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Hi all, now that I have found relief, I thought I would circle back and post about it here. I am not a doctor but this is my experience and obviously is not advice. I got a terrible 'flu' when I was 15 and got lots of persistent symptoms including daily brain splitting headaches that lasted for 45 years. That's the very abbreviated version. My headaches had a lot in common with cluster headaches but also had some differences. Busting was almost the only thing that helped me but I felt terrible when I was doing it so I didn't do it as often as I should to keep them at bay. I would get really bad vertigo for hours when I busted. Oxygen didn't help me at all and Vitamin D messed up my thyroid balance and caused other problems so it was a no go for me in larger doses. My doctor recommended low-dose Naltrexone and it has literally changed my life. I only get a few headaches a month and they are much more manageable. Sometimes, Tylenol at the beginning is all I need to get rid of one. That is unheard of for me. Sometimes I get the symptoms of a headache (tearing eye, swollen sinuses, stiff neck, etc) but no pain. While I know this is not the case for everyone, I have zero side effects from it and I know that many other people have the same experience. LDN is typically given in much larger doses to help people get off opioids. The typical dose for that is 50 mg and up. It is also given off-label for people with auto-immune illnesses, headaches and other uses, at tiny doses beginning at 1 mg. I can not stress enough how different my life is now. Wishing all of you a similar future.

They TMac, Good questions. 3 CH/night is not good and a 25(OH)D3 serum concentration greater than 150 ng/mL is not a worry by itself. The goal of the anti-inflammatory regimen is a CH pain free response. The fallback is a significant reduction in CH frequency from an average of 3 CH/day down to 3 to 4 CH/week as long as oxygen is available. Given the amount of vitamin D3 you've been taking and your 25(OH)D3 serum concentration is >150 ng/mL, I'll make a SWAG (sophisticated wild-ass guess) you're battling an immune system reaction caused by an allergy. An allergic reaction is characterized by the immune system's Mast Cells releasing large amounts of histamine. Histamine to a CHer is like Kryptonite to Superman, bad news. In the past, I and many other CHers found a first-generation antihistamine like Benadryl (Diphenhydramine HCL) taken at 25 mg four times a day brought the allergic reaction under control so vitamin D3 could again do its thing to prevent CH. First-generation (drowsy type) antihistamines like Benadryl (Diphenhydramine HCL) pass through the blood brain barrier to block histamine H1 receptors on neurons and glia throughout the brain. This is important for CHers as histamine insults neurons and glia in the trigeminal ganglia causing them to express and release CGRP, SP and likely other neuroactive proteins that are responsible for CH pathogenesis. Benadryl (Diphenhydramine HCL) works well in this role as an antihistamine but with the drawback that it induces drowsiness in many and it's also an anticholinergic (blocks the neurotransmitter acetylcholinesterase). As acetylcholinesterase is needed to allow nerve signals to pass from neuron to neuron through nerve synapse, Benadryl (Diphenhydramine HCL) slows down nerve functions. I suggested the use of Benadryl (Diphenhydramine HCL) be limited to a week to 10 days as it has also been associated with neurodegenerative disorders when taken for long periods of time. Fortunately, in early 2019 I began suggesting Quercetin, a naturally occurring plant flavonoid, as an effective antihistamine as it has no time limit on dosing and no anticholinergic properties like Benadryl (Diphenhydramine HCL). As a side note, Quercetin acts as an ionophore when taken with zinc that allows zinc ions to enter cellular cytoplasm to inhibit virus replication. Something you should think about with the Wuhan Coronavirus floating around. Loading? Yes, if I was getting hit like you have, I would start loading vitamin D3 at 50,000 IU/day for at least a week or until I made it through two full days CH pain free then drop back to the previous vitamin D3 maintenance dose at least 10,000 to 20,000 IU/week higher. Over the years, we've had a number of CHers with your problem, a high 25(OH)D3 serum concentration and the CH beast is still jumping ugly. In the past, loading vitamin D3 with a week to 10-day course of Benadryl (Diphenhydramine HCL) worked wonders in getting them back to a CH pain free state. Today, many CHers have found loading vitamin D3 and taking Quercetin has similar CH pain free outcomes. Over the last four months, I've worked with CHers who tried 4-Day "pulsed" loading schedules taking 200,000 IU of vitamin D3 on Day-1 then coasting without any vitamin D3 on Days-2, 3 and 4, taking all the cofactors daily. They repeat the 4-Day pulsed loading schedules until they experience a CH pain free response or four cycles. At that point it's prudent to drop back to a vitamin D3 maintenance dose and see your PCP/GP for a set of labs of your serum 25(OH)D3, calcium and PTH. If your serum calcium remains within its normal reference range, try three more pulsed loading cycles. If you do the math the 4-Day pulsed loading schedule still works out to an average dose of 50,000 IU/day for 4 days. They've also upped the Quercetin dose and added Turmeric (Curcumin) and vitamin C. The dosage here is 3 grams/day each of Quercetin, Turmeric (Curcumin) and Vitamin C with the 3 grams of vitamin C broken up into 3 equal doses taken throughout the day to maintain a relatively constant serum concentration. There are a couple studies that found vitamin C increased the effectiveness of both Quercetin and Turmeric (Curcumin) when taken together. Pulsed loading causes a spike in serum vitamin D3 concentration illustrated in the following graphic that increases the osmotic diffusion differential between vitamin D3 in the blood stream and vitamin D3 at the cellular level. This increased osmotic diffusion differential results in more vitamin D3 entering cells throughout the body much faster. Obviously, as CHers we're looking for this increase to occur in neurons and glia within the trigeminal ganglia to bring our CH under control. If you think this is an extreme vitamin D3 loading dose. It's not. There are studies using a single oral dose of 300,000 IU to 600,000 IU vitamin D3 with no adverse effects. Regarding your lab result for 25(OH)D3. Quest Diagnostics has two different 25(OH)D3 assay methods. They've a fast inexpensive automated assay for 25(OH)D3 that tops out at a serum concentration of 150 ng/mL and the QuestAssured Liquid Chromatography Dual Mass Spectroscopy (LC-MS/MS) assay method that reads total 25(OH)D (D2 and D3) up to 512 ng/mL. If your doctor didn't specify the Quest Diagnostics Test Name: 92888- "QuestAssureD 25-OH Vitamin D (Total), LC/MS/MS assay for 25(OH)D3" in your lab order, you likely got the low cost rapid automated assay. That said, a 25(OH)D assay >150 ng/mL although not a worry by itself, is meaningless if you're CH pain free. The important lab assays for you at this point are for your serum calcium and Parathyroid Hormone (PTH). Did your doctor order these two assays and do you have the results? As long as your serum 25(OH)D3 is within its normal reference range, there's no hypercalcemia (too much calcium in the bloodstream), a.k.a., vitamin D3 intoxication/toxicity. This means your 25(OH)D3 is not a worry no matter how high it goes as long as your serum calcium is normal. The following 3-year chart of my lab assays for serum 25(OH)D3, calcium and PTH are a good example. It illustrates my 25(OH)D3 serum concentration has been well above 100 ng/mL, as high as 188 ng/mL and has averaged 150 ng/mL since January of 2019 while my calcium serum concentration has remained within its normal reference range the entire time. My PCP understands vitamin D3 and calcium homeostasis so has no problem with my 25(OH)D3 serum concentration this high to prevent my CH as long as my serum calcium remains within its normal reference range. As you can see, it has. Hope this helps. Take care and please keep us posted. V/R, Batch