Hey Jeremy,

Good question.  The bar chart illustrating time to respond by day after start of regimen hasn't changed much.  It's still the same shape in terms of days to respond.  The only difference is the numbers of responders by day are greater.

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The response times tend to be shorter if CHers start this regimen with the 12-Day accelerated vitamin D3 loading schedule at 50,000 IU/day for 12 days.  I'll be doing another harvest of survey data the first of July and will update the days to respond chart.  I'll post the update.

Take care and please keep us posted.

V/R, Batch

Hey Jeremy,

Mike and Peter have provided some great suggestions.  Response times to the anti-inflammatory regimen will vary due to starting 25(OH)D serum concentration where less than 20 ng/mL will take longer than 30 ng/mL.  This is one of the reasons why I suggest CHers see their PCP/GP for a lab test of their serum 25(OH)D and to discuss this treatment protocol as there's another set of labs for serum 25(OH)D, calcium and PTH 30 days after start of regimen.

Allergic reactions to pollen, mold spores and dust mite poo can also delay a favorable response to this regimen.  These allergic reactions can be subclinical, i;e., no outward or obvious symptoms, but the allergic reactions is there cooking away making histamine. Too much histamine can make nearly all CH interventions ineffective.  The best thing to do if an allergic reaction is suspect is to start a week to 10-day course of Benadryl (Diphenhydramine HCL) at 25 mg every 4 hours during the day and at bedtime.  Just be careful and not drive as this much Diphenhydramine will make you drowsy.  If you need to drive during the day or be sharp as a tac, wait until you're home for the day then take 50 mg as you walk through the door and another 50 mg at bedtime.

Diet is another major factor in response times and has been an important part of this treatment protocol for several years. A proper diet can help reduce the time to respond with a significant reduction in the frequency of CH.  Inflammation and allergic reactions from dietary sources can delay a favorable response to this regimen. 

The dietary culprits responsible for this inflammation and allergic reactions that should be avoided include: All Sugars, Carbohydrates, Artificial Sweeteners, Diet Sodas, Wheat Products & Glutens (bread, pasta, cookies crackers and pizza), High Starch food types like bananas and potatoes, Peanuts and Cashews, Corn and Grain Oils. 

Several studies have found the Atkins-Ketogenic diet effective in reducing the frequency of cluster and migraine headache.  This diet is best started with a 24 to 36 hour fast drinking only water and taking the anti-inflammatory regimen supplements.  This burns up blood starch (glycogen) stored in the liver and in the process, shits the body over to a fat burning metabolism. 

Ketones are produced in the liver and are byproduct of metabolizing fats hence the term ketogenic or keto diet.  In fact, ketones are more efficient than glucose as a source of fuel and provide more energy per unit of oxygen used.  Brain cells metabolize ketones more efficiently than glucose from carbohydrates.

A keto diet, due to its high-fat nature, also leads to an increase of polyunsaturated fatty acids (PUFAs, such as DHA and EPA). This, in turn, reduces inflammation as well as oxidant production. PUFAs target inflammatory stress by inhibiting the expression of genes encoding for all pro-inflammatory factors.

Bottom line... If you want the fastest response to the anti-inflammatory regimen, start the Atkins-Ketogenic diet.

Take care and please keep us posted.

V/R, Batch

Hey Cocktail,

Mike and Patik provided you with some great comments so I'll address a couple other points about the anti-inflammatory regimen.  I'm a chronic CHer and I've taken the cofactors and conutrients illustrated in the following photo since 2011.  I've been CH pain free ever since.

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It's important to understand the roles of cofactors and conutrients taken in this regimen.  The cofactors are essential in the pharmacokinetics of vitamin D3 (what the body does to vitamin D3) and its pharmacodynamics (what vitamin D3 does to the body). 

In simple terms, the cofactors play an important role in the hydroxylation of vitamin D3 to its first metabolite 25-Hydroxy Vitamin D3, a.k.a., 25(OH)D (Calcidiol) and hydroxylating 25(OH)D to 1,25(OH)2D3 (Calcitriol), the genetically active vitamin D3 metabolite responsible for preventing our CH. 

The cofactors also play an important role in vitamin D3 pharmacodynamics (preventing CH).  For example zinc supports several essential enzymatic processes and is also found in vitamin D receptors (VDR) as a "Zinc Finger" thought to be responsible for attaching molecules of 1,25(OH)2D3 to strands of DNA to initiate genetic expression.  Vitamin A (retinol) forms a dimer (two molecule polymer) with the vitamin D3 metabolite 1,25(OH)2D3 that attaches to a vitamin D3 receptor element (VDRE) to initiate genetic expression.

