Hey Rose,

Good question...  Cutaneous allodynia: Pain resulting from an innocuous stimulus to normal skin or scalp, (like pain from the slightest touch), paresthesia - a slight tingling or prickling sensation prior to an attack, and numbness in the pain area during and following an attack, are common symptoms of the cluster headache syndrome. 

In short... no biggie...  When your cycle is over or prevented with the anti-inflammatory regimen... these symptoms will go away.

Try to see your PCP or neurologist for the 25(OH)D lab test.  If either of them are resistant to your request for this lab test or they tell you it isn't covered by your medical insurance for CH, tell them you're concerned about osteoporosis after taking prednisone...  This lab test is covered for that disorder.

Take care and please keep us posted.

V/R, Batch

Hey Baer,

I suspect you've a couple things going on that are keeping the anti-inflammatory regimen from working properly to prevent your CH.

The first is vitamin D3 absorption.  If you're taking 20,000 + IU/day vitamin D3 and still haven't reached a therapeutic 25(OH)D level around 80 ng/mL, you may not be absorbing the vitamin D3 completely.  Try popping the vitamin D3 softgel capsules between your back teeth and swirling the contents under your tongue and keeping it there for at least 5 minutes without swallowing. 

This sublingual method of taking vitamin D3 enables it to pass directly into the bloodstream through the arteries and capillaries under the tongue.  This bypasses the GI tract and makes more of the vitamin D3 available much sooner.

It's taken five years, but I think we have a balanced formulation in the anti-inflammatory regimen that supports sufficient vitamin D3 metabolism for most CH'ers to prevent their CH... 

We're basically looking at a biochemical reaction where the reactants, (vitamin D3 and the cofactors: magnesium, zinc, boron and vitamin A (retinol)) are all consumed in the process of making not only 1,25(OH)2D3, calcitriol, the active hormonal metabolite of vitamin D3, but also the enzymes needed in vitamin D3 metabolism. 

As most of this reaction takes place extrarenal at the cellular level throughout the body and brain, all the reactants need to be present in the right amount.

Accordingly, adding more magnesium may be required.  If you're taking 400 mg/day, bump the dose to 800 mg/day, but split this to 400 mg in the AM and 400 mg in the PM.  This will lessen the probability of osmotic diarrhea. 

An allergy can still be a problem as some allergies are sub-clinical, i.e., no outward or obvious symptoms.  Try some Benardryl (Diphenhydramine).  A single 25 mg tablet every 12 hours should work just fine.  Just be careful if you need to drive, you will get drowsy.  If driving is a must, take two of the 25 mg Benadryl tablets when you get home for the day.

Take care, please keep us posted and don't get frustrated ... There are a couple other things we can try.

V/R, Batch

Rookie,

I'd hold off on the antibiotic for a while to give the other changes an opportunity to kick start the CH pain free response.

If you do try an antibiotic, be sure to pick up a good probiotic and take it at the same time to help rebuild the friendly colonies of bacteria that will be killed off by the antibiotic... Roughly 70% of our immune systems resides in and around the ecosystems of friendly colonies of biota in our GI tract called the microbiome...  In short, a happy gut is a healthy gut.

As you've been on travel, I'd start the probiotic anyway...

Take care and please keep us posted.

V/R, Batch

Hey Nevres,

Thanks for the headzup you've started the anti-inflammatory regimen and good question.  Good move!  Over the last five years we've found this regimen is compatible with just about all the CH medications prescribed as abortives and preventatives.  Some neurologists are concerned that calcium reduces verapamil's therapeutic effect as a preventative. 

That said, the most recent version of the anti-inflammatory regimen starts with a minimum of 220 mg/day calcium.  Separating the verapamil and calcium doses by 12 hours appears to optimize the benefits of both without detracting from the CH preventative function of verapamil. 

Accordingly, the short answer is keep taking the anti-inflammatory regimen.  It is the only thing addressing the cause of your CH.

Check your PM inbox.  I've sent some additional information.

Take care,

V/R, Batch

Hey Andy,

Thank you for the wonderful update and kind words. It's comments like yours that do more to entice CH'ers to give this regimen a try than any of my long-winded posts. 

Aside from preventing my chronic CH, which like you, gave me back a quality of life I never thought possible with CH, this regimen has changed me as well. 

Reaching out to CH'ers with the anti-inflammatory regimen and capturing results like yours as well as from the online survey of CH'ers taking this regimen, has allowed me to observe many other benefits made possible by taking this regimen.  This has expanded my thinking into the benefits of taking this regimen to prevent and treat so many other medical conditions linked to a lack of vitamin D3.

Thank you again for the feedback and take care.

V/R, Batch

Hey Rookie,

Thanks for the update and great news.  Some of the first-gen antihistamines come in different formulations...  The best advise is stick with the brand that works...  In other words... if it ain't broken... don't fix it.

And if someone claims they have a first-gen antihistamine that works better...

Recall that Admiral of the Fleet of the Soviet Union, Sergey Georgiyevich Gorshkov once commented on a new weapon system his engineers claimed was better than the existing system that had worked well without problems for many years...

"Better is the evil of good enough."

Take care,

V/R, Batch

Hoppy,

Good question.  The pharmacokinetics of calcium and verapamil are similar.  They both need to dissolve in the GI tract, be absorbed into the bloodstream where enzymatic processes change the verapamil into a bioactive metabolite. 

As calcium is water soluble, it reaches a maximum serum concentration rapidly in 3 to 6 hours.  It also has a short half-life of ~ six hours as the kidneys filter it out and pump it over the side in urine rapidly.

When taken daily, the serum concentration of verapamil continues to build over several days to weeks until it reachs the point of equilibrium for the dose taken.  Dr. Heaney's chart below tells the same story with vitamin D3 as it would for verapamil.

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At some point prior to reaching an equilibrium for a given daily dose, the serum concentration of the verapamil metabolite reaches a therapeutic threshold... and "starts working" to produce the desired effect.

Taking all the verapamil at one time is just as effective in building serum concentrations of its metabolite as taking the total dose split up over the day.

Accordingly, separating the doses of each by 12 hours, gives verapamil and calcium an equal opportunity to do their biological thing without calcium adversely impacting the effectiveness of verapamil.

Hope that answers your question.

Take care,

V/R, Batch