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Dropping by to share a review article just published in The Journal of Headache and Pain which adds to the growing body of research suggesting microbial dysbiosis is implicated in migraine pathogenesis. It found migraine patients have less diverse gut microbiomes with elevated bacteroidetes, proteobacteria and firmicutes as well as reduced faecalibacterium, a butyrate producer known for its anti-inflammatory effects. This imbalance may increase gut permeability resulting in neuroinflammation impacting migraine onset and severity. Probiotics and synbiotics reduced migraine frequency, severity, and painkiller use (excluding triptans) in five randomized trials, though results varied by strain and population. Unravelling the gut-brain connection: a systematic review of migraine and the gut microbiome https://thejournalofheadacheandpain.biomedcentral.com/articles/10.1186/s10194-025-02039-7 Could similar microbial mechanisms apply to CH? I suspect so. We know CH shares neuroinflammatory pathways with migraines and a couple of recent CH studies suggest there may be a systemic inflammatory component in CH as CH’ers, regardless of whether chronic or episodic (in or out of bout) were found to have elevated levels of oncostatin M and I believe it was the most recent paper that identified a distinct difference in inflammatory cytokine profiles between episodic and chronic CH sufferers. Elevated cytokine levels in the central nervous system of cluster headache patients in bout and in remission https://thejournalofheadacheandpain.biomedcentral.com/articles/10.1186/s10194-024-01829-9 Distinct Alterations of Inflammatory Biomarkers in Cluster Headache: A Case Control Study https://onlinelibrary.wiley.com/doi/10.1002/ana.27205 So what evidence is there that perhaps diet may be a key therapeutic target for CH? We have the 2018 Lorenzo study to refer, where 15 of 18 chronic CH patients had a therapeutic response with 11 of those achieving clinical remission on a ketogenic diet with the author stating “we observed for the first time that a 3-month ketogenesis ameliorates clinical features of CCH.” Is it reasonable then to ask might its efficacy lie in shifting the microbiome towards a less inflammatory profile? Efficacy of Modified Atkins Ketogenic Diet in Chronic Cluster Headache: An Open-Label, Single-Arm, Clinical Trial https://pmc.ncbi.nlm.nih.gov/articles/PMC5816269/ If you read into the literature on vitamin D3, I think there is a strong case for the vitamin D3 regimens use as a preventative therapeutic option to have in the CH toolkit given it’s unique role in modulating the immune response – notably in a dose dependent manner, as shown in one of my all-time favourite vitamin D research papers, somewhat supporting the proposed 10,000iu per day dosage as per the regimen. Disassociation of Vitamin D’s Calcemic Activity and Non-calcemic Genomic Activity and Individual Responsiveness: A Randomized Controlled Double-Blind Clinical Trial https://www.nature.com/articles/s41598-019-53864-1 The above paper was written by Professor Michael Holick, regarded as one of the pioneering vitamin D3 researchers, alongside others like Wagner and Hollis etc. He also wrote another paper showing that vitamin D3 modulates the human microbiome, increasing beneficial bacteria and decreasing pathogenic bacteria. The Effect of Various Doses of Oral Vitamin D3 Supplementation on Gut Microbiota in Healthy Adults: A Randomized, Double-blinded, Dose-response Study https://pubmed.ncbi.nlm.nih.gov/31892611/ The emerging “psilocy-biome” research is nothing short of intriguing too. Psilocybin may alter gut microbiota, increasing beneficial bacteria and reducing inflammation. It could act via the gut-brain axis with microbes metabolizing psilocybin to influence serotonin pathways or dampen neuroinflammation though this needs more study there was a fantastic paper recently published exploring this subject. Further, if the anti-inflammatory effects of psilocybin are in part derived from the interaction with the microbiome, might this contribute to variation in therapeutic response to psilocybin for CH? Mind over matter: the microbial mindscapes of psychedelics and the gut-brain axis https://www.sciencedirect.com/science/article/pii/S1043661824002834 From my humble perspective it is an exciting time to be following the research. It is interesting as a sufferer to hypothesize where all this may converge in the context of CH. It is also tempting to speculate that a patient led vitamin D3 regimen dated as early as 2011 aligns nicely with what recent research is suggesting in respect of the underlying inflammatory component now suspected in CH, particularly given my personal success with the regimen since 2015. As always, anyone considering the regimen is encouraged to doing it under the care of a physician and the regular monitoring of labs for calcium, PTH and 25(OH)D vitamin D.

