Would it be beneficial to start the Batch’s Anti-inflammatory regime without Calcium and Magnesium?

I am an episodic CH’er suffering for over 15 years; however, I was just diagnosed with CH two years ago.  This year’s cycle is the very first time that I am trying sumatriptan (zomig) as abortive and a corticosteroid taper (perdisone) as preventive. The medication has stopped the headaches, but has lengthened my cycle considerably, and it’s giving me very severe side effects.

My neurologist wants me to try verapamil, to replace and reduce the side effects of the corticosteroids. I have never used verapamil, I do not know if it is going to work and at what dose.

At the same time I want to start Batch’s Anti-inflammatory regime, because my current level of 25(OH)D serum concentration 15.6 ng/mL. However, my neurologist opposes to add calcium supplements since he points out that it will interfere with verapamil.

In Batch’s regime, it is outlined that “in order to minimize a possible interaction with calcium that may limit verapamil effectiveness, separate the verapamil and calcium doses by at least 8 to 12 hours.”  However, this is not possible to me, since I must take verapamil 3 times a day (every 8 hours). In other words, I would have to skip or move one dose of verapamil, in order to try Batch’s regime. I am concerned that by doing that verapamil will not be as effective, and it is imperative for me to move away from prednisone right now.

Additionally, I have never been able to tolerate any presentation of magnesium, including the glycinate, which is supposed to be the one with less laxative effects. I am researching on taking magnesium oil that I understand can be applied on your skin, but I am not certain if it would be effective in this regime.

How effective the regime would be if I don’t take these two supplements?  I was planning to do a 2-week load of 50 IU of vitamin D3 per day. Would that be completely worthless if I skip calcium and magnesium?

Welcome to CH.com.

I'm sure Batch will respond to your query. I had a similar dilemma before I started the Anti-inflammatory regimen.

Following a discussion with my Doctor we agreed to forego starting the Verapamil for one month and follow the D3 regimen, including calcium. If it didn't work I would start on Verapamil.

I never got to Verapamil. Been on D3 ever since with great success. This might be an approach you can discuss with your Doctor.

Best, 

Peter.

Thanks Peter - my main concern is that I was about to start the 2-weeks load of 50,000 IU/day and without a calcium supplement that would be detrimental to my bones

Rick,

I don't think it would do your bones any harm but it just would not work without Calcium. It is the most important cofactor in Batch's regimen.

Again, I would urge you to discuss with your Doctor trying it (exactly as Batch recommends) for 4 weeks, before trying Verapamil.

Think about it. You're suffering for 15 years (about the same as myself).  4 more weeks won't kill you and it could change your life. It has done for 80% of those who have tried. Good odds in my book.

"What have you got to lose only your headache?". (Quote attributed to Barbara).

Best of luck and please keep us posted.

Peter.

The Calcium Citrate supplement has been taken out of the vitamin D regimen! You get the amount of calcium needed for the regimen to work in the Kirkland Mature Multi Vitamin.

Cheers Hoppy

Hola Ricardo,

Great question and you've received some great answers.

As far as I can tell based on data from several studies and a lot of feedback from hundreds of CHers taking this regimen...  There's no problem skipping or taking the calcium if you're starting this regimen and you're already taking verapamil or are planning to take it.

However, although the calcium is optional, you do need to take at least 400 mg/day magnesium. 

The enzymatic processes that hydroxylate vitamin D3 to 25-Hydroxy Vitamin D3 [25(OH)D3] and that also hydroxylate 25(OH)D3 to 1,25(OH)2D3 both consume magnesium at a high rate. 

Taking vitamin D3 and doses ≥10,000 IU/day without magnesium supplements will result in a magnesium deficiency and a calcium-magnesium imbalance.

Our muscles need calcium to contract and magnesium to relax...  In short, with a magnesium deficiency, muscles tend to cramp... 

Leg or arm cramps are a minor problem when they happen...  However when the heart starts cramping... a.k.a., an arrhythmia, that galloping or fluttering feeling in your chest can be very frightening and gets your attention tout suite.

Your 25(OH)D serum concentration indicates a clear vitamin D3 deficiency so you're taking the correct action starting the 2-Week vitamin D3 loading schedule.

Regarding taking the anti-inflammatory regimen with the calcium and starting verapamil... It's dealer's choice...  I'm inclined to go with Peter's suggestion option to start the anti-inflammatory regimen and wait a month to 6 weeks before starting the verapamil if you're still getting hit.

From a clinical perspective, starting the anti-inflammatory regimen and waiting on the verapamil is a good choice as it will tell you if this regimen is responsible for a reduction or cessation of your CH symptoms.  If you start both at the same time, you'll never have that answer.

