*** A 1 year and (nearly) 1 month update on Vimovo (naproxen with esomeprazole magnesium)/10,000iu vitamin D3/10mg melatonin ***

I was an episodic CH sufferer since 2007, and I had been a chronic CH sufferer since August of 2014. Since starting a daily regimen of 500/20mg Vimovo, a 10,000iu vitamin D3 tablet, (I've also found that regulating my sleep cycles with 5-10mg melatonin tablets is helpful in getting your sleep cycles back on track), and I have had exactly ONE single CH since Nov. 2nd, 2015! It has been 100% effective!! No, I'm not exaggerating. Only ONE single CH since I started taking  this regimen, and that single CH is explained very easily below.

NOTE: I am now down to 1 daily 10,000iu D3 tablet, and only 1 Vimovo every few (3-5) days. The Vimovo is so effective, I don't even need 1/day any longer.

December 1st 2016 Update - still pain-free!

Actually, I have had exactly ONE CH in the one year I've been on this regimen. Why one? Simple. My GP decided after my latest blood test that my 25(OH)D serum level (Vitamin D3) level was 'a little high' (I believe it was about 100nm or so) so she decided I should cut down to one 10,000IU tablet per week instead of basically 1 per day. All was OK for about 3 1/2 weeks or so, until I noticed a little bit of a shadow when I woke up the morning of Sunday November 25th. Still not having taken any Vitamin D3 or Vimovo, about 45 minutes after falling asleep Sunday night, I woke at 1:40am in the early morning hours of Monday November 26th with the first CH I've had in over a year! Clearly, the reduction of my D3 intake had brought this on, so I immediately resumed with 2x10,000IU tablets of D3+1x500/20mg Vimovo. Luckily, this CH was comparatively mild (about a 4-5), and as I have resumed the D3+Vimovo before bedtime every night since, I've had no more CHs. I've also just had a good chat with my GP. This REALLY works!

How I arrived at augmenting Batch's D3 with Vimovo or
How about an NSAID to turbo-charge the D3 anti-inflammatory regimen?

The key was that I knew Batch was onto something with the D3 anti-inflammatory approach. So I looked further into how inflammation works. The simple mechanism is:

                      ------->                                            ---->                               ----->
COX-2 enzime catalyzes arachidonic acid in your body into prostaglandin, which swells tissue surrounding your trigeminal nerve, causing CH

While D3 inhibits the expression (production) of COX-2 to an extent, NSAIDs inhibit the enzime catalyzation process of arachidonic acid into prostaglandin. Normally, NSAIDs such as Ibuprofen take far too long to work once you start to sense the onset of a CH. Even taken almost continuously by themselves, they have not stood out as completely effective against CH. But I wondered, as a chronic CH sufferer (I was getting 1-2 every day, and sometimes even 3 in a 24 hour period, for over a year) and taking the D3 regimen, what would happen if I ALSO took an extra strength Advil (Ibuprofen) once every 4-6 hours (maximum dosage) for several days. Would I get a CH? The answer was no! I did not get a headache so long as I took the Advil every 4-6 hours! (What I didn't know, at the time, but later found out, is that there is a synergistic boost to the effectiveness of both the D3 and NSAIDs such as Ibuprofen and Naproxen when combined). But of course, you can't take Advil every 4-6 hours forever. So I looked at other treatments in the NSAID family, and quickly came across Naproxen.

D3 + Naproxen would work, but Naproxen without a protein pump inhibitor might not be good for you over time

