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igdc, this is a kind of guide to the treatment options we're most familiar with. Maybe you'd want to look it over, just for preparedness' sake: https://clusterbusters.org/forums/topic/6213-basic-non-busting-information/ It doesn't address the new CGRP pharmaceuticals (Emgality, Aimovig, Ubrelvy, and others), which might be worth trying. And people are always mentioning new things that seem to have helped them. Do not underestimate the potential power of busting!!!!! It's discussed at the end of the post I just linked you to, and also under the blue "New Users..." banner at the top of each page.

igdc I keep a log book of every cluster I get with how long and what I did to abort each one. It does help me because things change and what is working today may not work for me next week. I can go back and see what I did to get out of a funk the last time. I am chronic so I do not have any cycles that give me any length of pain free days but I do have cycles that ramp up from time to time. Spring time usually beats me up followed by summer when it is hot out around here.

Actually yes, it comes right on schedule on the Equinox. It helps me to prepare knowing that too.Kind of 'classic; isn't it? To cover all cycles, I should say the week of the Equinox.That covers them all.

@spiny, Is it really that exact, to the day? I think my first was September 26th. A migraine (for which I'm also chronic) or jaw pain following a replaced filling, I thought. I traveled for work, did alright with headaches here and there... and by the middle of October, it was full-blown terrible. Do I need to keep a calendar to map patterns for future years? And yes, it does help me to know that I have a good doctor whose treatments seemed to help... but even then, it takes time. And I suppose there's no way to know if it would work again. Ack... scary. Thanks for the replies and wishing you both well.

Yep, the fall is my time of year as well. Already been working on it.

I definitely get the fear quotient. My cycle will begin on Sept. 21st. I make sure that I have my gear all lined up and ready to go. Plenty of O2 on hand! Also, I stay on the D3 Regimen. Are you doing that? It really does help many of us!! I up my D intake to 15,000 as opposed to the normal 10,000/day. In addition, I make sure that I follow a set sleep schedule. Get up the same time daily, no matter what. The better armed that I am, the less stress I have. If you bust, then do that in advance. Put that info on a closed board - Members Only - and you will get a lot of replies from those who rely on that. Then, just breath deep, decide you have done all that you can and move on with life. Good Luck!

Hi, I am an engineer from Mexico. CH started when I was in high school, though they were fewer and a lot less painful then. CH got really bad in 2014, since then they have been coming every year and lasting from September - November. Before I share my last cycle experience. I want to make it clear that it was hell, pain would put me on my knees and make me lie down on the floor, I would hit the floor/walls with my fist, some times with my head, I cried, I screamed, I even ended a long term relationship because of it. It was a very dark time for me. She left on august, CH hit me the first week of September, it was bad. I'm not trying to be negative and bring you down, I just wanted to make clear that CH for me is as bad as it is for every one else, and since I kind of came up with a solution (I hope) I didn't want you guys to think that maybe it worked for me because my problem is not CH and may be a migraine or something else less severe than CH. I was diagnosed during university. Diagnose was confirmed by a neurologist back in 2013 when it become a problem because of the severity of pain. I could not attend early classes at graduate school because of CH. Since 2013 I've tried different drugs (medicine), oxygen, everything legal and prescribed by a neurologist. And the results were not very promising, you know how it is. Drugs kind of help, but the result (at least in my case) is far from solving the problem. 2017's cycle was 3-6 episodes a day, sometimes 8. And oxygen would only delay the 10 level pain (I rank it from 1-10, 10 being wanting to.. you know). As I said, it was hell. During 2017's cycle I noticed that doing pull-ups would abort almost immediately the pain, but the attack would come again later. So during work if I felt it was coming I went to do pull-ups and it worked 100%. The problem was that after 3-4 attack attempts I was exhausted and would just let the next one hit. Then I would use the oxygen. So the attacks were inevitable. The pull-ups (push-ups and running too) helped me to abort attacks but I had to face them at the end. The cycle was over and I became curious about the pull-ups, so I did a little research. I don't want to make this a long letter, so I will be straight and tell you some medical findings and facts. What is the mechanism that causes CH? *The pain from CH is caused by the dilation, or widening, of the blood vessels that supply blood to your brain and face. This dilation applies pressure to the trigeminal nerve, which transmits sensations from the face to the brain. It is unknown why this dilation occurs. Sugar *Glucose, a form of sugar, is the primary source of energy for every cell in the body. Because the brain is so rich in nerve cells, or neurons, it is the most energy-demanding organ, using one-half of all the sugar energy in the body. *Sugar may trigger hormonal changes, particularly in the hormones epinephrine and norepinephrine. These hormonal shifts change the way blood vessels in the brain behave, potentially triggering a headache. *Elevated blood glucose harms blood vessels Testosterone and serotonin levels on CH sufferers *It was found that testosterone levels are lower than they should during cycles. For some reason, our testosterone levels drop during cycles/episodes. *Serotonin releases get out of control during episodes. What did I do? So basically I tried to restore to normal whatever hormones were low, avoid sugar and processed foods because of all the chemicals they have which might act as neurotransmitters or get mine all jerky and bad. Sugar NO SUGAR: On January 1st 20018 I cut sugar 100% from my diet. I have not had a single snickers/milky way (oh how I loved those!) in a year. Now don't get confused, sugar is not fructose. I mean I kept eating fruits, but quit refined sugar. Testosterone and serotonin levels As I said, I tried to restore to normal hormones levels. Did you know that ketogenic diet has helped treat CH? Guess what diet helps you get testosterone levels up? A protein rich diet. Guess what's in the ketogenic diet: lots of protein. Guess what else helps you with testosterone? lifting weights. I had never been a gym guy, but this time it was worth a try so I bought some weights and was very disciplined about it. Thas it, it worked 100%. I will edit and continue the post telling you how I know it worked but It's almost 2 am so I'm going to bed. I hope this helps you and gives you hope. Best wishes for 2019! J. Pablo