The essential cofactors are contained in the Kirkland brand Adult 50+ Mature Multi.  This multi-vitamin and mineral supplement is formulated with nearly all the vitamin D3 cofactors we need.  It just doesn't have sufficient magnesium or any vitamin K2 complex which is why I added the 400 mg/day magnesium and the Super K with advanced K2 complex.

The worry about calcium being contraindicated while taking verapamil is over blown.  Cardiologists who prescribe verapamil for their heart patients also suggest  low doses of supplemental calcium to prevent osteopenia/osteoporosis.  Accordingly, the 220 mg of calcium in the Adult 50+ Mature Multi does not pose a problem reducing the effectiveness of verapamil in preventing CH.  It does help prevent osteopenia/osteoporosis, so this is a logical and beneficial rationale for taking the Adult 50+ Mature Multi.  It's likely the verapamil wasn't all that effective in preventing your CH or you wouldn't have started this regimen.

For reference I've had two sequential DEXA scans (Dual-Energy X-ray Absorptiometry) for bone mineral density (BMD) 5 years apart since starting the anti-inflammatory regimen and if anything, my BMD has actually improved.

Conutrients are responsible for the same anti-inflammatory and CH pain prevention as vitamin D3 so provide an additive effect to increase the CH preventative capacity of this regimen.  They include the Omega-3 fish oil and Vitamin K2 complex (MK4 & MK7) in the LEF Super K with advanced K2 complex. For a detailed explanation why we need Vitamin K2 MK4, see the following link:

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enefits-as-nature-intended/?mc_cid=0fdbba3d66&mc_eid=8c4ce63207

Bottom line, it's best to follow this treatment protocol by taking the cofactors and conutrients illustrated in the photo above by brand and dose.

Regarding the vitamin D3.   I switched from the Nature's Bounty liquid softgel vitamin D3 over to the Bio-Tech D3-50 (50,000 IU water soluble (micellized) form of vitamin D3) in July of 2018 as illustrated in the following photo.
 
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I've found the Bio-Tech D3-50 to be faster acting and more potent at the same dose in terms of elevating and maintaining serum 25(OH)D concentration than the oil-based vitamin D3 formulations.

Here's the bottom line foot stomper (something very important to remember). I took a download from the online survey database of 316 CHers starting this regimen since December of 2011 on the 4th of July.  The overall raw efficacy of this regimen has remained consistent through the end of 2018 with 80% of CHers taking it achieving a significant reduction in the frequency of their CH from an average of 3 CH/day down to an average of 3 CH/week in the first 30 days.

What jumped out of the data I collected on the 4th of July was the raw efficacy (for episodic and chronic CHers) in the first 6 months of 2019.  It jumped to 90% of CHers starting this regimen achieved a significant reduction in the frequency of their CH from an average of 3 CH/day down to an average of 3 CH/week in the first 30 days.

I've done a regression analysis of this 6-months of data looking for any reason for this 10% increase in efficacy to 90% and the only factor I could find was most of these CHers may have started this regimen with the Bio-Tech D3-50.  I say this as all my post about this regimen since July of 2018 have mentioned taking the Bio-Tech D3-50 suggesting to take it instead of the oil-based vitamin D3 formulations. 

I also updated my webpage at VitaminDWiki at the following link in July of 2018 with a photo of the Bio-Tech D3 50 Multimedia File Viewing and Clickable Links are available for Registered Members only!!  You need to or I'll take another download of the survey data the end of 2019.  If this trend continues, the efficacy of this regimen in preventing CH is greater than all the other CH prophylaxis combined.

There's another very interesting factoid.  The download rate for the anti-inflammatory regimen CH (and migraine) preventative treatment protocol at the following link Multimedia File Viewing and Clickable Links are available for Registered Members only!!  You need to or has remained constant at 20 to 25 downloads per day since I posted it on my VitaminDWiki webpage 21 Jan 2017 through 28 March of this year.  Multimedia File Viewing and Clickable Links are available for Registered Members only!!  You need to or

within 24 hours of a webinar presentation by Dr. Brian McGreeney, MD, "Boston_Headache_Doc" at Clusterbusters, titled Alternative Treatments for Cluster Headache during the 2019 Migraine World Summit, the download rate for this treatment protocol jumped to 160 downloads a day.  During his webinar presentation, Dr. McGreeney spent 4 minutes discussing the use of vitamin D3 as a user developed and supported, very effective CH preventative. 