Naproxen had been one of the emergency room 'cocktail' pills I had been given at the hospital when I had to be admitted back in September of last year with a force 10 CH (a CH so strong, even the normally somewhat effective Zomig 5ml nasal spray couldn't put a dent in it, and one which kept going, even after an hour!), and I had started to feel better fairly quickly. At that time, I had written off any of the pills in the 'cocktail', and figured the CH had just petered out on its own. But armed with the knowledge that continuous dosing of Ibuprofen, along with my D3, had blocked any CHs for 5 days solid, I was encouraged to try Naproxen. However, Naproxen by itself can be problematic when taken over time, due to the potential it has to cause upper gastro-intestinal tract bleeds. I was somewhat discouraged, but luckily, I came across a version of Naproxen called Vimovo, which comes with another ingredient called esomeprazole magnesium (a protein pump inhibitor) which greatly reduces the stomach bleed potential of the Naproxen, and is considered safe for long-term usage for most people. In addition, the Vimovo is a slow-release formula, which lasts for 12-24 hours, instead of Ibuprofen's wholly inadequate 4-6 hours. Aha! I will try this Vimovo, I thought, and see if it can also stop my CHs! I lucked out and got a quick appointment with my specialist, who agreed to give me a prescription for Vimovo. I started taking it on Oct. 15th, and I also focussed hard on getting myself to sleep before midnight every night possible (as I've always had trouble falling asleep). I even got a prescription for Trazadone (an anti-depressant which also works very well as a sleeping pill) to make me fall asleep when necessary, and I started taking 10mg melatonin tablets to keep me asleep. (Although I only rarely use the Trazadone, I've been taking the 10mg melatonin almost every night since late October. If you take them together, you'd better not have to be somewhere in the morning! They REALLY knock you out!) I got 5 CHs during this loading dose period (I must have had one hell of a lot of inflammation in my body!) from Oct. 15 to Nov. 2nd, but after Nov. 2nd, none at all!

Vimovo dosage

I have been taking only 1 Vimovo every few days, although the maximum dosage on the prescription is 2/day, which is great, since it seems to have power to spare for stopping CHs. I have also been experimenting with skipping Vimovo tablets, and I've gone up to 5 days before the soreness in my hand and an extremely faint shadow in my head warned me I'd better resume taking them. For me, the Vimovo has been so effective, I even get warnings to resume them BEFORE I ever get a CH. How awesome is that? At this point, I am still experimenting with how little Vimovo I can take and still remain pain-free. Understandably, I am something of a wimp when it comes to the prospect of deliberately trying to trigger a CH, but with the interest (and skepticism) many have shown in this augmentation to the Batch D3 regimen, I am determined to provide some hard data on just how little Vimovo is required to make this work. My hunch after three months is, it might take a surprisingly small dosage of Vimovo to maintain a pain-free life, along with the D3 regimen.

Although there are some health considerations/concerns with the longer-term effects of Naproxen, in conjunction with the Esomeprazole Magnesium in Vimovo, they seem entirely manageable for most people, and from what I have read (and been personally experiencing) significantly less worrisome for most people than treatments such as Verapamil, which slows your heart rate to potentially dangerous levels and made me extremely tired and mentally dazed at the dosages which seemed to be required for mere partial efficacy.

Role of melatonin/sleep regularity

I don't know just exactly how much of a role the improvement in my sleep regularity is playing in all this--probably quite a bit--so I can only say that if you try the Vimovo/D3 treatment, and you're still getting any CHs, you really should get serious about taking strong melatonin tablets every night (mine are Nature's Path 10mg - the 1-1.5mg ones are nowhere near strong enough to keep me asleep effectively) to help you get a good sleep, as this almost certainly reduces inflammation in your body, too.

Anyhow, this is such fantastic news that I am going to start a new thread on the site for this. Please, if you are a chronic CH sufferer, ask your doctor/specialist about getting a prescription for Vimovo. Your CH's CAN be stopped dead for good!

NOTE: Further down in this thread, there is some petty sniping about the safety of the Naproxen in Vimovo. To provide you with an unvarnished, objective take on Naproxen with a protein pump inhibitor, which is what Vimovo is, here is the wikipedia entry:

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In short, Vimovo should be safe, even for people with a history of stomach ulcers, but of course, please consult your doctor before taking it anyhow.

Interesting post, thanks for sharing Anubis.  I'll be interested to see what Batch has to say about this but good on you for digging a bit. Hope your pf days are long and happy.

It may well be the combo of the D3 and melatonin that are doing the bulk of the work here. and remember he isn't using the vimovo as a painkiller but as an ant inflammatory, which sort of ties in with the whole D3 concept.
I wouldn't toss this out the window just yet, rather debate it sensibly, its working for him.

