arterial blood even further.

When the chemo sensors in the brain detect an elevation in CO2 levels and drop in arterial pH, an acid-base homeostatic mechanism kicks in and the brain signals the heart to beat faster, the lungs to breath faster and the arteries to dilate.  It does all this to pump more blood to the lungs where the excess carbonic acid can be cast off or downloaded from blood hemoglobin as CO2 and oxygen in uploaded. 

This increased respiration rate and heartbeat will continue until the excess CO2 is cast off to allow CO2 levels to fall back in the normal range and the arterial pH to rise back into the normal range.  At that point the brain signals the heart to slow to a normal rhythm and respiration to slow to a normal rate.  It also signals the dilated arteries to constrict back to a normal lumen (diameter).

Understanding this acid-base homeostatic mechanism and knowing that it works in both directions to maintain an acid-base balance in an arterial pH range of 7.35 to 7.45 is the key to understanding how to use oxygen therapy more effectively and why higher flow rates that support hyperventilation are needed.

When we breathe 100% oxygen at normal respiration rates, we elevate the partial pressure of oxygen in the blood above normal.  This is defined as hyperoxia and this condition is a component of the cluster headache abort mechanism with oxygen therapy. 

The exact mechanism(s) remain(s) unclear, but hyperoxia from breathing 100% oxygen stimulates vasoconstriction and as vasodilation is part of the pathophysiology of the cluster headache, stimulating vasoconstriction helps stop the pain and abort the cluster headache.  This leaves us with the following physiological equation:

   hyperoxia = vasodilation = CH abort

Now here's where CO2 levels play a role in the cluster headache abort mechanism during oxygen therapy.  We already know from the discussion above on acid-base homeostasis that an increase in carbonic acid (CO2) levels in the blood stream above normal (hypercapnia) will trigger vasodilation. 

It also turns out that when carbonic acid (CO2) levels in the blood stream drop below normal (hypocapnia), acid-base homeostasis kicks in to trigger a decrease in heartbeat, a slowing of the respiration rate and vasoconstriction.  This is done to slow the loss of carbonic acid (CO2) from the lungs and allow it to build back up to normal levels. 

That means if we can lower the carbonic acid (CO2) levels in the blood stream below normal (hypocapnia), we can stimulate vasoconstriction. 

How do we do this?  Simple...  We intentionally hyperventilate long enough to raise arterial pH above the normal range of 7.35 - 7.45.  This results in respiratory alkalosis.

That leaves us with the following physiological equations with respect to oxygen therapy at flow rates that support hyperventilation:

If
  hyperoxia = vasoconstriction
and
  hypocapnia = vasoconstriction
then 
  hyperoxia + hypocapnia = greater vasoconstriction = faster CH abort

Now here is where things can get complicated.  From the study that Ricardo cited where they added 5% CO2 to the oxygen breathed by the children, they observed no vasoconstriction.  That leaves us with the following physiological equation with respect to the relative vasoactive strengths of hyperoxia and hypercapnia:

  hypercapnia > hyperoxia

In other words, excess carbon dioxide in the bloodstream is a more powerful vasodilator than excess oxygen is as a vasoconstrictor.

Let's see how that plays out when we're trying to abort a cluster headache with oxygen therapy...

If we breath 100% oxygen at a flow rate of 15 liters/minute and remain motionless with a low level of physical activity, we should be able to bring about an abort of the cluster headache as long an the cluster headache pain is low enough to allow us to remain at a low level of physical activity.

However, if the cluster headache pain starts us rocking back and forth or dancing in circles and the level of lung ventilation provided by an oxygen flow rate of 15 liters/minute is insufficient to cast off the excess CO2 resulting from the increased physical activity, an abort with oxygen therapy may not be possible or it will take much longer than normal.  That leaves us with the following physiological equation:

   hyperoxia + hypercapnia = vasodilation ≠ CH abort

This is why we say that oxygen therapy at flow rates that support hyperventilation is more effective with shorter abort times than oxygen therapy at flow rates ≤15 liters/minute.

This discussion assumes that through the act of intentionally hyperventilating with 100% oxygen, we are able to bias the acid-base homeostasis mechanism to achieve a greater level of vasoconstriction regardless of the level of physical activity and this will result in a fast abort of the cluster headache pain and triggering mechanism. 