Yea but you need a brain first for that to work, so I'd say that a few of us on here have got No chance, what you think @Bejeeberand @BoscoPiko? Not mentioning any names

Actually, sunlight IS good for the brain and CNS disorders. https://digital.kenyon.edu/cgi/viewcontent.cgi?article=1043&context=skneuro

I have had 3 bouts of shingles on the same side as CH (2 before CH started, one since), I do often wonder if that could be linked because the virus for Chicken Pox /Shingles embeds itself in the nerve endings within the spine (terminology there may not be 100% scientific but you get the idea). Luckily I've only had it once on my face but, when that did happen, it was as if someone had drawn a line from the middle of my forehead, through my left eye, down to the base of my left ear - ie. right where a lot of the frontal pain occurs during CH. When I had shingles on my back it was just to the left of my spine midway up mytorso - right at the base of where I feel the shoulder pain, frustratingly out of reach for self-massage during an attack. Due to the trouble modern medicine has with getting to the bottom of CH I think there's a mix of genetic and environmental factors that play a part but I would not be surprised to see this linked one day.

There are those that would argue that Chicago is on another planet.

I've not seen rain for 29 days in UK just pure sunshine

You don't have to go that far away. We haven't seen the sun in Chicago for months.

I'm just gonna move to a planet with no sun!!!!!!!

My ramp up in intensity and frequency was from the 11 th of May, so I peaked a little early .

Sign up for Clusterbusters 10th Annual #CureForCluster Virtual 5k, for U.S. residents purchasing a race bag, they can still be ordered to arrive on time if you order by the May 27th. Shipped Race Bags will only be available for purchase by U.S. residents as an add-on. We cannot ship outside the U.S. Our virtual 5k can be run or walked at any location, so you can join us from anywhere in the world. Registration is open through June 6th. The event will kick off on June 7th and can be completed any time in the month of June. We look forward to seeing photos and awareness raised for cluster headache. This year, we have partnered with Alliance for Headache Disorders Advocacy (AHDA) to support Headache on the Hill: A Visual Installation representing all headache disorders while our event continues to raise awareness and funds for cluster headache. For info and to register: https://runsignup.com/cureforcluster5k

Hi, I expected there to be a peak in intensity in CH. From studying records of CH patients, I noticed peaks corresponding to the dates when the Sun changes signs, and even more so if it is afflicted at the same time. In this case (mid May), it was afflicted by Mars. But this time, people didn't experience any noticeable peak, so I need to look deeper into it.

FDA Approves Auto-Injector for Migraine, Cluster Headache | MedPage Today It says, "DHE can relieve pain associated with cluster headache attacks, particularly when administered intravenously." Of course, this is not an IV autoinjector.

I did pretty good through this period but the cycle has been ramping down for a while now.

Same here. No real changes in frequency or intensity. Stijn ,Can you tell us what you expected to happen?

No change in my clusters so far this week at all due to earth wind or fire. See you on the dark side of the moon!

I gave it a go a few years back. The first month it seemed to help by the 3rd month things were back to normal with my clusters. I have heard both good and neutral results about it, we are all a little different. If you can get it for a reasonable price I would say to give it a try. I was taking 3x's the migraine dose, I think it was like 100mg? 3 shots once a month. Make sure they are room temp when you use them or it will hurt.

Hi @dehabel, Sorry to hear your bangers are back. Unfortunately from what I've read it's somewhat common after coming off a steroid taper. I haven't read any promising reports about Emgality but you can search the threads by using the search function at the top of each forum page. Do you have oxygen to help get you through? Are you taking any other preventives?

I can’t take it any longer. Finished the three days of steroids. Fourth day they are back. Anyone have luck with Emgality?

You know to tell the dentist not to use epinephrine, I hope. It's a big trigger for many people. (As I understand it, it's added to Xylocaine because the epi reduces bleeding, so the actual anesthetic to avoid is Xylocaine+epinephrine.) This is from a post somewhere else: "Anesthetics containing epinephrine (such as Xylocaine) and nitrous oxide have been identified by some people as triggers. Ask your dentist to use something else: Prilocaine seems not to cause bad effects. Another person has mentioned carbocaine as an anesthetic that didn't trigger his CH."

DMT experiences and advice - Theory & Implementation - ClusterBusters

I’m in the fifth week of this cluster and last weeks have been hell. if it gets even worse today or tomorrow I will report.(I hope not

I'm in cycle right now and I have had it fairly easy for the last week so if I get some bangers on those days I will let you know.

Instead of debating the issue. Let’s see what happens this Wednesday and Thursday. To anyone in a cycle right now: it would be helpful if you could give us feedback and share here if you’re indeed experiencing a rise in intensity of CH attacks during these days.

Cluster fingers crossed.