Hoppy wrote on Jan 29^th, 2016 at 5:22pm:


Not a long time clusterhead that hasn't tried any number of treatments...including naproxen+...as has been reported and tried before...myself included. It seemed to work a tiny bit for me...umm...sorta like cayenne pepper up the nose. Long term?.....nope.....but... WHATEVER works for you does me no harm...just be prepared for when it DON'T....

I agree with Wayne and Hoppy. My previous neuro...top headache specialist in Seattle then ....and now a primary at Stanford....said SHORT term use of naproxen...for MINOR cluster hits was ok (unenthusiastically)... but absolutely useless for major... and unacceptable for long term use as the resulting side effects were highly dangerous..................

Best

Jon

Quote:


Not talking about an aspirin, I'm talking about taking 10,000iu of Vitamin D3 (Batch regimen), 1 or 2x500/20mg Vimovo daily, and regulating your sleep routine with 10mg melatonin, and even sleeping pills of some sort (for me it was trazadone) if necessary to get you back on an 8 hours/night sleep routine. But the Vimovo/D3 combination was the 'new' break-through discovery I wanted to share with everybody. I really works. I swear it. Not a single CH in 3 months now, and I was chronic from Aug. 2014 to Nov. 2nd 2015, when I started this.

Take it or leave it, I just felt it was my moral duty to report something that stopped CHs from happening for me.

Wayne wrote on Jan 29^th, 2016 at 4:20pm:


You're welcome, and thank you, Wayne, for at least believing my results. Frankly, I've tried many things that others have said worked, to no avail, and become quite cynical about suggested treatments myself. I swear to god, I would never post this unless it was really, truly working for me.

And no, I don't know exactly what part of my routine is the single most critical, though I would say that it's probably whatever is reducing/inhibiting production of COX-2 in my system, but I do know that when I have stopped the Vimovo for more than 3-5 days a couple of times, I have started to get shadows again, so I go back on it, along with the D3 and melatonin/regular sleep routine. I am currently 3 days into trying to go without Vimovo again (just taking D3 and melatonin) and so far, so good.

One point I want to make here, too, is that I can now drink alcohol. Yes, you heard me right. I can have a couple of beers, I can drink some wine, I can have liquor. For first time in a few years last week, I actually got tipsy on margaritas at a Mexican restaurant! And no CH! That's one of the things that made me think this is really something effective, and not just a fluke. I could NEVER drink alcohol once I went chronic without getting a severe CH beating, until now. Same goes for chocolate and cheese, etc. In fact, nothing I eat now causes a CH. If that's not evidence that something is working, I don't know what is.

A detailed explanation because you deserve details

Since a lot of responders seem to be skeptical about the Vimovo/D3/melatonin approach, I decided to explain how I arrived at it in the first place, and to provide additional details about it.

BlackLab, I completely understand that there will be people who can't take Vimovo (Naproxen+Esomeprazole Magnesium). My comment about Verapamil is based on personal experience, as well as my own neurologist's opinion. The fact that I had to get regular blood pressure tests just to be allowed to start and continue taking it should give you some idea of how potentially dangerous it is. My GP was very concerned about me trying Verapamil, and by contrast, she didn't bat an eyelash at me taking Vimovo. Verapamil wasn't very effective for me anyhow. I had to take it at the maximum dosage of 960mg (very nearly the maximum permitted dosage of 1,000mg) in order to see any changes in my CH frequency at all, and at that dosage, I was starting to have trouble concentrating and physically exerting myself. Even climbing a small staircase was wearing me out. I considered that unacceptable, as I'm a relatively fit 46 year old. In the end, Verapamil didn't even completely stop the CHs, so what was the point? Vimovo, by contrast, does not cloud your brain or make you tired/unable to exert yourself. You are entirely yourself, physically and mentally. It has had no more noticeable effect on me than taking an Advil: basically zero. In addition, the naproxen in Vimovo is considered much less associated with cardiac effects than other NSAIDs, and for me, the esomeprazole magnesium negating the potential of naproxen to cause stomach bleeding potential renders it safe enough for me, and clinched the deal as a potential treatment, at least for the short and medium term. I am still on the lookout for something that can do what it does with fewer potential long-term side-effects, but I would point out that even straight naproxen was responsible for fewer fatalities in 2014 than Ibuprofen, the main ingredient in Advil, so I hardly consider it to be a 'dangerous' substance.

