Gonna try this. Already take fish oil, upped my D3, taking Costco mature vitamin and Os Cal. What else? Should I take a big dose of D3 to start? They sell 10,000 ones. Sorry new to all this. Meds have cut O2 breakthru ones to k6. Topamax and Verapamil. I week 3 of first major cycle.

My major discovery is most people think a major headache is a hangover. They have no idea. Including employers.

Re: Magnesium tolerability.

Hi to all,

Batch, you may want to run your eye over this and see what you reckon in relation to appropriate Magnesium absorption. Your opinion and expertise, as always, is invaluable.

I am on the regimen, my chronic CH is still there, as I find out from withdrawing and re-introducing the regimen in order to establish efficacy. It is working well for me so far.

I have had reports of poor Magnesium tolerability from quite a few regimen users on the Aussie CH site. I myself am struggling with finding the right magnesium supplement. Mag Citrate seemed to cause too many Gastrointestinal issues, despite the high bioavailability, it increased gastrointestinal motility and reduced GI transit time to the point where (I think) other regimen co-factors were passing through the system, before they could be absorbed.

Also causing excessive reflux, which required that I resume a proton-pump inhibitor (Nexium) which, again, appears to block nutrient uptake. When I took Mag citrate, I had reflux real bad, went for the Nexium and within 36 hours, BANG, CH again. Drop the Nexium and the Mag Citrate and add a D3 loading dose, and we're away again, CH free.

So, I am left with the Mag Oxides in small amounts found in Centrum, total 100mg per day, which is a small amount of a Mag with low bioavailability. I'm still looking for a good, tolerable source of Magnesium in my regimen for CH. A work in progress...

One Aussie CH site user suggested Magnesium Orotate, which I have not been able to find much research on.

An aside here, with relevance...
Another friend of mine has Cervicogenic Headache.
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His condition involves strong unilateral face pain behind the eye, into the jaw and temporal areas. The onset is quick, but the duration much longer - days and/or weeks, very different from CH, with severity much less than CH, but quite disabling for him nonetheless. His condition involves degeneration of cervical neck structures (as revealed in scans), resulting in some disc bulging and pressure on C1-2-3 nerves, which are connected to the Trigeminocervical nucleus.

About Cervicogenic Headache:
"The condition’s pathophysiology and source of pain have been debated, but the pain is likely referred from one or more muscular, neurogenic, osseous, articular, or vascular structures in the neck. The trigeminocervical nucleus is a region of the upper cervical spinal cord where sensory nerve fibers in the descending tract of the trigeminal nerve (trigeminal nucleus caudalis) are believed to interact with sensory fibers from the upper cervical roots. This functional convergence of upper cervical and trigeminal sensory pathways allows the bidirectional referral of painful sensations between the neck and trigeminal sensory receptive fields of the face and head."

This type of headache is generally responsive to anti-inflammatory treatments, Indocid, Ibuprofen, Diclofenac etc. Trouble is, the poor bugger has a very rare GI condition called Achalasia (Very complicated condition of the Esophagus) His GI system does not tolerate run-of the-mill anti-inflammatory approaches, whatsoever.
Like CH, these headaches of neck origin do not respond well to opiates, or most other treatments. The Achalasia excludes him from most otherwise effective NSAIDs/medications, for various GI reasons.

We needed to find him a means of anti-inflammatory relief after all others had shown positive responses, but failed the GI tolerability test for him in his very specific condition.

Noting the anti-inflammatory response he had seen from medication in his headaches but not tolerated for GI reasons, I suggested he try to customise a regimen adaption for his specific needs. We came up with a regimen adaption for him, but did not need to aim as high with D3 dosing (The guy is 6"3 and 55kg, thin as a rake due to the Achalasia condition and we're not dealing with CH here):

He takes daily:
4000IU D3
Fortified high Calcium milk supplement
6 X 1500mg Fishoil
2 X Centrum Multivitamin (Vit A, K etc)

After 6 months of this, due to the health benefits of this regimen alone (No colds, subsequent loss of appetite, weight loss and hospitalization), he is now 65kg and looking healthy for the first time in 15 years. That's a 10kg increase, that has not occurred in the last 15 years.
Both GPs and my mate have put this down to the only introduced variables - this regimen. The 25(OH)D tests are low for CH (160nmol/l), but appropriate for his weight and condition.
(Thanks again Batch, your ideas have saved a life here, though not CH related)

We were experimenting, introducing co-factors one at a time and got to Magnesium Citrate. He reported almost complete headache relief once introducing Magnesium Citrate, but it was again, intolerable due to GI issues, especially in Achalasia. With no room for reduced GI transit times and potential weight loss, the Mag Citrate had to be quickly abandoned. Most other types of oral Magnesium were even more poorly tolerated in his condition.

