Helm,

What you're describing with the up-tic in frequency of your CH indicates you need a higher vitamin D3 dose.  The quick fix is two to three days at a vitamin D3 dose of 50,000 IU/day followed by an increase in your maintenance dose by 5,000 to 10,000 IU/day.  In other words, if your maintenance dose was 10,000 IU/day, bump it to 15,000 or 20,000 IU/day for a month then see your PCP for labs of your serum 25(OH)D, total calcium and PTH.  As long as your serum calcium remains within its normal reference range and PTH remains in the lower third of its normal reference range, there's no problem with the new vitamin D3 maintenance dose or the elevation in serum 25(OH)D.  I'd also make sure to drink 2.5 liters of water a day.

If the up-tic in your CH frequency was due to a major allergic reaction (entirely possible), 25 mg of Benadryl (Diphenhydramine HCL) every 4 hours during the day for a week to 10 days should do the trick.  Just be careful and don't drive while taking this much Benadryl as it will make you drowsy.  If you need to drive or be super alert, hold off on the Benadryl until you're home for the day then take 50 mg and another 25 to 50 mg at bedtime. If the up-tic was due to a minor allergic reaction, a day or two of Benadryl should be sufficient.

If the up-tic is due to an infection, I'd jump on Vitamin C at 1000 mg every 3 to 4 hours during the day for a week to 10 days.  Our bodies lack the enzyme needed to produce endogenous vitamin C so we need at least 2000 mg/day from supplements and diet anyway...

I'd be careful with the BC Powder (Aspirin 1000 mg and Caffeine 65 mg)...  I avoid the NSAIDs, (Aspirin, Tylenol (Acetaminophen), Aleve (Naproxen), Advil (Ibuprofen)...  They all cause GI tract bleeds...  even the "heart healthy" 81 mg Bayer Aspirin... I've found chewing up 20,000 to 50,000 IU of vitamin D3 and swirling the contents under the tongue for five minutes without swallowing works more effectively in relieving pain than aspirin with no GI tract bleeds.

Take care and please keep us posted.

V/R, Batch

Ryan,

Several CHers in similar situations found that a few days of Benadryl (Diphenhydrmine HCL) at 25 mg every four hours, stopped the "burn through" CH hits while taking vitamin D3 loading doses.  You've tried it before...  so give it another try.

It's also time to drop back from the vitamin D3 loading dose of 50,000 IU/day to say 20,000 IU/day and evaluate...

The Vitamin K2 should help.  Are you still taking the Vitamin B 50 or B 100 complex?  I spoke with Dr. Stasha Gominak at the 20th Workshop on Vitamin D in Orlando, FL last March.  She's been suggesting a vitamin D3 regimen very similar to the anti-inflammatory regimen.  In fact, I included her suggestions on adding the 3 month course of Vitamin B 50/100 Complex in the anti-inflammatory regimen three years ago.  At the workshop she said she's now suggesting her patients stay on the vitamin B 50 Complex full time...  I'm still evaluating this.

Take care and please keep us posted.

V/R, Batch

Ryan,

You're in what I call the "tuning phase" of taking this regimen were we vary the amounts of regimen supplements to find the right balance to keep us CH pain free.

Accordingly, you can double the Omega-3 fish oil... and add a good probiotic.  Too many CHers, myself included at times, treat the gut like it was made of cast iron...  Not so...  It contains colonies of bacteria (biota) most of which are friendly and essential to good health called the microbiome.  The microbiome can be wiped out with a course of antibiotics causing all kinds of health problems.

The roles of probiotics and the microbiome in maintaining healthy immune systems and overall good health were not topics of interest to medical science until 1999 when the first study using probiotics was registered in clinicaltrials.gov, "Use of Probiotic Bacteria in Prevention of Allergic Disease in Children 1999-2008".  There have been 948 studies registered in clinicaltrials.gov listing probiotics as the intervention in a wide array of medical conditions since then...  110 in 2017.  The Gut-Brain Axis has also become a hot topic in the last 10 years with respect to neurological conditions.