Obviously, if you have any of the medical conditions or risk factors mentioned by the manufacturer of Vimovo, you will need to speak with your doctor before considering it. Now that I'm CH-free, I am going to look around for possible alternatives to Vimovo. But I felt it was my civic duty to report what led a chronic sufferer to a CH-free experience with Vimovo to other CH sufferers. Just a note to those nattering at me about Vimovo: If you're not chronic, you have the luxury of knowing the cycle you're in will probably end. When you're chronic like I was for over a year, the possible side-effects of taking Vimovo seem piffling, as your quality of life is in the toilet. You want the pain to stop, and you'll do whatever it takes to make it stop. What I'm offering is advice on possibly the least dangerous way to do this there currently is, so please bear this in mind when sniping. The idea is not to stay on Vimovo for the rest of my life, but to use it as a 'big gun' to just make the damned CHs stop and stop for an extended period of time. On this count, it has, in combination with the rest of my routine, been 100% effective. Note that I said '100%' and not some lower figure. I have had NOT ONE (not even a little, tiny level 1 CH--even that sensation which preceded a CH and lingered after the pain left, or shadowing, is now absent) in 3 months on this routine.

I do think the Batch D3 regimen is on the right track--the anti-inflammatory track--it just wasn't quite effective enough on its own for me, and that's why I'm posting this supplemental anti-inflammatory treatment in this thread. I don't know if Vimovo 500/20s would stop CHs by themselves, as I haven't tested that, but as a major component of an over-all anti-inflammatory routine, including a rigorous attention to regulating my sleep patterns with strong (10mg) melatonin tablets, I'm merely reporting that I'm CH-free, and I wasn't CH-free on just the D3 regimen after over two months of meticulously following it.

The story

So, after a month and a half of taking the full Batch D3 regimen, and finding that it was not stopping my CHs, I felt I had to resort to some kind of anti-inflammatory supplementation. I based my research on the basic premise behind Batch's regimen, which is that CHs are caused by an inflammation response in our bodies. After all, many people had reported success with the Batch D3 regimen, it just hadn't been as effective for me, and several others in that thread have also reported less than stellar efficacy.

What actually causes inflammation?

Since many had reported success using Batch's anti-inflammatory D3 regimen, I believed the essential approach was sound, but perhaps, just not potent enough: that CHs are caused by inflammation, and specifically, inflammation of the tissues surrounding the trigeminal nerve. I believe that during a cluster attack, the tissues around the trigeminal are swelling, constricting the the nerve in much the same way that a boa constrictor crushes its prey. The immediate question for me as a victim of this torture was simply, what is the proximate cause of this inflammation? What makes your tissues around your trigeminal nerve swell? My reading indicated that prostagladins are responsible for tissue swelling, and that there are two things in your body that produce prostaglandins:

COX-1: responsible for "baseline levels of prostaglandin", and COX-2, which produces additional prostaglandins through "stimulation". (Multimedia File Viewing and Clickable Links are available for Registered Members only!!  You need to or )

Bingo! COX-2 is produced on demand by your body in response to tissue stress. In other words, put simply, it's COX-2 that makes your thumb swell if you bang it with a hammer, and my reasoning is that somehow, in CH sufferers like us, SOMETHING is causing the production of too much COX-2, likely on a circadian cycle (or a messed-up circadian cycle) of some kind, and over-production of COX-2, and consequent over-synthesis of prostagladin is causing inflammation in the tissues surrounding our trigeminal nerve.

An arthritis aside

In my case, I also 'lucked out' (if you can call arthritis of any kind 'lucky') in noticing that my right hand joints were starting to get arthritic joint pain around the time that I went from episodic to chronic back in August of 2014. For me, this was another clue that Batch was on the right track with an anti-inflammatory approach. After all, arthritis of the type my doctor says I have is caused by inflammation of the joints. Hmmm. Inflammation! COX-2!

