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Back in February of this year my neurologists decided to try me on emgality at 300 mg each month for 3 months. The first month I took the medication I had zero migraines at first then as the weeks went by I started getting cluster headaches totally off season for me since my cluster headaches are every three years for approximately 18 weeks and I had them last year. The clusters brought on by this drug were not normal for me in other ways too. My normal clusters hit hard level 10 last about an hour without medication (imitrex) and I get them multiple times over the course of each day and night. yet the ones caused by the emgality were approximately 2 per day (24 hours) and rarely passed a 5 on the pain scale. after the first time I took it the second month not realizing it was in fact the drug due to me having a root canal done in the first month. The second month the clusters got worse right after taking the second dose and I noticed other side effects such as eye strain, joint pain all over and some stomach issues. as the month progressed I noticed the clusters got less intense and then I took the third dose and it got worse again only this time my migraines were normal as before I tried this medication so now instead of helping at all it just made life worse for me. So in closing I would not recommend this drug. Hope this helps someone, Mark

Hey Amholla, Good question. For starters, we've found the 12-Day accelerated vitamin D3 loading schedule at 50,000 IU/day for 12 days, a total loading dose of 600,000 IU of vitamin D3, to be effective in elevating serum 25(OH)D3 concentration by 60 ng/mL above the starting/baseline concentration. You're going to need at least another 10 days loading vitamin D3 at 50,000 IU/day to meet the minimum loading schedule. The following chart illustrates the time to respond to this treatment protocol in days from start of regimen with a significant reduction in CH frequency (from a mean of 3 CH/day down to a mean of 3 CH/week). As you can see, the majority of CHers experiencing a favorable response do so within the first two weeks on this treatment protocol. This next chart illustrates the time in days to a complete cessation of CH from start of regimen. This is a subset of the above time to favorable response. There are several factors that influence time to respond. The first is the starting or baseline 25(OH)D3 serum concentration. Seeing your PCP/GP for this lab test before starting this treatment protocol is important. If the starting 25(OH)D3 serum concentration is low, it takes longer to elevate to a therapeutic concentration above the CH threshold. The following normal distribution chart illustrates the results of baseline labs for 25(OH)D3 among 313 CHers experiencing active bouts of CH before starting this treatment protocol. If you didn't obtain this lab test before starting treatment, you're shooting in the dark when it comes to estimating a response time. The odometer and speedometer on your body's dashboard are not working. You don't know how far you've come or how fast you're going towards a favorable or CH pain free response. This next chart illustrates the normal distribution of 25(OH)D3 lab results after ≥ 30 days on this treatment protocol among CHers who experienced a favorable response with a reduction in CH frequency or a complete cessation of CH. If you look at the blue sigmoid S-shaped cumulative probability curve in this chart, you'll see that 25% of CHers on this treatment protocol have responded by the time their 25(OH)D3 serum concentration reached 60 ng/mL. There's another chart CHers taking this treatment protocol should understand. It's the 25(OH)D3 time course response to various doses of vitamin D3. As you can see at a vitamin D3 dose of 10,000 IU/day it can take a month for the 25(OH)D3 response to reach 60 ng/mL. Clearly, waiting 30 days or more to experience the sought after pain free response while following this treatment protocol is too long for CHers. This is why we start it with an accelerated vitamin D3 loading schedule taking 50,000 IU/day of vitamin D3 for a minimum of 12 days as illustrated in the following graphic. The latest revision to this treatment protocol now calls for loading at 50,000 IU/day with the Bio-Tech D3-50 and all the cofactors illustrated in the photo below until there's been a significant reduction in CH frequency or a CH pain free response or 30 days whichever occurs first, then see your PCP/GP for a second set of labs for serum 25(OH)D3, calcium and PTH. We made this switch as the Bio-Tech D3-50 water soluble 50,000 IU vitamin D3 has a higher bioequivalence in elevating serum 25(OH)D3 at the same dose as the oil-based liquid softgel vitamin D3 formulations. We switched to the Methyl Folate + B complex from the vitamin B 50/100 complex for the same reason. If you're CH pain free and your serum calcium is within its normal reference range, you're good to go. Drop the vitamin D3 intake to a maintenance dose of 50,000 IU/week. If you haven't experienced a significant reduction in CH frequency and your serum calcium is within its normal reference range, continue loading for another 15 days then see your PCP/GP for another round of labs for 25(OH)D3, calcium and PTH. We've had a number of CHers continue loading vitamin D3 under a physician's supervision with frequent labs for 25(OH)D3, calcium and PTH, achieve CH pain free responses between 160 ng/mL and 189 ng/mL 25(OH)D3 and still maintain their calcium serum concentration within its normal reference range. The 3-year chart of my labs for 25(OH)D3, calcium and PTH are a good example. The second pacing factor in time to respond is a combination of body mass and body mass index (BMI). An adult male weighing 90 Kg (198 lbs) with a BMI ≥ 30 can easily take twice as long and need twice as much oral vitamin D3 as an adult male weighing 80 Kg (176 lbs) with a BMI of 24 to achieve a favorable CH response to this protocol. The third factor that causes the most problems for CHers starting this treatment protocol is an allergic reaction. Allergens cause the immune system's Mast Cells to release large quantities of histamine. This histamine in turn triggers neurons and glia in our trigeminal ganglia to express Calcitonin Gene-Related Peptide (CGRP). CGRP is one of four neuropeptides responsible for the neurogenic inflammation and pain we know as CH. As long as mast cells are releasing histamine, none of the CH preventatives (including vitamin D3) will be effective. Bottom line, histamine to a CHer is like Kryptonite to Superman - Bad news. If you do suspect an allergic reaction is interfering with vitamin D3 in preventing your CH, you need to treat the allergy with an antihistamine. In 2019 Quercetin became the antihistamine of choice over Benadryl (Diphenhydramine HCL) when CHers suspect or realize they're having an allergic reaction. 1 gram/day Quercetin is a good starting point and you can titrate the dose p to 3 grams/day. 1 to 3 grams/day Resveratrol and 6 to 8 grams/day vitamin C are also part of the intervention for allergic reactions. If there's no joy after a week of the above interventions for an allergic reaction, start taking the Benadryl at 25 mg every four hours throughout the day. If there's still no joy with vitamin D3 preventing your CH, see your PCP/GP for a 5-day burst dose of prednisone at 50 mg/day. Burst doses of prednisone at 50 mg/day for a period this short should not require a taper. If the burst dose of prednisone results in a reduction in CH frequency, see your PCP/GP for a consult with an allergist to find out what is causing the allergic reaction. This latest revision to the posted version of this treatment protocol is still in work. I hope to have it completed and published on vitaminDwiki.com soon. Take care and please keep us posted. V/R, Batch