Verapamil also carries some onerous side effects including too low a BP and arrhythmias.  A study done by Dr. Peter Goadsby a few years ago on verapamil as a CH preventative indicated roughly a third of CHers who started verapamil even at the lowest dose, experienced arrhythmias.  The conclusion of his study was to take an EKG before starting verapamil as a baseline with an additional EKG a month after starting verapamil.

Hope this helps.

Take care,

V/R, Batch

Thank you everyone for the responses.

It seems that my main problem is Magnesium then. I suffer from celiac disease and other GI problems, which might as well be the cause of my D3 deficiency and even my CHs!

Magnesium Glycinate really hurts my stomach. What type of Magnesium do you guys recommend?  I know that cutaneous magnesium oil is not an option as you may need a lot to make to to the 400 mg./day required.

Or what about intravenous magnesium? Does that even exist?

Hi Rick,
From what I know, Magnesium Glycinate is the go to, when the others (Oxide and Citrate) are giving you the shits.

Cheers Hoppy

Ricardo,

I should have asked if you had any other medical problems...  Celiac disease can and will pose problems with magnesium absorption.  I sent you an email earlier tonight with a possible solution that may help.

In the mean time, discuss probiotics with your gastroenterologist or primary care physician if you're not already taking them. 

The important thing at this point is getting started on the rest of the anti-inflammatory regimen with plenty of vitamin D3.  As your 25(OH)D lab indicates a vitamin D3 deficiency, it is also very likely you have a magnesium deficiency as well.

A vitamin D3 deficiency feeds two heads of the Celiac Disease monster, leaky gut and inflammation.  The 2-Week vitamin D3 loading schedule is a good start, but you may need a much higher vitamin D3 maintenance dose given you have Celiac Disease and Cluster Headache.  I'll send you some additional information on this topic by email.

My best suggestion at this point is to work with your PCP or gastroeneterologist with respect to vitamin D3 therapy.  You will need extra lab tests of your serum calcium and parathyroid hormone.  You will need these tests as a baseline reference as you increase your serum 25(OH)D. 

The problem with higher vitamin D3 intakes > 40,000 IU/day is they may result in excess serum calcium (hypercalemia) and excess urine calcium (hypercalciuria) which usually occurs first.   

The solution here to avoid hypercalciuria and hypercalemia if need to take higher therapeutic doses of vitamin D3 is avoid calcium rich foods and calcium supplements. You'll also need to drink 2.5 liters of water a day to help flush excess calcium from the kidneys.

A 24-hour urine collection is also a good idea so they can measure creatinine clearance and Calcium/Creatinine Clearance Ratio.

One final question...  Have they started you on any of the biologicals like Infliximab (Remicade) as a treatment for your Celiac Disease?

Take care and please keep us posted.

V/R, Batch

This topic has been extremely helpful. I have been taking the D3 regiment for 9 days and 2 days ago started verapamill. I'll stop the verapamil and give the D3 a couple months.
Thanks OP

great idea mfocht,
then you'll know if the D3 regimen will keep you PF. There's a good chancce it does.
All the best

Batch,
Where is the latest official Anti-inflammatory regime details? I think I stated with an old one from another site and didn't do a high initial booster dosage after reading posts on here. I started taking full regime about a week ago and partial about 2 weeks ago.

Hey JK,

Good question.  I keep the latest version of this regimen updated at the following link, halfway down the first page.  I also include the latest results from the online survey of CHers taking this regimen to prevent their CH.

START PRINTPAGEMultimedia File Viewing and Clickable Links are available for Registered Members only!!  You need to or END PRINTPAGE

Take care and please keep us posted.

V/R, Batch

Hello Batch -

I finished the 2 weeks of the anti-inflammatory regime. I checked my vitamin D3 levels were in 88.7 ng/mL. My headaches are not coming back and now I am tapering prednisone.  I was at 70mg per day, now I am at 17.5mg per day. So either the cluster stopped by itself or the vitamin D3 worked!  I am not stooping the regime. I am at 10K IU now per day plus the rest of the vitamins.

The problem that I have now is horrendous chest pains, like asthma.  I think it is the prednisone tapering.  However I wanted to ask you, do you know if the regimen may cause shortness of breath and chest pains?

I am having the regimen at dinner time, and shortly after I get cold sweats, and get very weak....  the shortness of breath and chest pains are all day long though. So I moved the regime to lunch time, and I got them shortly after. Any advise or tweaking you recommend in the regimen while tapering prednisone?

I am taking max amounts of everything in the ranges advised by the regimen (with 10K IU id Vitamin D3). Should I try to decrease them to the minimum?

Thanks,
Rick

Hey Rick,

Thanks for the update.  Glad to hear you're CH pain free.

As I indicated in the email this morning, we've not seen symptoms like these attributed to the anti-inflammatory regimen.  That doesn't mean they can't happen.

Use the process of elimination by stopping one of the supplements each day until you no longer have the symptoms you reported to find the culprit.

Take care and please keep us posted.

V/R, Batch