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Posts posted by CHfather

  1. Tony, it looks to me like this is the same as the numbered items in the ClusterBuster Files.  As far as I know, these particular documents haven't been updated since tommyd posted them.  Now that THMH has made it possible for me to attach documents again, would you like me to copy the 13 entries from the CB Files into a Word document for you? (I think there's a small problem with including the outdated info, but I don't know what to do about that.)

    5 hours ago, Tony Only said:

    Thank you again CHfather (and for all that you do!) :)

    What I do is not half as much as you do. 

  2. Tony, maybe this is what you're looking for???? https://clusterbusters.org/forums/topic/681-1-the-clusterbuster-method-a-quick-rundown/?tab=comments#comment-8322  (Asking this question to anyone who happens to be reading this thread: This document contains this statement about tryptamines: "For aborting attacks, they rival oxygen in safety and effectiveness." This puzzles me. Is this true, but no one does it anymore except on rare occasions (maybe because of the five-day "shutting the door" principle/rule)?  From the time I have been here (~10 years), I really don't recall anything being pushed about using them to abort, and they don't seem to effectively do that a lot of the time. Maybe as a SPUT?)

    Tony, IF this is what you are looking for, it's the first of the 13-part series provided by tommyd back in 2010.  You can see all of them in the ClusterBuster Files section.  A lot of them are out of date. If you are looking for a summary of busting to share, I think the document under the "New Users - Read Here First" banner at the top of each page is probably as good as we have.  


  3. Tony, do you mean the 2006 article by Sewell, Halpern, and Pope, "Response of Cluster Headache to Psilocybin and LSD"?  If so, I have it. But I can't attach it here because I have apparently already used up my allotted attachment capacity.  Tried to paste it, but the formatting all falls apart, as you can see below.  Left in here in case you want to try to wade through the mess.  If you PM me an email address, I can send it that way. (It used to be easily located at the main CB page, but that seems quite jumbled now.)

    Response of cluster
    headache to psilocybin and LSD
    Abstract—The  authors  interviewed  53  cluster  headache  patients  who  had used  psilocybin  or  
    lysergic  acid  diethylamide  (LSD)  to  treat  their  condition. Twenty-two of 26 psilocybin users 
    reported that psilocybin aborted attacks; 25 of 48 psilocybin users and 7 of 8 LSD users reported 
    cluster period termination;
    18  of  19  psilocybin  users  and  4  of  5  LSD  users  reported  remission  period extension. 
    Research on the effects of psilocybin and LSD on cluster headache may be warranted.
    NEUROLOGY 2006;66:1920–1922
    R. Andrew Sewell, MD; John H. Halpern, MD; and Harrison G. Pope, Jr., MD
    Cluster headache, often considered the most painful of all types of headache,1  affects 
    predominantly men (0.4% vs 0.08% of women) and typically begins after age  20  years.  The  
    disorder  is  categorized  as  either episodic,  occurring  for  1-week  to  1-year  periods,  in- 
    terspersed   with   pain-free   remission   periods,   or chronic, in which the headaches occur 
    constantly for more  than  a  year  with  no  remission  longer  than  1 month.2    Ten  percent  
    of  episodic  cluster  headaches ultimately  evolve  into  the  chronic  form,  and  these are  
    termed  secondary  chronic.  In  standard  descrip- tions  of  cluster  headache,  an  attack  
    refers  to  the actual paroxysm of pain, a cluster period refers to a period  of  time  when  
    attacks  occur  regularly,  and  a remission period refers to a prolonged attack-free in- terval.3  
     Oxygen and sumatriptan are the mainstays of acute abortive treatment, whereas verapamil, lith- 
    ium, corticosteroids, and other neuromodulators can suppress attacks during cluster periods. No 
    medica- tions  are  known  to  terminate  cluster  periods  or  ex- tend  remission  periods.  The  
    effects  of  the  ergot alkaloid derivative lysergic acid diethylamide (LSD) and the related 
    indolalkylamine psilocybin on cluster headache  have  not  previously  been  described  and may 
    include such properties.

