Slacker,

Sorry the CH beast made a house call after a pleasant absence... I'm with Peter and Thierry... Starting a good probiotic and Benadryl (Diphenhydramine) is a good course of action at this point.  I take the Kirkland brand "Allergy Medicine" from Costco if I suspect an allergy is booting me out of remission while on a maintenance dose of vitamin D3.

I had to take Benadryl this last March when alder and maple pollen were blowing around like a dust storm and the beast jumped ugly on me at a maintenance dose of 10,000 IU/day vitamin D3 that normally kept me CH pain free.

The rationale for a CH'er taking Benadryl with the anti-inflammatory regimen is interesting to downright fascinating...  Here are a few factoids and a theory to make my point.

1) The CH syndrome involves neurogenic inflammation and pain... (nothing new there)...

2) The neurogenic inflammation and pain associated with CH are the result of substance P and calcitonin gene-related peptide (CGRP) being released by neurons in the hypothalamus and trigeminal ganglia...  Several studies have found serum CGRP levels elevated during the pain phase of cluster and migraine headaches...

3) The leading theory on the mechanism of action by which the anti-inflammatory regimen prevents CH is associated with genetic expression. 

This is where vitamin D3 and 25(OH)D3 enter the nuclei of target neurons located in the hypothalamus and trigeminal ganglia where enzymes hydroxylate (metabolize) them to the active vitamin D3 metabolite 1,25(OH)2D3.  1,25(OH)D in turn merges with retinoic acid (vitamin A) to form a new molecule that attaches to a vitamin D3 response element (VDRE) on target genes within these neurons.  This results in genetic expression that down regulates/suppresses the production of substance P and CGRP within these neurons as illustrated in the following graphic.

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4) Allergic reactions (caused by a wide variety of allergens) trigger an immune response that results in the release of histamines.

5) The term ‘neurogenic inflammation’ has been adopted to describe the local release of inflammatory mediators, such as substance P and CGRP from neurons.

Once released, these neuropeptides induce the release of histamine from adjacent mast cells.  In turn, histamine evokes the release of substance P and calcitonin gene-related peptide; thus, a bidirectional link between histamine and neuropeptides in neurogenic inflammation is established. 

For CH’ers, this bidirectional link between histamine and neuropeptides in neurogenic inflammation represents a self-sustaining circular chain reaction and vicious cycle resulting in horrible and in many cases, unstoppable CH pain.

6) If histamines are released as a result of an allergic reaction, it triggers the circular chain reaction with a vicious cycle of CH...

7) If we treat the allergic reaction with Benadryl (Diphenhydramine), a first-generation anti-histamine that passes through the blood brain barrier to block histamine H1 receptors on neurons within the hypothalamus and trigeminal ganglia, we break the circular chain reaction and vicious cycle...

Sooo... after all that... taking a 25 mg tablet of Benadryl (Diphenhydramine) twice a day (AM and PM) can stop the allergic reactions and in the process, help the anti-inflammatory regimen prevent CH... 

Benadryl is also a CNS depressant and you will get drowsy... Don't drive if you need to take it.  If you do need to drive, Peter's suggestion to take 50 mg of Benadryl after you've driven home for the day is a good idea...

Hope this helps...  It's a lot to digest... However, if you buy into this line of thinking, it answers a lot of questions why cluster headache occur like they do...

Take care and please keep us posted,

V/R, Batch

Slacker,

Sorry you're having a rough time.  Are you taking all of the vitamin D3 cofactors including:  400 mg/day magnesium, a good mature multi with at least 12 mg/day zinc, a trace of boron, and vitamin A (retinol)? 

Have you gone to your PCP for the 25(OH)D lab test? If so, what was your serum concentration of 25(OH)D.  Without knowing your 25(OH)D serum concentration, we're shooting in the dark at what to do next.

If your 25(OH)D is not up around 80 ng/mL, a higher vitamin D3 daily intake may help.

If your 25(OH)D serum concentration is ≥ 80 ng/mL, there's likely another reason or reasons while you're still getting hit... 

When was your last annual physical exam?  What other health problems are you dealing with and if you're treating them, what other medications are you taking?

A low arterial pH (too much acid) can override vitamin D3's capacity to prevent CH...  We're not talking much of a downward shift in pH.  The simple way to test if a low pH is your problem is to drink a baking soda tonic for a couple days.

A half teaspoon of Arm & Hammer Baking Soda in a half glass of water 4 times a day, an hour after eating and right before bed.  If your CH symptoms subside, a longer term fix is to eat an alkaline diet.

See:

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and my favorite...

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Take care and please keep us posted.

V/R, Batch