Reducing your COX-2 level is the key

So the issue for me quickly became, if my body is over-producing COX-2, and that's causing excessive prostaglandin production which is now giving me arthritis and CHs, what will inhibit that? Since the vitamin D3 regimen (D3 helps to inhibit COX-2's catalysation of arachidonic acid into prostaglandin) was not eliminating my CHs; (at best, they were somewhat milder, and almost as frequent) I decided it needed some help. If even extremely high doses of D3 were still not sufficient to stop my CHs, perhaps I simply had far too much COX-2 in my system to begin with. I am chronic after all. So I decided I had to find something that would reduce the amount of COX-2 in my body in the first place: to look for a 'big gun' that would work in partnership with the D3, to help push down my inflammation levels even more and keep them down: a knock-out blow, so to speak, and NSAIDs are that 'big gun'.

NSAIDs are known, effective inhibitors of COX-2. As I've already mentioned, just as a test for my theory that inhibiting COX-2 should halt CHs, I experimented on myself by taking two extra strength Advils (Ibuprofen) every 4-6 hours continuously for 5 days. In the past, and even at the very beginning of my CH odessey back in 2007, I had tried taking Advils to deal with the headaches, but of course, as I quickly discovered for myself, and as my specialist subsequently confirmed, orally-administered Advils don't kick in quickly enough to prevent the onset of a CH (although they did seem to help once they did start to take effect--but of course, I was never really certain it was the Advil that curtailed the duration of a CH, or if the damned thing had just ended on its own), so like all of you, I had long-since abandoned Advil as an effective treatment for a CH onset. However, what I wanted to find out for this experiment was, would taking Advil on a continuous basis, ie BEFORE I even get the sense of a CH onset PREVENT the CH from happening. So I timed the Advils to approximately an hour before I expected the next CH. This started pushing the CHs around in terms of timing, but didn't stop them altogether, so I decided to go all-out and just take them every 4-6 hours (maximum dosage, though hospitals regularly administer much higher doses of ibuprofen for certain conditions) continuously, for a set period of 5 days. I've always had a cast-iron stomach, so I knew this would not be an issue. Note that immediately preceding this experiment, I was getting at least 1 CH each and every day (often two or even three in a 24 hour period) for over a year, with only the occasional exception, and even then, I never enjoyed more than one skipped CH in a row. The round-the-clock, maximum dose Advil experiment worked like a charm! I did not get a single CH for those 5 days! Could be fluke, I thought. I had been let down many times with different treatment approaches, but I decided to pursue the notion that it HAD worked, just in case.

Round the clock Advil works, but what is a more sustainable NSAID?

So it was then that I decided to find the most sustainable form of NSAID that would do what the Ibuprofen was doing, and based on my own evaluation of the risks, and the fact that Vimovo was both naproxen accompanied by a protein pump inhibitor, esomeprazole magnesium, and was designed as a slow-release, coated formula, I chose to try Vimovo. An interesting coincidence, is that Vimovo is normally prescribed as an arthritis treatment! So I made an appointment with my neurologist and told him my idea. He said that, as he did not have anything known to be effective as a treatment for chronic CHs, he was willing to write me a prescription for Vimovo. I went out and filled it that same afternoon, and started taking the maximum dosage of 2x500/20mg Vimovo every day on Oct. 15th, while also continuing to take 10,000iu Vitamin D3, a Centrum multi-vitamin, 10mg melatonin each night after sundown, and making myself go to bed between 9-12am, even if I had to also take a sleeping pill (Trazadone in my case.) My symptom diary says I had 9 CHs from Oct. 15th to Nov. 2nd, and then nothing. I have not had a single CH since Nov. 2nd of 2015 (I am not exaggerating--I mean not a single, solitary CH, not even the sense of a strong shadow, although I've noticed a couple of very minor shadows when I have tried going for more than 4-5 days without any Vimovo).

Do I think this is the magic cure for CH, and no further work needs to be done? Of course not. Is it a substitute for the D3 regimen? No. But if you can take it (ask your doctor/PHP) and especially if you are chronic, this may be the only thing that gives you your life back, as it has done for me.