90% of my busts, I've done on my own. When on my own I would always line up a movie to watch. Something funny, something I've seen 100 times so there are no surprises. I've also learned that having someone around (a babysitter I think everyone calls it) isn't enough on its own. This person needs to engage with you. Let me explain. When my best friend and I rented this place together, she was 'around' when I busted. That is to say, probably in her room or off doing her thing, but in the house. I felt safer cause I wasn't alone, but was still left to my own devices. Eventually she agreed to try a small amount of mushrooms to combat her depression, and when she did her bust, we also invited her son over, (who has plenty of experience with mushrooms). The two of them split a 1.2 gram dose, and I was the sober babysitter. The two of them had a GREAT time. They laughed, watched funny films, talked. My best friend REALLY enjoyed her minor trip. She then realised that leaving me alone when I busted isn't what I needed. I needed to engage with people. I think the dose level has a lot to do with it too. I've found 1.2 gram is a good dose for me. I've worked my way all the way up to 2.4, and really did not enjoy that. Granted, this was during the time I was more or less on my own. Even at 2.4 I didn't hallucinate. MG

Nyquil contains 25% alcohol. Alcohol is one of the big triggers and would be counter intuitive to busting. Potter

iPain, From what I gather in your post, I suspect your dose is 'on the fence' of tripping. Jeebs mentioned above that many here have discussed the same issue, if the dose is just over the tripping threshold, many have increased anxiety (myself included). If I take 2g it's a completely different experience than when I've taken 1.2g. 1.2 and my thoughts are very distracted and regularly just "want it out of me". 2g and I might have 5 minutes of anxiety then i'm offffffff to wonderland... PFW,

A good hike can go a long way on a trip... AWAY from lots of people as communication can be difficult.