Is this the only mechanism in play?  No.

Another related mechanism occurs when we hyperventilate with 100% oxygen.  It's called the Bohr effect.  Under normal conditions when the blood pH is low as it is in the body and brain tissues, hemoglobin offloads oxygen and uploads carbon dioxide.  When the blood pH is high as it is in the lungs, hemoglobin offloads carbon dioxide and uploads oxygen.  This is the normal oxygen and carbon dioxide transport mechanism between the body and lungs.

However when we artificially elevate arterial pH in the lungs even further through the act of intentionally hyperventilating with 100% oxygen, hemoglobin increases its affinity for oxygen and uploads more oxygen than normal.  This results in a super-oxygenated flow of blood to the brain greater than the hyperoxia from breathing 100% oxygen at normal respiration rates and that results in an increased level of vasoconstriction.

Clearly, there are other mechanisms involved in the cluster headache abort process with oxygen therapy and that's what Ricardo wants to learn.  That leads us to a possible question as to which is the predominant mechanism in play, acid-base homeostasis, or a cocktail of hormones, enzymes, and chemical messengers triggered by hyperoxia?

I don't know...  The neurochemistry involved is well above my pay-grade. 

What I do know from personal experience, and from the results of an informal pilot study we conducted with 7 other participants, is that oxygen therapy at flow rates that support hyperventilation is far superior with greater efficacy as a cluster headache abortive than is possible with oxygen therapy at a flow rate of ≤15 liters/minute.  Moreover this method of oxygen therapy has significantly shorter abort times.

Take care,

V/R, Batch

Couldn't have said it better myself, Batch!   :)
Having taught the basics of respiration and gas laws to Anatomy & Physiology students from various texts, I'm going to print out your missive and use it as a supplemental reference!
-Gary

Batch,

Looking at the question he asked, it pretty much involved oxygen use.


Quote:

I'm really interested in oxygen and what it's doing to our brain.  IS it activating our hypothalamus?  Or is it really just vasoconstriction at work?  Anybody have any other info on that?

Your post was good coverage of the oxygen abortive mechanism. 


Following that question ...


Quote:

I like to know as many pieces of the puzzle that I can , that's all.  I'm a neurology nut...And one of my strong points has always been to be able to take small parts of information and put them together to come up with a more complete idea of what's going on.  I 100% believe that the more knowledge I have about the beast, what keeps it here and what makes it go away (and why), the better.  You might just be surprised at the info you can come up with when you put a whole lot of small stuff together.

What keeps them here is not using oxygen.   ;) 

What makes them happen is a harder question.

   
The mechanisms involved with oyxgen you have mentioned seem to be encompassing enough to be more than a small piece.







This is an article about an unrelated disease, but in its symptoms it brings up much of the process you described.


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Quote:

Central neurogenic hyperventilation (CNH) CNH is the human body's response to reduced carbon dioxide levels in the blood. This reduction in carbon dioxide is caused by contraction of cranial arteries Symptoms of CNH have been observed to vary according to the progression of CNH. The initial symptoms of CNH include a low arterial partial pressure of carbon dioxide, a high or normal arterial partial pressure of oxygen, high arterial pH, and tachypnea.[3][4][5][9][10] The partial pressure of carbon dioxide has been noted by Yushi et al. to drop as low as 6.7 mmHg, while oxygen saturation remains at 99-100%.[9] Respiratory alkalosis is induced in people affected with CNH, which stimulates the hyperpnea to attempt to compensate the rise of the blood’s pH.[5] Some of the reported cases of CNH claim alkaline cerebral spinal fluid (CSF). This condition is thought to result from severe hypocapnia that induces blood vessels in the brain to constrict, leading to brain ischemia.[5]

Maybe the footnoted articles may lead somewhere and possibly have something to offer, or it's familiar to you and abets what you've compiled.


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Clearly, there are other mechanisms involved in the cluster headache abort process with oxygen therapy and that's what Ricardo wants to learn.  That leads us to a possible question as to which is the predominant mechanism in play ...

Thanks guys!  This is the kinda stuff I'm talking about!