Role of regular sleep

As part of a comprehensive, all-out assault on anything that could cause inflammation in my body, in addition to the Vimovo, I also decided to get very serious about regulating my sleep schedule. Ever since I was a teenager, I have had trouble falling asleep consistently at a set bedtime (I've had enough experience since my first definite CHs in 2007 to know that staying up late almost guaranteed CHs/stronger CHs). So I decided, in addition to taking the Batch D3 regimen, and the Vimovo, to get something that would knock me out to sleep, if necessary (trazadone), and something that would keep me asleep if I didn't take a trazadone (melatonin). To further guarantee sleep success, I even got a prescription for Tramadol in order to eliminate the possibility that a CH might wake me up an hour into sleep. I only took 2-3 of these over the course of the preliminary period Oct. 15th-Nov. 2nd. They are an opioid, so not recommended for any sustained use, but the sure as hell kept me asleep when a CH might well have woken me up!).I had found that the 1mg or 1.5mg melatonins were not strong enough to keep me asleep, so I found 10mg melatonin tablets at Costco (Nature's Path 10mg). These do an admirable job of this.

So my approach from Oct. 15th of last year can be summarized as:

1) Daily use of Batch D3 regimen (10,000iu of Vitamin D3 if nothing else).
2) 2 Vimovo 500/20mg per day, always with meals, while trying to break the chronic cycle, then 1 Vimovo 500/20 (or less) for maintenance. (I am still experimenting with how many days I can go without the Vimovo, just taking the D3/melatonin--I can now go several days at a time before sensing any shadows; that I should take a Vimovo).
3) Sleep regulation, using 10mg melatonin, and occasionally, using trazadone to make me unconscious if necessary. (I even got a prescription for Tramadol in order to help me sleep--only took 2-3 of these over the course of the preliminary period Oct. 15th-Nov. 2nd, to keep me asleep in the event of a CH). This involves going to bed around the same time and getting up whenever you need to, but sleeping in is absolutely recommended whenever possible. You can never get 'too much sleep'. That is a myth. Your body will never sleep longer than it needs to! This is important!

It took about 18 days to completely stop the CHs, but after Nov. 2, not a single CH. I scaled back the Vimovo to 1 500/20mg tablet per day, and have tried 2 or 3 times cutting out the Vimovo, and just taking the D3+multivitamin and the sleep regulation routine. So far, no CHs, but I have resumed the once daily Vimovo whenever I have sensed a shadow, which is also often accompanied by additional arthritic soreness in my right hand. I am now experimenting with taking only 1 Vimovo whenever I have the vague sense of a shadow, and then going more days to see how long I can go before the next vague sense of a shadow. Note that these are not full-on shadows, like I would get before an actual attack. These are even less intense that those. They're more like a hint of a shadow, which is more than enough!

All I know is that this Vimovo/D3/melatonin routine has worked flawlessly for me for over three months now. Not a single CH. I don't know how much of a role the various parts of my routine play in the cessation of my CHs, but probably, all of them are needed. It's possible there is a synergy between the D3 and the Vimovo. I have not tried stopping the D3, so I don't know.

Believe me, as a fellow CH sufferer, I would not lie about my results to fellow sufferers. What would be the point? I promise that if anything changes, and the treatment routine I'm following suddenly proves itself ineffective, I will update everybody. I don't know how helpful this will be for episodic sufferers, though I'd venture to guess that it will work for you, too. But if you are a chronic CH sufferer and you can do what I'm doing: if you can get approval from your doctor for Vimovo 500/20mg, and you can take 10,000iu of D3 and get yourself to sleep on a regular sleep schedule, using melatonin and/or something even stronger whenever necessary, to make yourself sleep, you owe it to yourself to try this for at least a couple of weeks. I promise it will not be a waste of your time.

Thank you for your support, Wayne. I am only reporting my experience out of the same sense of civic duty that I felt when I was military. I don't want anybody else to suffer with CHs like mine if I have information that can help them avoid that torture. People can do with this information as they will. If they're scared to death of any component in my routine, nobody's forcing anything down their throat. Constructive criticism is good. Petty sniping is not helpful to anyone.

I will continue to update this thread in the event that the treatment routine I'm following fails, or at milestones of success, to keep everyone updated on its effectiveness. I will also try to answer any questions I can. Please feel free to ask me anything, and I will do my best to respond.

Wayne wrote on Jan 29^th, 2016 at 4:20pm:


It's the D3 and Vimovo. Positive about this, because I was taking the D3 and the melatonin for a couple of weeks before I even started the Vimovo, and it wasn't working. Only once I introduced the Vimovo did my CH's stop. After they stopped, I was able to taper down the Vimovo to 1 per day, and now, I've been able to get it down to 1 Vimovo every few days (3-5). Believe it. It works. Otherwise to take crap from skeptics.

