I’m not a fan of aspirin or any of the other NSAIDs for that matter primarily due to the risk of GI tract bleeds.  There are other, far safer and effective ways of alleviating pain and lowering the risk of thrombosis that you can take for the rest of your life.

Some of my reasoning is based on the following links:

Even Low Dose of Aspirin Can Cause Intestinal Bleeding
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Don’t TOUCH that next dose of aspirin until you’ve had this important test
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Blood Clot Prevention
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If you read through the above links, you’ll see that the anti-inflammatory regimen provides a safe alternative to aspirin in alleviating pain and preventing thrombosis…  Add some Curcumin, CoQ10, and some Vitamin C and it gets even better for the cardiovascular system.

Take care,

V/R, Batch

Hey Vee,

Thanks for the wonderfully detailed update.  The short answer to your question is "All of the above."

The active ingredient responsible for the prevention of your CH is vitamin D3.  That said, vitamin D3 requires co-factors in order to support the genetic expression that prevents CH. 

Without the cofactors: magnesium, zinc, boron, vitamin A (retinol), vitamin D3 would not be as effective in preventing your CH and other health benefits.  Omega-3 fish oil acts as an anti-inflammatory and vitamin K2 helps prevent calcium buildup in soft tissues and arteries.  It also helps build bone mineral density.

For example, magnesium and zinc support the enzymatic reactions that hydroxylate (metabolize) vitamin D3 to 25-Hydroxy Vitamin D3, a.k.a., 25(OH)D.  They also support another enzyme that hydroxylates 25(OH)D to 1,25(OH)2D3, the active hormonal form of vitamin D3.  Boron acts as a catalyst in the above reactions.

When all this takes place within neurons in your trigeminal ganglia, 1,25(OH)2D3 combines with retinoic acid (Vitamin A (retinol) to form a 2 molecule dimer that attaches one end to a genetic strand at a vitamin D receptor (VDR) that just happens to be occupied by a zinc molecule, and the other end to a retinoid receptor (RXR).  This combination of VDR and RXR is called a vitamin D response element (VDRE).

Genetic expression is very interesting.  Once the vitamin D:Vitamin A molecule is attached to a gene within a neuron, it unlocks the neuron's genetic library of instructions and the neuron starts executing them.  These actions include replication, differentiation, an increase or decrease in genetic products, proteins and peptides, and programmed cell death (apoptosis)... what we would want to happen with cancer cells...

All of the above chemical reactions are consumptive...  In other words, vitamin D3 and the co-factors are consumed in this chemical reaction, used once, and then eliminated by the nerve cell.  Accordingly, they all need to be replaced on a daily basis, hence the daily anti-inflammatory regimen.

Genetic expression isn't limited to neurons within the brain and trigeminal ganglia.  A 2010 research study identified 2776 genomic positions occupied by the VDR and 229 genes with significant changes in expression in response to vitamin D3.  Accordingly, genetic expression takes place throughout the body and in particular, our immune system. 

In short, vitamin D3 and the co-factors turbocharge the cells that make up our immune system making them better equipped to handle the constant flood of antigens, (bacteria, virus and fungus). 

The net result of taking the anti-inflammatory regimen is fewer colds and the few that do happen are short lived with symptoms clearing in 24 to 36 hours instead of lingering for a week or more.  Flu becomes very rare.  We also sleep better with quality restful sleep, anxiety attacks go away and we just feel better.

What is also very interesting is the anti-inflammatory regimen also stops shingles from spreading.  Moreover, starting loading doses of 50,000 IU/day for 4 to 5 days at the first symptom of shingles stops the pain and prevents the outbreak of the painful rash.  What's not to like about that?

Take care and please keep us posted.

V/R, Batch

Hey Scorpion,

You've made a very interesting and fascinating post.  A ketogenic diet and the anti-inflammatory regimen with 10,000 IU/day vitamin D3 are not mutually exclusive.  I suggest a similar diet avoiding sugars and carbohydrates along with the vitamin D3 regimen.

My preference is the Atkins diet witch is very similar to a ketogenic diet and I add medium-chain triglycerides (MCTs) like coconut oil which is also part of a ketogenic diet.

The word cure often raises eyebrows around here when used in reponse to any cluster headache intervention.  When taken at face value, with a complete cessation of CH symptoms...  it appears appropriate... None the less, there are distinctions between a cure and a remission and you've interchanged both in your post.

I tend to take the more conservative approach in the distinction between a cure and a remission with respect to the anti-inflammatory regimen... 

I'm 71, I've had CH for over 20 years, diagnosed as chronic in 2005, but I've been pain free of CH since I started the anti-inflammatory regimen in 2010 with a few exceptions...  Each year I stop taking this regimen as a burn-down test of my 25(OH)D reserves until CH symptoms return...

It usually takes from 7 to 10 days without vitamin D3 before CH symptoms recur... and that tends to happen when my serum 25(OH)D concentration that normally averages 80 ng/mL, drops to 55 ng/mL or below.  Accordingly I still have CH. 

It's interesting to note, I drove my 25(OH)D over 164.7 ng/mL with no adverse effects while under a physician's supervision with monthly labs including serum 25(OH)D, calcium and PTH...

My serum total calcium averaged 9.8 (Normal Reference Range 8.5 to 10.5 mg/dL) and PTH and my PTH remained low as expected at 22 (Normal Reference Range 17 to 70 pg/mL).

What was really interesting was after six weeks with no vitamin D3, I remained CH pain free...  My 25(OH)D serum concentration at that point was still 117 ng/mL so it had not dropped to the 55 ng/mL threshold where my CH symptoms usually return.

Accordingly, for me and many other chronic CHers, we can remain CH pain free and in remission... as long as we keep our 25(OH)D serum concentration above a threshold and in the "Green Zone" of 60 to 110 ng/mL by taking an average of 10,000 IU/day vitamin D3.

Wikipedia has a well thought out review of this topic with references...

"A cure is the end of a medical condition; the substance or procedure that ends the medical condition, such as a medication, a surgical operation, a change in lifestyle, or even a philosophical mindset that helps end a person's sufferings. It may also refer to the state of being healed, or cured.

A remission is a temporary end to the medical signs and symptoms of an incurable disease. A disease is said to be incurable if there is always a chance of the patient relapsing, no matter how long the patient has been in remission.

The proportion of people with a disease that are cured by a given treatment, called the cure fraction or cure rate, is determined by comparing disease-free survival of treated people against a matched control group that never had the disease."

Ultimately physicians look for "Medical Evidence" provided by conclusive data from two or more appropriately powered RCTs (n ≥ 100 participants), before they start using/prescribing any intervention...  Even then, the distinction between cure and remission is either blurred or not addressed.

With all that in mind, I'm inclined to think the distinction between a cure and remission really doesn't matter to a CHer... as long as intervention that results in a lasting pain free response... is reliable and repeatable... for as long as we take it.

Take care and thanks again for the post.

V/R, Batch