Hey SJ,

I'm very familiar with your problem.  It's very likely you're experiencing what I call a CGRP cascade.   When that happens, none of the CH interventions work including oxygen with hyperventilation.

What is happening here is you're likely also suffering from an allergic reaction.  These can be subclinical, i.e., no obvious or outward symptoms... but the allergic reaction is still there causing mast cells to degranulate releasing a flood of histamine and other neuroactive peptides.

When the histamine reaches neurons and astrocytes in the trigeminovascular complex, it triggers the release of calcitonin gene-related peptide (CGRP).  This is the nasty neuropeptide thar causes neurogenic inflammation and the pain we know as CH.  It gets worse.  When the CGRP reaches mast cells, it triggers the release of even more histamine.

When that happens, we're essentially experiencing a circular chemical chain reaction releasing a cascade of CGRP that continues until one or more of the chemical reactants are consumed at which point the chain reaction ends and so does the CH...  for now...  Unfortunately, our bodies recharge the mast cells, neurons and astrocytes within one or two hours and the vicious cycle starts all over again.

One of the best ways to stop a CGRP cascade is to take a first-generation antihistamine like Benadryl (Diphenhydramine HCL).  First generation antihistamines  cross the blood brain barrier (BBB) to block histamine H1 receptors at the genetic layer and this stops the CGRP cascade... CH too.  Second- and third-generation antihistamine cannot pass through the BBB so will not be as effective as a first-generation antihistamine.

When I experience this problem, I take 25 mg of Diphenhydramine every four hours during the day.  This allows vitamin D3 to do its genetic expression thing to slow or halt the release of CGRP and in the process bring our CH under control.   I also make sure I drink at least 2.5 liters of water a day.

Benadryl (Diphenhydramine HCL) will make you drowsy so don't drive if at all possible while taking this much.  If you do need to drive or be super sharp during the day, take 50 mg of the Diphenhydramine when you're home for the day and another 25 to 50 mg at bedtime.

Inflammation from infections can also trigger a CGRP cascade.  If you suspect an infection, taking 6 to 10 grams of vitamin C a day can help.  I take 2 grams of vitamin C with breakfast, lunch and dinner plus an additional two grams in between and at lease 1 gram at bedtime with lots of water.

Take care and please keep us posted.

V/R, Batch

SJ,

I understand your situation.  Yes to questions #1 and #2.  Allergic reactions screw the pooch for CHers...

If there's at least 4 hours between the time you get home and bed time with no driving in between, taking 25 mg of Diphenhydramine as you walk through the door and 25 to 50 mg at bedtime should do the trick.

You can also bump the vitamin D3 maintenance dose by 5,000 IU/day or even 10,000 IU on top of your regular dose.  I'd also double up on magnesium taking 400 mg with breakfast and another 400 mg with dinner. 

Please keep us posted.

V/R, Batch