Just another quick supplemental information update to the D3/Vimovo/melatonin variation I've been taking, and which has been working for me, a hitherto chronic CH'er, for over 3 months.

What causes the inflammation that triggers CHs?
My thought is that CHs are caused by inflammation in the tissues surrounding the trigeminal nerve. The inflammed tissue expands and much like a boa constrictor crushing its prey, the tissue crushes the trigeminal, causing a CH. The chemical that inflames the tissue is prostaglandin. How is prostaglandin produced? To keep this simple, for the purposes of CH, the relevant culprit for prostaglandin synthesis is COX-2

Now, looking more carefully at both Vitamin D3 and what it does and the naproxen in Vimovo and what it does, here's my basic summary to make it easier for everybody to perhaps understand why these two seem to have been so effective for me when taken together to halt CHs:

-Vitamin D3: basically inhibits COX-2's production of prostaglandins
-Naproxen: basically inhibits the production of COX-2 in the first place

Thanks to Batch sending me an article about Vitamin D3's ability to inhibit prostaglandin pathways, I've been able to get a better overview of what's going on. My theory is that in CH sufferers, like many other inflammatory disease sufferers, the body is periodically overproducing COX-2, possibly in some kind of synch to the body's circadian rhythms. High doses of Vitamin D3 help mitigate the effectiveness of COX-2 in catylising arachidonic acid into prostaglandin, which is very helpful, but if you have a huge amount of excess COX-2 released into your blood, this is only going to have a somewhat limited effectiveness. My idea was to add a 'right hook' to Vitamin D3's 'left hook', and to simultaneously reduce the body's ability to produce COX-2 in the first place. So there's less COX-2 to catalyse arachidonic acid, as well as a reducing the remaining COX-2's ability to synthesize arachidonic acid into prostaglandin. My goal now is to find the minimum effective dosage of Vimovo. Bearing in mind that I was and still am taking at least 10,000iu of D3 everyday, regardless of my Vimovo dosage, I have gone from taking the maximum 2x500/20mg daily for 2 weeks in order to stop the CHs, to 1x500/20mg daily maintenance once they stopped, to taking less than 1 per day now. I can now reliably go for 3-5 days without taking any Vimovo before sensing any shadows, and so far, resuming a single Vimovo dosage has kept me from getting any CHs. I now get a warning shadow long before I ever get a CH! I have not yet tried to see how long I can stay off the Vimovo before I get an actual CH, as I'm sure all of you will understand, I am not eager to get one. However, when I am satisfied that I have been pain-free for long enough that this treatment is incontrovertibly effective, I may try to see how long it would be without Vimovo before my COX-2 levels increased naturally back up to the levels where I once again get a CH.

Massages sometimes gave me even worse CHs?
Not only am I a chronic CHer who has been completely CH-free for over 3 months now on a D3/Vimovo/melatonin regime, but there are other factors which seem to make the reduced COX-2/reduced COX-2>prostaglandin anti-inflammatory theory 'add-up'. For one thing, I used to (before the current regimen) get particularly bad CHs immediately following after a deep-tissue massage. I now know why. Arachidonic acid, the 'fuel' for COX-2 to produce prostaglandin, exists in the largest concentrations in your skeletal muscle tissue! So, whenever I had a deep-tissue massage or did strenuous exercise, it was releasing larger quantities of arachidonic acid into my bloodstream, providing my already elevated levels of COX-2 with more 'fuel' with which to produce prostaglandin, and thereby, inflame the tissues surrounding my trigeminal nerve! It all makes sense now!

Also, I started getting osteo-arthitic pain in my right hand around the time I went from being episodic to chronic back in August of 2014. This lends credence to the theory that excess COX-2 was at least partially responsible for both the arthritis and the chronic CHs. Also, the fact that the D3/Vimovo routine has not only halted my CHs, but also largely mitigated the arthritic sensations in my right hand is only further evidence that maintaining low COX-2 levels is an effective treatment for both conditions. At Batch's suggestion, I have also started taking Vitamin K2 (K7) on a regular basis--something I only just started doing 2 days ago--and it already seems to be helping to further eliminate the arthritic sensation in my hand that I was waking up to, in the last two mornings.