    Case  series.   We  were  contacted  by  a  34-year-old  man,  diag- nosed  with  episodic  cluster 
     headache  at  age  16  years,  who  re- ported  a  complete  remission  of  his  cluster  periods  
    when  he repeatedly used LSD on a recreational basis between ages 22 and
    24 years. Cluster periods resumed once he stopped. Based on this experience, he attempted to treat 
    his cluster headache by ingest- ing  psilocybin-containing  mushrooms  every  3  months  and  again 
    achieved  lasting  remission.  On  three  occasions  when  he  missed his scheduled dose, a cluster 
    period reoccurred.
    Intrigued  by  this  history,  we  located—through  cluster  head- ache support groups and an 
    Internet-based survey—several hun- dred people with cluster headache who reported use of 
    psilocybin- containing mushrooms or LSD specifically to treat their disorder, and we administered a 
    standardized questionnaire (available from the  authors).  The  consent  form  and  study  were  
    approved  by  the McLean  Hospital  institutional  review  board.  We  restricted  our analysis  to 
     the  53  individuals  who  1)  agreed  to  be  contacted  for evaluation by telephone or e-mail 
    and 2) met International Classi- fication of Headache Disorders-2 criteria for cluster headache and 
    allowed  us  to  obtain  copies  of  medical  records  documenting  a diagnosis  of  cluster  
    headache  by  an  MD  or  DO.  If  the  medical records  did  not  support  the  diagnosis,  the  
    subject  was  excluded from  further  analysis.  The  final  sample  included  subjects  from 
    across  the  United  States  as  well  as  Great  Britain,  The  Nether- lands,  and  South  
    Africa.  We  found  no  significant  differences  be- tween  men  and  women  on  demographic  
    indices  or  headache features (table 1). Notably, 31 (58%) of the 53 individuals reported that 
    they had never used psilocybin or LSD except to treat their cluster headache, and a further 13 
    (25%) had used these drugs for recreational purposes only in the remote past during adolescence.
    Results are summarized in table 2 and listed in complete form
    in table E-1 (on the Neurology Web site at www.neurology.org). Of the 32 subjects with episodic 
    cluster headache, 19 had used sub- lingual psilocybin during cluster attacks; 17 found psilocybin 
    to be effective in aborting attacks (defined as ending the attack within 20  minutes).  Only  one  
    subject  had  used  sublingual  LSD  for  an acute attack, reporting it to be effective. 
    Twenty-nine subjects had used psilocybin prophylactically during a cluster period; 15 (52%) 
    reported that it was effective (defined as causing total cessation of attacks), and a further 12 
    (41%) reported partial efficacy (defined as  attacks  decreasing  in  intensity  or  frequency  but 
     not  ceasing). Five of six LSD users reported cluster period termination. Twenty subjects  
    ingested  psilocybin  during  a  remission  period;  19  re- ported  an  extension  of  their  
    remission  period,  in  that  their  next expected cluster period was delayed or prevented 
    entirely. Four of five subjects reported similar remission extension with LSD.
    Of  the  21  subjects  with  chronic  cluster  headache,  5  of  7  re-
    ported that psilocybin aborted a cluster attack; 10 of 20 reported that psilocybin induced a 
    complete termination of cluster attacks;

    and  a  further  8  reported  partial  efficacy.  Of  two  chronic  cluster

    headache  patients  who  ingested  LSD,  both  at  subhallucinogenic doses, one reported no attacks 
    for 10 days, and the other reported none  for  2  months.  Interestingly,  22  (42%)  of  the  53  
    subjects reported partial or complete efficacy (as defined above) from sub- hallucinogenic doses of 
    psilocybin or LSD.

    Discussion.   Our  results  are  interesting  for  three reasons.  First,  no  other  medication,  
    to  our  knowl- edge,  has  been  reported  to  terminate  a  cluster  pe- riod.  Second,  unlike  
    other  ergot-based  medications, which must be taken daily, a single dose of LSD was described as 
    sufficient to induce remission of a clus-
    Additional material related to this article can be found on the Neurology Web site. Go to 
    www.neurology.org and scroll down the Table of Con- tents for the June 27 issue to find the title 
    link for this article.


    From  the  Biological  Psychiatry  Laboratory  (J.H.H.,  H.G.P.)  and  Clinical Research  
    Laboratory  (R.A.S.),  Alcohol  and  Drug  Abuse  Research  Center, McLean Hospital/Harvard Medical 
    School, Belmont, MA.
    Funding sources include MAPS of Sarasota, FL (J.H.H., H.G.P.), and NIDA, NIH T32-DA07252 (R.A.S.). 
    No funding source had any role in study design; collection, analysis, or interpretation of data; 
    writing the report; or submis- sion of the manuscript.
    Disclosure: The authors report no conflicts of interest.
    Received December 20, 2005. Accepted in final form March 10, 2006.
    Address  correspondence  and  reprint  requests  to  Dr.  R.  Andrew  Sewell, Oaks  Building,  
    ADARC,  McLean  Hospital,  115  Mill  St.,  Belmont,  MA 02478; e-mail: asewell@mclean.harvard.edu
    1920   Copyright  ©  2006 by AA    Enterprises, Inc.