The download rate since Dr. McGreeney's webinar presentation has remained at an average of 100 downloads a day.  Between the 3rd of July and the 7th, od July, there were 916 downloads for an average download rate of 229/day.  I think it's safe to say the word about the efficacy of this regimen is getting out.

Given CHers all over the world are aware of this download site at VitaminDWiki, I can only conclude this dramatic increase in the download rate of this treatment protocol is due to migraineurs who watched Dr. McGreeney's webinar presentation at the 2019 Migraine World Summit.  I've additional evidence this is the case as I'm seeing an up-tic in PMs and email from migraineurs since Dr. McGreeney's presentation.  They are now outnumbering CHers.

Take care and please keep us posted.

V/R, Batch

Jeremy,

Thanks for the update.  Your 25(OH)D response to a vitamin D3 dose of 10,000 IU/day is on target... but still too low for a complete cessation of all CH symptoms.

Data from the online survey suggest you need a 25(OH)D serum concentration of at least 90 ng/mL for a lasting CH pain free response.  The simple way of elevating your 25(OH)D rapidly is to take a 50,000 IU loading dose of vitamin D3 for two (2) days.  100,000 IU of vitamin D3 usually results in a gain of 10 ng/mL on top of the existing serum concentration.  You'll also need to increase your vitamin D3 maintenance dose from 10,000 IU/day up to 15,000 IU/day.

Take care and please keep us posted.

V/R, Batcj

Hey Shokaveli,

Thanks for the headzup you're starting the anti-inflammatory regimen.  I'm in the process of updating the posted version of this treatment protocol on my webpage at VitaminDWiki at the following link with a change in the suggested type/brand of vitamin D3 from the oil-based liquid softgel 5,000 IU vitamin D3 formulations to the Bio-Tech D3-50 50,000 IU water soluble vitamin D3 capsules.

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I and many other CHers have found the Bio-Tech D3-50 to be faster acting with a higher bioequivalence than the liquid softgel formulations at the same dose.  What this means is more CHers respond faster to this treatment protocol.  The following photo illustrates the supplements I take.

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You can order these supplements from amazon.com and iherb.com whichever has the best price.  I'd like to point out that at 22 cents per capsule taken once a week, the cost of this form of vitamin D3 is ~ 3 cents/day.  Two of the 5,000 IU liquid softgels cost 12 cents a day.

Dosing with the Bio-Tech D3-50 is different when it comes to the maintenance dose.  I've been taking one (1) of the Bio-Tech D3-50 capsules a week.  I think this is a good starting maintenance dose after the 12-Day accelerated vitamin D3 loading schedule illustrated in the following notional graphic.

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As you can see, the 12-Day vitamin D3 loading schedule at 50,000 IU/day for 12 days elevates serum 25(OH)D far more rapidly than just taking a maintenance dose of 10,000 IU/day which can take a month or more to elevate your 25(OH)D to a therapeutic level capable of preventing your CH.  Taking the 12-Day accelerated loading schedule means you elevate your serum 25(OH)D to a therapeutic level faster for the expected reduction in CH frequency or complete cessation of CH symptoms.

You may need to lower the vitamin D3 maintenance dose following the 30 day labs by adding an additional day or more between doses from one 50,000 IU capsule a week to one capsule every 8, 9 or 10 days.  The key is frequent lab tests until you reach a stable dose and 25(OH)D response as you'll see in the following charts of my labs for 25(OH)D, calcium and PTH over the last 3 years.

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My PCP has no problems with my 25(OH)D3 concentrations this high as long as my serum calcium remains within its normal reference range.  As you can see, it has.  It's normal for PTH to be at the low end of its normal reference range when serum 25(OH)D is above 100 ng/mL.  What you need to avoid is taking the PTH eto zero by pushing your 25(OH)D too high like > 190 ng/mL.  Like anything else, if the parathyroid glands sense there's no need to produce the PTH, they will eventually stop expressing this hormone and that would not be good.

Regarding the efficacy of this regimen.  Data from the latest harvest of the online survey of CHers taking this regimen indicate 90% of CHers reporting in the first six months of 2019 are experiencing a significant reduction in the frequency of their CH.  That is up from the year-over-year average of 82%.  I suspect this up-tic in efficacy is due to the Bio-Tech D3-50.  This is a raw efficacy with no corrections for the placebo effect or confounding factors like episodic CHers confusing a favorable response with end of cycle.  For practical purposes, who cares with a raw efficacy of 90%

Take care and please keep us posted with your results after starting the anti-inflammatory regimen.

V/R, Batch