Hi everyone,

I'm new to this website and a first time poster, so first let me apologise if I have posted this in the wrong section. Also, sorry in advance for the long post, but I'm looking for any help I can get.

A bit of background for context

32 year old male, CH sufferer for 6-7 years. Originally from Edmonton, Canada (go Oilers!), but have lived in Brisbane, Australia (go Broncos!) for the last 5 years.

Historically, my cycles have been pretty consistent: 2-3 hits per 24 hours, 30-45 minutes in duration, cycles last anywhere from 2-4 weeks. Remission periods have typically been between 10-12 months.

It was only about 2.5 years ago that I finally got a PCP to agree with my CH self-diagnosis and was able to get a referral to a neurologist who specialises in headaches. I was given 50mg Sumatriptan tablets as an abortive. If I took 2 of the 50mg tablets as soon as I felt a hit coming, it was usually pretty successful in aborting the hit within 15-20 minutes.

I chose to stay away from Verapamil and Prednisone because my cycles weren't very long and I was in a period of remission when I saw the neurologist (rookie error), so the side effects of those meds didn't seem worth the risk to me.

Current situation

I have been in another cycle for the last 5 days. Before this cycle started, it had been my longest remission period of over 1.5 years, so I'm sure you can all understand how mentally and emotionally devastating it was when this cycle started after so long.

I have still been getting 2-3 hits per day, but they are longer in duration, anywhere between 45-120 minutes. The biggest change, however, is that the Sumatriptan tablets seem to be hit-and-miss, at best, in terms of aborting the hits. Yesterday evening, for example, I took two 50mg Sumatriptan tablets at the very first sign of a hit, and felt no relief whatsoever until almost an hour later. Whether that was from the tablets taking longer to kick in, or the hit just running its natural course, I'm not sure.

The other thing to note is that I am currently 7 months into a year-long trip through South America. I have some Sumatriptan tablets with me, but I suspect that the likelihood of getting other meds (injections, nasal spray, etc.) is pretty low, given that I don't speak fluent Spanish, and that I'm often in locations where even finding a doctor or pharmacist is a bit of a stretch.

Some questions

Is it possible that high altitude is impacting the efficacy of the Sumatriptan tablets, or increasing the severity and duration of the hits?

• I'm currently in Bolivia, much of which is at fairly high altitudes (currently at 2,800m / 9,200ft). Over the next couple months, I'll be continuing to travel across Bolivia and Peru, getting to elevations as high as 5,000m / 16,000ft above sea level.

Would taking a D3 supplement, but not the whole regimen, result in any observable improvement?

• I had never heard of the Vitamin D3 regimen before finding this site and I'm really intrigued. I fully plan to start the regimen when I get back to Australia, but unfortunately, that won't be until January 2018. For the reasons noted above and various others, starting the full regimen while I'm still on the road in South America might not be realistic, and I also want to get a lab to run my serum 25(OH)D levels. At a minimum, I should be able to find some over-the-counter Vitamin D supplements, so if I started taking those alone, would it have any effect?

Caffeine - trigger or abortive?

• I've seen a lot of conflicting information about caffeine a trigger for CH, but also being used as an abortive (like in the case of caffeine/taurine energy drinks). Can anyone clarify this? I love coffee, but I'm a bit lost as to whether I should be avoiding it when I'm in a cycle. And are energy drinks actually effective as an abortive? Besides more Sumatriptan tablets, that might be the only other thing I can reliably get my hands on. Any brands/kinds that work reliably in anyone's experience?

If you've made it this far, thanks for your patience. And if you have any answers, advice or thoughts on the above, thanks in advance for those as well.

This looks like an incredible community and wealth of resources. I'm really glad to have found it. 

Batch,

Thank you so much for the response and suggestions. This information really is invaluable.

I'll do my best to source some D3 softgels and magnesium while I'm still on the road and see what kind of results come from that.

Interesting point regarding potential allergies impacting the efficacy of Sumatriptan. I'll get my hands on some Benadryl or something similar and hopefully that will result in the Sumatriptan being effective again, as it's the only abortive I have with me right now.

Hopefully I can report back soon with good news.

Cheers for the welcome, Brian.

That's a good point about the changing altitude. When I'm in a cycle, getting on a plane is a sure-fire way to go through hell.

Thankfully, I'll be moving to lower altitudes gradually over the next month or two, so fingers crossed it doesn't prolong this particular cycle too much.

Can't wait to be back at sea level in Oz!!