    Table 1 Cluster headache characteristics by sex and subtype
    Headache features

    Headache type               n                 Age, y Episodic

    Attack duration, min

    Attacks/day at peak

    Cluster period duration, wk

    Remission period duration, wk

    Men                            26               45 (8)                          97 (66)             
                5.5 (3.7)                        13 (10)                              11 (10)
    Women                         6               45 (11)                        66 (34)                
             6.2 (3.0)                        15 (10)                                9 (5)
    Total                           32               45 (8)                          91 (60)            
                 5.6 (3.5)                        13 (10)                              11 (9)
    1° Chronic                                                                                          
    Men                              6               48 (8)                          79 (57)            
                 9.8 (7.4)
    Women                         1               38 (NA)                       90 (NA)                 
           8.0 (NA)
    Total                             7               47 (8)                          81 (53)           
                  9.6 (6.8)
    2° Chronic                                                                                          
    Men                            10               45 (6)                        105 (70)              
               6.9 (3.0)
    Women                         4               46 (10)                      139 (64)                 
            7.5 (1.0)
    Total                           14               45 (7)                        115 (68)             
                7.1 (2.5)

    Data are presented as mean (SD).
    1° = primary; 2° = secondary; NA = not applicable.

    ter period, and psilocybin rarely required more than three  doses.  Third,  given  the  apparent  
    efficacy  of subhallucinogenic  doses,  these  drugs  might  benefit cluster headache by a 
    mechanism unrelated to their psychoactive effects.

    Table 2 Reported efficacy of principal reported treatments for cluster attacks, cluster periods, 
    and remission extension

    Several limitations of this study should be consid- ered.  First,  it  is  subject  to  recall  
    bias,  because  it relies  primarily  on  participants’  retrospective  re- ports.  However,  6  
    participants  (11%)  provided  de- tailed   headache   diaries   that   corroborated   their 
    recall. In addition, 3 (6%) of the 53 participants tried psilocybin for the first time subsequent 
    to consenting to  participate  in  the  study  but  before  being  ques- tioned;  2  reported  
    complete  efficacy  and  1  reported partial  efficacy—a  prospective  response  rate  consis-

    Medication Acute treatment

    Total, n

    Effective, n (%)

    effective, n (%)

    Ineffective, n (%)

    tent with our retrospective findings.
    A  second  consideration  is  the  possibility  of  selec- tion  bias,  in  that  individuals  with 
     a  good  outcome

    Oxygen                          47          24 (52)        19 (40)           4 (9)
    Triptans                        45          33 (73)          8 (18)           4 (9)
    Psilocybin                     26          22 (85)          0 (0)             4 (15)
    LSD                                 2            1 (50)          0 (0)             1 (50)
    Propanolol                    22            0 (0)            2 (9)           20 (91)
    Lithium                         20            1 (5)            8 (40)         11 (55)
    Amitriptyline                25            0 (0)            4 (16)         21 (84)
    Verapamil                     38            2 (5)          22 (58)         14 (37)
    Prednisone                    36          15 (45)          5 (14)         15 (42)
    Psilocybin                     48          25 (52)        18 (37)           3 (6)
    LSD                                 8            7 (88)          0 (0)             1 (12)
    Remission extension
    Psilocybin                  22 (31)      20 (91)           NA              2 (9)
    LSD                             5 (7)          4 (80)           NA              1 (20)

    Nine additional individuals had taken psilocybin and two addi- tional had taken lysergic acid 
    diethylamide (LSD) purposefully for remission extension but were not yet due for another cluster 
    period at the time of our evaluation; hence, for them, efficacy could not be scored.

    may  have  been  more  likely  to  participate.  Recruit- ment over the Internet also selects for 
    younger, more educated, and more motivated subjects,4  likely lead- ing to increased reported 
    Third,  participants  were  not  blind  to  their  treat- ment,  raising  the  possibility  of  a  
    placebo  response. However, cluster headache is known to respond poorly to placebo; controlled 
    trials have shown a placebo re- sponse of 0% to prophylactic medications such as vera- pamil,5  
    capsaicin,6  and melatonin,7  and less than 20% to  abortive  medications  such  as  sumatriptan.8  
     There- fore, it seems unlikely that we would have found more than  50  cases  of  apparent  
    response  to  psilocybin  or LSD through placebo effects alone.
    Our  observations  must  be  regarded  as  prelimi- nary,  in  that  they  are  unblinded,  
    uncontrolled,  and subject to additional limitations as described above. Therefore,  our  findings  
    almost  certainly  overesti- mate the response of cluster headache to psilocybin and LSD and should 
    not be misconstrued as an en- dorsement  of  the  use  of  illegal  substances  for  the 
    self-treatment  of  cluster  headache.  However,  given the high reported efficacy for this 
    notoriously refrac-
    June (2 of 2) 2006   NEUROLOGY 66    1921

    tory condition, it is difficult to dismiss this series of cases  as  entirely  artifactual.  
    Further  research  is warranted.