Researchers have found a direct two-way communications link between the gut and the brain via the Vagus nerve.  They've also found chemical links between the gut and brain where neuropeptides produced in the gut play a role in neurological conditions...  The vasoactive intestinal peptide (VIP) should ring a bell for CHers.  This neuropeptide plays a major role in the pain phase of cluster headache and migraine pathogenesis.

Bottom line... a happy gut is a healthy gut...

Take care and please keep us posted.

V/R, Batch

Hey Ryan,

For starters, howz the head?  Have the frequency, severity and duration of your CH dropped any while taking this aggressive regimen?

Regarding my comments on what you’re taking, I’ll tell you what I would do, in order and why.

1.      Drink 2.5 liters of water a day.  This helps flush excess calcium from the kidneys

2.      Have my PCP order labs for my serum 25(OH)D, calcium and PTH.  Taking 50,000 IU/day vitamin D3 is OK for 12 to 16 days. Taking a dose this high longer than that can push calcium homeostasis past its limits to maintain serum calcium within its normal reference range resulting in hypercalcemia (too much serum calcium).  I won’t know this without lab tests.  The alternatives are reduce the vitamin D3 dose and if I didn’t ,  I’d avoid all calcium supplements and calcium rich foods (all dairy products). 

3.      Make sure I was taking at least 400 mg/day magnesium.  Taking large doses of vitamin D3 > 10,000 IU/day consumes magnesium rapidly.  Without magnesium supplements, taking this much vitamin D3 will result in a calcium-magnesium imbalance causing muscle cramps and possibly an increase in CH frequency.  Magnesium, Omega-3 fish oil and 2.5 liters of water a day keep my blood pressure in the green… and I’m 73.  I also have a BP cuff and use it weekly.

4.      Increase the Omega-3 fish oil dose to 2000 mg/day.  Omega-3 is a potent anti-inflammatory agent that helps prevent CH.

5.      I am not a fan of psychoactive drugs so avoid taking antidepressant medications like Fluoxetine (Prozac) and Trazodone.  Their off-label use in treating primary headaches does far more harm than good.  They can even cause headaches.  Vitamin D3 and Omega-3 fatty acids are far more effective in treating anxiety and or depression without adverse side effects.

6.      Benadryl (Diphenhydramine HCL) is only a short-term treatment.  300 mg/day is the maximum total daily dose and two weeks is the max duration…  Obviously we shouldn’t drive if taking Benadryl as it will cause drowsiness.  If Benadryl (Diphenhydramine) doesn’t result in a drop in the frequency of CH after thee days, discontinue as excess histamine is not the problem.  If it does work, dietary changes are in order.

7.      Start a good probiotic and continue taking it until the bottle is empty.  Probiotics help repopulate colonies of bacteria and biota in the GI tract called the microbiome.  Most of these colonies are friendly and symbiotic… Some are not.  A good probiotic helps increase the colonies of friendly bacteria.

8.      Change my diet to avoid all sugars and limit fresh fruit intake to one serving a day.  Avoid high starch carbohydrates including grain and grain products including bread, pasta and all grain oils and margarine. Good oils include EVOO, avocado oil, butter and coconut oil. Eat Organic NON GMO fresh green and yellow veggies, wild caught fish (salmon, halibut, cod, anchovies), free range beef, lamb, pork, turkey, chicken and eggs.

9.      If I was still having problems controlling my CH, I’d increase my daily vitamin C intake from 2000 mg/day to 6,000 mg/day (1000 mg every 2 to 3 hours during the day and at bedtime.  Vitamin C is an effective antibacterial, antiviral and antifungal agent that doesn’t kill off the GI tract microbiome. I’d also start taking Turmeric (Curcumin) at 1000 mg/day as it is a great natural anti-inflammatory agent...

10. Not sure about the heart medication...

11.  The results of taking prednisone will be telling...  If you respond, the level of inflammation preventing vitamin D3 from controlling your CH is high...

Take care and please keep us posted.

V/R, Batch