Hey Barry,

Thanks for the kind words.  Measuring saliva pH can be a crap shoot at times as pH levels can and will jump around throughout the day and from day to day.  The best way to determine systemic pH using saliva pH as an analog is to do at least three measurements at the same time each day and average them. The sampling technique is also important.

In an attempt to characterize the role of arterial pH in the pathophysiology of cluster headache triggering and abort mechanisms, I conducted a small test by measuring the pH of my saliva before a cluster headache and five minutes after an abort with oxygen therapy at flow rates that support hyperventilation.  I also did this over a two-week period to see if there were any trends without any overt change in diet.

I started by collecting saliva pH measurements three times a day as an analog of arterial pH in order to generate a daily average.

I then measured my saliva pH after awakening with a cluster headache and again following the abort with this method of oxygen therapy plus 5 minutes to allow for the saliva pH to equalize with arterial pH.  The results of this two-week test are illustrated in the graphic below.

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The green line is my daily average saliva pH computed from measurements taken in the morning prior to breakfast, mid-day prior to lunch, and in the evening prior to going to bed.  I rinsed my mouth with water and waited 5 minutes prior to each of these pH measurements to ensure I minimized the effect of any contaminants that could skew the results in one direction or another.  For example if you take a swig of Coke or Pepsi then take a saliva measurement it will read very acidic with a low pH.

The red dots and lines in the above graphic represent my saliva pH measurements taken as soon as I awoke with a cluster headache and the blue dots and lines represent the saliva pH measurement taken 5 minutes after the abort with oxygen therapy.

All the cluster headaches occurred while sleeping and were between pain level 3 and 4 on the 10-Point headache (Kip) pain scale. I aborted all of them with oxygen therapy at flow rates that support hyperventilation (35-40 liters/minute) in 3 to 4 minutes to a pain free state.

I also added pulse oximetry readings starting on Day-7 taking readings at the same time as the saliva pH measurements.  The results are what I expected.  I suspect if I would have had use of a capnometer, I would have seen significantly higher ETCO2 readings than normal upon awakening with a cluster headache.  I also expect these ETCO2 reading would be clearly higher than after the abort with oxygen therapy at flow rates that support hyperventilation.  The reason for the low ETCO2 readings following an abort with this method of oxygen therapy is simple.   This method of oxygen therapy casts of CO2 faster than the body generates it through normal metabolism.

Days 5,10, and 11 I had no CH.  During the evening of Day 14 I had three CH.  This coincided with the day where my daily average saliva pH was lowest.

As you can see from all of the nights where I had a cluster headache this method of oxygen was able to elevate the pH of my saliva on every attempt.

Granted this data is clearly anecdotal with me being the only study subject.  Having said that, the data and results were consistent with what we expected.

Influencing systemic pH with diet and calcium citrate supplements is a horse of a different color as this process is largely metabolic in nature so it occurs at a much slower pace taking several hours where elevating arterial pH with hyperventilation takes only a few minutes.

There's enough medical evidence from a few studies to suggest calcium citrate and citric acid from lemonade or limeade acts as a buffer on the stomach's gastric juices and contents to raise their pH from 2.0 up to a pH of 4.9.  There are also a sufficient number of papers claiming a diet of alkaline forming foods can raise systemic pH.  See the following link:

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Ultimately, anything that can raise systemic pH to the high end of the normal pH of 7.35 to 7.45 or above should stimulate vasoconstriction and that should help lessen the frequency and intensity of cluster headache.

Take care,

V/R, Batch

Hey Gary,

I used the pH test strips from pHION at the following link:

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Shoot me an email and I'll send you the excel worksheet Michael Berger developed that I used during this test.  Update the date then fill in the data and it will build the graph automatically.

Take care,

V/R, Batch

skeevedout,

Thanks for the feed-back.  Are you also taking the calcium citrate tablets formulated with vitamin D3, magnesium and zinc?  More that a few have found adding a couple of these tablets a day helps. 

There are other ways of measuring the effectiveness of this regimen...  For example, is your oxygen therapy working better with faster aborts? Do you feel better in general?

We're still collecting data on this regimen and although several CH'ers are experiencing a reduction in the frequency and intensity of their CH in the first two days after starting it, others appear to be taking a little longer.

As to continuing or not...  that's your call.  Like all other types of treatments for our disorder, none are 100% effective. 

To my way of thinking, it's all a matter of assessing the risk-benefit ratio. 

If the risk of harmful side effects is low and the benefits appear to offer only a marginal improvement...  it's a push.

If the risk of harmful side effects is relatively high and the benefits appear marginal...  you need to make a decision...  is the treatment worth taking?

If the risk of harmful side effects is low and the benefits appear high...  It's a no-brainer.

Would you continue to take verapamil if you were still experiencing the same number of heavy hits a night?

What I can say is this is a very healthy regimen with no harmful side effects and a high upside potential to keep you as healthy as possible.  My wife is on this same regimen and she doesn't have CH.  She feels great and bounces around the house and yard like a kid.  Me too for that matter.

Take care,

V/R, Batch

Hey Skeevedout.

Good question.  The complete regimen is actually a combination of two separate regimens I've used to lower the frequency and intensity of my CH...

I originally started using them to improve the abort times with oxygen therapy during high cycles where the aborts with oxygen therapy took longer than usual.

We think the anti-inflammatory regimen works to reduce the neurogenic inflammation in and around the trigeminal nerve that's associated with the cluster headache syndrome...   The buffering regimen elevates arterial pH making it more alkaline in the hopes of reducing the vasodilation also associated with the cluster headache syndrome. A low arterial pH (too much acid) tends to trigger vasodilation and that aggravates CH.

The anti-inflammatory regimen consists of 10,000I.U. vitamin D3 and 2000mg to 3000mg Omega 3 Fish Oil taken daily.

The buffering regimen consists of 2 to 3 of the calcium citrate tablets formulated with vitamin D3 (800I.U. in two tablets) magnesium and zinc washed down with citric acid from lemonade or limeade taken each day.  I've also used margarita mix as it has additional citric acid. 

The combination of calcium citrate and citric acid acts as a buffer on the stomach's gastric juice and contents elevating the mix from a pH of 2.0 up to 3.9.  The magnesium helps in this process as well.

Hope this helps clarify what I take on a daily basis.

Regarding oxygen therapy... it is the most effective and least invasive cluster headache abortive available to us.  It has no harmful side effects.  It's also the least expensive abortive and there's no limit on insurance coverage like there is on imitrex due to it's cost. 

If used at flow rates that support hyperventilation, oxygen therapy can result in abort times that rival the subcutaneous injections of imitrex (sumatriptan succinate).  I would typically abort my CH in 3 to 4 minutes with this method of oxygen therapy if I caught the CH early.

Take care,

V/R, Batch