Hey Shadia,
Most medical diagnostic labs in Canada use a unit of measure for 25(OH)D serum concentrations based on molarity instead of metric weight. In other words the unit of measure for the 117 is in nmol/L (nanomoles per Liter) instead of nanograms per milliliter.
The normal reference range for the 25(OH)D lab test is a serum concentration of 75 nmol/L (30 ng/mL) to 250 nmol/L (100 ng/mL). As the majority of CHers need an average 25(OH)D serum concentration of 80 ng/mL (200 nmol/L) to have a favorable or pain free response to the anti-inflammatory regimen, your 25(OH)D serum concentration of 117 nmol (46.8 ng/mL) is too low to achieve a favorable response to dose of vitamin D3.
Now that you're on the vitamin D3 loading schedule of 50,000 IU/day vitamin D3, your serum 25(OH)D concentration is increasing rapidly towards the target of 200 nmol/L (80 ng/mL).
The following normal distribution curves (bell shaped curves) illustrate the range of 25(OH)D serum concentrations reported by CHers with active bouts of CH before starting the anti-inflammatory regimen and 25(OH)D serum concentrations reported after treatment with a favorable response or a complete cessation of CH symptoms.
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As you can see, your 25(OH)D serum concentration of 117 nmol/L (46.8 ng/mL) is at the high end of the distribution curve for CHers before start of regimen with active CH and at the low end of the distribution curve for CHers experiencing a favorable response to this regimen.
Soooo... after all that... if you stick with the vitamin D3 loading schedule of 50,000 IU/day vitamin D3 for a total of 8 to 10 days then drop back to a maintenance dose of 10,000 IU/day, I'm confident you're going to be CH pain free and loving life very shortly.
Be sure to see your PCP for lab tests of your serum 25(OH)D, calcium and PTH a month from now.
Regarding a link between menstruation and CH... There's a clear link between menstruation and migraine headache. I've checked a number of sources for similar linkage to cluster headache. In contrast with migraine, little is known about the relation between cluster headache and menstrual cycle, oral contraceptives, pregnancy, and menopause.
That said, we've seen clear changes in CH patterns in women during and after pregnancy so it's reasonable to expect the hormonal changes during menstruation could also cause changes in CH patterns.
My theory of cluster headache and the efficacy of vitamin D3 in preventing CH centers on the role of inflammation and an immune system response. As inflammation and an immune system response both consume vitamin D3 and its metabolites, it is clearly possible that the inflammation associated with menstruation is consuming sufficient vitamin D3 and its metabolites at a high rate.
If your serum concentrations of vitamin D3 and 25(OH)D were at the tipping point of keeping you CH pain free at a constant dose of vitamin D3, then menstruation could easily tip the balance leaving too little vitamin D3 to prevent CH.
Again, in any event, you've taken the appropriate action starting the vitamin D3 loading schedule.
Take care and please keep us posted.
V/R, Batch
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