We felt we had really cracked it with the Magnesium, with no head pain whatsoever, but the lack of Mag tolerability just got the better of him. So with a heavy heart and a bloody sore head, my friend near gave up and went down the Oxycontin route, which I helped steer him well away from.

I investigated other means of getting Magnesium into the body, other than the GI route. Mineral absorption across the skin is generally poor, but I remember the old Epsom salt baths, otherwise known as Magnesium Sulfate.

We ordered up a 25kg bag of bath grade Magnesium Sulfate.
After a couple of weeks using around 180gms, in a 60L bath at 50 degrees Celsius, he reported his headaches had backed off significantly, now gone.

I used this study as a starting point, noting that Magnesium levels found in the serum and urine had increased significantly after Magnesium Sulfate baths.

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I know in my friend's case, this is not CH we are treating, but if the studies are correct, maybe this is a way for CHers to get the Magnesium they need, if lack of GI tolerability has otherwise ruled out it's use?

Just an idea...

Cheers, Ben.

Regarding magnesium...it took me a couple of tries to find a form which did not cause GI upset.  I finally had to settle on a more expensive product, but it has been working very well for me so far.  It is a 100% chelated magnesium--chelated with the amino acids glycine and lysine. Because of this patented bonding to an amino acid, it can be taken with or without food. Although, I usually take it with food.  My  240 count bottle costs between $15-$18 depending on the company from which I order.  I have been taking three 200 mg tabs/day, which is keeping me pain-free.  When I'm fully past my usual CH episode season in a few weeks, I hope to cut back to two tabs/day and see if that would be adequate. The side benefits of good magnesium absorption for me has also been a noticeable reduction in nerve pain from some other conditions I deal with. 

I wanted to share my experience. First let me say I am by no means saying this treatment doesn't work great for some. My experience has been fairly disappointing.

First off - I could not get my Neuro to get the lab test - as it was his recommendation to not take D3. He quite frankly dismissed it as unrelated and wasn't willing to go down that road. I live in a fairly small town - he is the only Neuro here.

So I tried it anyway.

Beginning: My headaches were hitting once a day at about 3am. I began regimen on 4/22.

While taking - My headaches began increasing to 3-4 times an evening. Work was severely impacted. Doctor finally got me on O2 and got a script for Imitrex Injections (yay!)

Increased dosage - I increased my D3 to 25,000 for 3 days. I noticed on these days I jumped up to 5 headaches each day.

Terminated regimen - The first night I stopped taking them, I only had 2 CH's that night. One the next day, so 3 but not the 5.

After regimen - Within 2 days of no longer taking I now am back to just the one in the middle of the night, and sometimes not even that.

Now I realize I am likely getting near the end of my bout. It is also certainly possible that getting to the end of my bout and stopping taking them just happened to coinicide and that is the reason for the relief. However - it certainly did not seem to be helping and in fact seemed to be making them worse. I can definitely say I had way more Kip9-10's during these last several weeks until I stopped than I have ever had in my life.

I hope others have success, but I personally will not do this again.

Hey Jason,

Sorry to hear youre not having much luck. I was in the same boat as you 5 days ago, feeling like the regimen was actually doing more harm than good.

Dont know if you read my recent post or not but I had been on the regimen for over a month but still getting hit hard and thinking of giving it up. Batch replied to my post with several suggestions.

1. check mag. supplement- should be mag. citrate
2. add vit. A and K2
3. elevate your ph by taking baking soda or alka seltzer      
    in 4oz of water.

I did these things and almost immediately things started getting better!!! ( elevating my ph was the key)
In the 5 days prior to making these adjustments I had 17 ha's.
In 5 days since i have had 6! And nothing above a kip-6, all aborted with energy drinks and/or an ice pack.

My neuro did the same thing on the 25(oh)d test. You could pay for the test yourself or get with a PCP. But the 2 labs I called said they only gave results to Dr.'s. Batch gave the link to ZRT labs.