I got testosterone replacement therapy for low T as one part of my preventative regimen. I asked my neuro for it after reading this paper: http://www.ncbi.nlm.nih.gov/pubmed/16732838and printing it out for my doc. Testosterone, melatonin, all sorts of things affect each other, and you have to have a holistic approach to the balancing the whole system -

MG - Agreed that hormone levels has something to do with it, certainly in at least some people. This is an interesting set of research by Dr. Rozen - http://www.ncbi.nlm.nih.gov/pubmed/?term=clomiphene+and+rozen+and+%22cluster+headache%22 According to Wikipedia, Clomid does the following in men (off label of course): Clomifene citrate has been found very effective in the treatment of secondary male hypogonadism in many cases.[14] This has shown to be a much more attractive option than testosterone replacement therapy (TRT) in many cases because of the reduced cost and convenience of taking a pill as opposed to testosterone injections or gels.[15] Unlike traditional TRT it also does not shrink the testes and as a result can enhance fertility.[citation needed] Traditional TRT has the risk of inducing a chemical gonadectomy, although with monitoring and low-dose hCG as adjunct, this is usually preventable and reversible.[16] Because clomifene citrate has not been FDA approved for use in males it is prescribed off-label. Due to the fact that Clomifene is now a generic medication in most markets, it is unlikely that a drug company would pursue FDA approval for use in men now because of limited profit incentive, mostly due to the relatively small market potential.[17]However, the single isomer of clomifene, enclomiphene under the brand name Androxal, is currently under phase 3 trials for use in men.[18][19] So maybe this is something we should collectively be mentioning to our doctors.

Going back to the OP and the comment/question about Steroids. I think, and from my own personal experience, there is a very strong connection between clusters and hormone levels. ALTHOUGH, I've always seen it to be connected with people who have a low Testosterone count. Taking steroids would increase your testosterone, and thus have the potential (maybe) to reduce clusters. I would be surprised if it caused them. That said, I'm not a medical doctor and my knowledge on the subject isn't exhaustive. When I transitioned from Male to Female, I took an anti-androgen that stopped my Testosterone (T) production, and at the same time took a very high dose of Oestrogen. It was during this period when my clusters started, and here is the theory behind the connection. Thanks to some scientists in the Netherlands, we know that the hypothalamus in women is smaller than in men. We are also pretty sure that when someone changes their gender, and thus changes their hormones from being T based to Oestrogen based, it reduces the size of hypothalamus so that it matches that of a genetically born woman. So, hormones impact the hypothalamus. We are also pretty certain that clusters stem from the hypothalamus because the hypothalamus controls the body's clock as well as body temperature, etc. etc. As clusters often occur at the same time of day, same time of week, same month of the year, etc. etc., it is believed they are triggered by the hypothalamus. My clusters are a direct result of me screwing with my hormone levels, altering my hypothalamus and thus triggering the clusters. My Neuro believes I was pre-disposed to having them anyway, and it was my altering my hormone system that triggered them. Who knows, I may have gotten them at some point in my life anyway, or maybe not. But I do suspect that if you take something that alters the balance of your hormones, and you are pre-disposed to having clusters, you are very likely to trigger them. MG