That's all for this update!

Please do not hesitate to ask me any questions!

anubis44 wrote on Feb 5^th, 2016 at 2:29pm:


  O2 at 25lpm with a non-rebreather mask such as the Optimask is safe and effective.  Naproxen is not safe nor effective.

           Potter

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On the contrary. There are PLENTY of ifs ands and buts about this.

It's naproxen with esomeprazole magnesium. The esomeprazole magnesium mitigates potential to induce stomach bleeds. It's a very different proposition from straight naproxen. In any case, if my experience is anything to go by, you'll only have to take the maximum dosage of Vimovo of 2x500/20mg daily for about two weeks, then you'll be stepping it down to maybe one 500/20mg every few days. I'm a chronic sufferer who's been CH-free all of a sudden for over 3 months with D3 and Vimovo.

It's not bad advice if your doctor says it should be safe for you, and it stops your CHs dead cold. You're going to be taking so little Vimovo (naproxen) once you've got your COX-2 levels low enough to stop the CHs, that it is almost certainly not going to harm most people. Your sniping about this being bad advice is only going to turn some sufferers away from something that is likely safe and effective. Is that what you want, mate? [/quote]

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From what I understand, Vimovo is both safe and effective for the vast majority of people. Really, it's at least as safe as Advil (Ibuprofen), if not safer. It's usually prescribed as a long-term arthritis medication. THIS IS NOT NAPROXEN BY ITSELF. I WOULD NEVER ADVOCATE NAPROXEN BY ITSELF, so please smarten up, get off your grouch couch and inform yourself. My life was practically ruined by episodic and then, chronic CH, and I'm letting anybody who wants to know, know how I managed to make the pain stop and get my life back. Period. NO ego involved, just a sense of civic duty.

Read the actual stats for this med before you judge it, and not just the mandatory US-style scare-the-crap-out-of-people warnings the company MUST publish in the US because you have the most litigious society on the face of the earth, and they're trying to cover their asses from even the most ridiculous of lawsuits. My own specialist didn't bat an eyelash writing the prescription for this because, his words: "My treatment options for you now that your are chronic are quite limited anyhow, so if this works for you, by all means take it. It's MUCH safer than cortico steriods like prednisone or botox injections, which are the only other treatments left in my tool-kit to try to break your chronic condition." You're also utterly ignoring how little Vimovo is required to obtain my results. We're talking about only 2 WEEKS of the maximum dose for me, and HALF the maximum dose for a week or so afterwards, and EVEN LESS THAN HALF of the maximum dose thereafter for maintenance. To be 100% (not 99%, or 98%, or some other, lesser percentage) CH-FREE. I don't need oxygen, I don't need Zomig (Zolmitriptan), I don't need anything other than my ~10,000ius of D3, the occasional Vimovo so far to maintain, and 10mg melatonin most nights to regularly get a good night's sleep. I'm 100% CH-free, and no, I'm NOT bullshitting you. I mean literally not even a tiny, little Kip.5 CH in 3 months, after one or more CH's EVERY SINGLE DAY for over a year leading up to this treatment.

O2 is an abortive technique that has never been reliably effective for me. With very small quantities of Vimovo supplementing my D3, after the initial loading dose to stop the CHs, it has been a 100% reliable preventative. Not ONE CH in 3 months for a chronic CH'er. I don't even need to keep a Zomig 5ml in my pocket anymore. I can now drink as much alcohol as I like, eat whatever I want, even the darkest chocolate or MSG-laden Chinese food (which used to utterly guarantee my demise by CH). You name it as a trigger and I can now do it, without any risk of a CH. Beat that with you O2. I'm not going to walk around with an Oxygen tank everywhere I go. If you want to do that, knock yourself out, but don't snipe and ward others away, especially chronic suffers, from something that might just give them their life back.

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No ego. Just results. I'm only bothering with this thread because I don't want others to suffer as I did. Period. Ego be damned.

At this point, I'm beginning to suspect you just don't want what I'm doing to work, frankly.