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To me this is much less painless than having to deal with the almighty Dr., tell them what you want to do, explain why, pay your co-pay twice. They send the results to you.
I've sent back my test and curious about the results, but I'm feeling better thats all that matters.

Hope this helps Jason, Hang in there, make adjustments as necessary.

And many thanks to Batch!!!!

since we're on the subject thought i'd add my recent purchase from the Vitamin Shoppe.

Magnesium Citrate 300 quantity 200mg each
$17.99 bottle. 
Equals 6 cents per 200mg aka 12 cents per 400mg.

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-Gregg in Las Vegas

That's good SouthernCluster! Drugfree also, no imitrex for a week. But still not ready for a "Beer Test"!

Re: Changing D3 brands.

I read a recent JAMA study that found differences between the declared on label measurement (IU) that showed D3 content variability as much as 9% to 140%, not only from brand to brand, but from capsules made by the same manufacturer in the same bottle.

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The study is here (if this image works...)


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(Apologies if I get this image link wrong, I have woeful internet connection and cannot reload the page, sorry)

Maybe there's an efficacy issue right there...

Re: Regimen seemingly making CH initially worse before it gets better.

During the first 2 months of taking the regimen, I experienced 4-5 attacks per day. Severity was up, but I could not attribute this to anything outside of my ordinary Chronic CH. I suspected that with initially very low (19nmol/l) 25(OH)D levels, that I was cashing cheques faster than I could bank D3 supplements... Some 50,000IU loading doses, 5000IU X 3 per day (every 8 hrs) and all the cofactors meant the regimen eventually kicked in. With co-factors as a catalyst, it seemingly unlocked the potential of stored D3 and it is working well.

However, during the course of experiencing the 70 odd drugs I have trialed in CH, I did notice one thing and I'm not sure I can properly articulate this here. I will give it a try...

Any drug that actually relieved my CH, seemed to have a possibility of making it worse, either on the downward side of the half-life, or as it tapered off at end of trial or in wash-outs.

Prednisolone is an example of a steroidal anti-inflammatory that commonly does this. Many people will note the "falling off a cliff" end to their Pred taper. When the Pred dose drops, just before the pituitary gland can kick back in and naturally produce it's daily 7.5mg of Cortisol, CH definitely gets worse in the absence of a suitable preventive drug.
Hence, why Cortisone is a transitional therapy.

This "hand-over" point, or "gap" between cessation of taking steroidal anti-inflammatory Cortisone (and it's cascade effect) and the body's natural Cortisol production has always increased severity in my CH until it could stabilise. Some of my worst ever attacks, (11s) were in the 2-3 days after a Pred taper "flicked the switch" before my body could produce it's own supply.

Aside from immune system consumers and comorbid conditions, could it be that D3 initially has it's own "inter-dose withdrawal"? it's effects are initially dosage time dependent? a half-life issue? a sterol withdrawal effect? or some other as yet unknown effect where as it "wears off" in between initial doses it may actually bring about increased severity or frequency? or even CH rebound?

Many, many drug therapies have done this to me.
It was important with those drugs too, to persist until within desirable and measurable biomarker windows/specifications, before abandoning attempts to establish efficacy in CH.

I know these are complex scientific questions that we are not likely to be able to answer and I defer to Batch's statistical evidence here, but cashing cheques, I really do know what you mean Batch...

Sticking it out with the regimen (with abortives at hand) and getting pathology tests may well be the key, I think.

Just a thought...

Following Batch's advice was the best thing I did, my thoughts aside...

Cheers, Ben.

Started the D3 regimen 3 weeks ago, at the tail end of my spring episode which means getting 3 hits a day, even with Topamax.  I am now almost off the Topamax and have been hit-free for a full week.  I started at a level of 39 (blood work taken before beginning) so I have been taking 50mg D3 once a week, 20mg the rest of the week for the past 3 weeks.  I plan on tapering down to 20mg once a week and 15mg in a week and then down to 10mg.  I am taking the rest of the regimen as recommended as well.  I have had a couple of twinges that did not even need O2!  To me, this has been a major improvement and I plan on sticking with this.  Yes, I will get tested again soon.  This is way better than taking medications with their side effects, for me, especially since I was still getting hits and then using my aborts!  Thank you for this regimen!!!!