    The authors thank Nancy K. Mello, PhD, and Kimberley Lindsey, PhD, for their comments on an earlier 
    version of this manuscript, and Robert Wold, Earth and Fire Erowid, for assistance with data 

    1.  Dodick  DW,  Rozen  TD,  Goadsby  PJ,  Silberstein  SD.  Cluster  headache. Cephalalgia 
    2.  Headache  Classification  Subcommittee  of  the  International  Headache Society. The 
    International Classification of Headache Disorders. Cepha- lalgia 2004;24 (suppl 1):44–48.
    3.  Ekbom K. Some remarks on the terminology of cluster headache. Ceph- alalgia 1988;8:59–60.
    4.  Etter  JF,  Perneger  TV.  A  comparison  of  cigarette  smokers  recruited through the 
    Internet or by mail. Int J Epidemiol 2001;30:521–525.
    5.  Leone M, D’Amico D, Frediani F, et al. Verapamil in the prophylaxis of episodic cluster 
    headache: a double-blind study versus placebo. Neurol- ogy 2000;54:1382–1385.
    6.  Marks DR, Rapoport A, Padla D, et al. A double-blind placebo-controlled trial  of  intranasal  
    capsaicin  for  cluster  headache.  Cephalalgia  1993;13: 114–116.
    7.  Leone M, D’Amico D, Moschiano F, Fraschini F, Bussone G. Melatonin versus  placebo  in  the  
    prophylaxis  of  cluster  headache:  a  double-blind pilot study with parallel groups. Cephalalgia 
    8.  van Vliet JA, Bahra A, Martin V, et al. Intranasal sumatriptan in cluster headache: randomized 
    placebo-controlled double-blind study. Neurology 2003;60:630–633.




    • Like 1

  4. I don't know a lot about methlypred, so I can only say that those dosages sound low, and I feel certain they're much too frequent. Here's what one expert says about dosage and use: "Corticosteroids in the form of prednisone 1 mg/Kg up to 60 mg for four days tapering the dose over
    three weeks is a well accepted short-term preventive approach. It often stops the cluster period, and should be used no more than once a year to avoid aseptic necrosis." https://clusterbusters.org/wp-content/uploads/2014/03/GoadsbyClusterTreatment.pd

    I don't know of a medical O2 tank that is 2000 liters, but that's a big one (M size, I guess), which is good. I've written a bunch about O2 use at this file (same as I linked before), so maybe you can take a look there and see whether you have further questions. https://clusterbusters.org/forums/topic/6213-basic-non-busting-information/ 10/15 lpm might be fine, or it might not be enough. Your mask might be fine (with some modifications), or you might want to try upgrading to the "Cluster O2 kit."  Your breathing strategy might be fine, or you might want to try something different. All addressed in there. I'd also note (quoting from there): "Some people have observed that for some reason when the O2 level in their tank is “low,” the O2 doesn’t work as effectively for aborting, or might not work at all. “Low” in some cases can be as much as a third of a tank remaining. Something to be aware of."  Batch has also posted data about how it can take a while at first for O2 use to become fully effective, so that might be a "normal" O2 issue you're having. Another tip for using O2 that might or might not be in there is to look down toward your feet as you use it. Don't ask me . . . but many people find that it helps.  With a proper system and techniques, you ought to be getting aborts in less than 10 minutes.

    Also in that doc are some things people can do when they don't have O2. There are a bunch of them, with caffeine or energy drinks/shots the most common. Also, Benadryl, melatonin, "brain freeze," and some other possibilities.  I just don't know what you want to do with the baby in there.

    I really don't know why the Maxalt and Cambia have those CH exceptions so prominently stated.  One of these days I might look into that.

    You can also look things up using the search bar at the top right each page. Just a good thing to know about.


    • Like 2

  5. My gosh, that's a whole lot of powerful stuff you're taking.  You have a headache doctor who specializes in working with pregnant women, so I am very reluctant to overstate anything.  And you don't say how often you are using the various abortives and possible preventives, so I can only tell you some things we might say to someone on those meds.

    1. Most people with CH don't need 6mg of sumatriptan to stop an attack.  2mg is usually enough; I would say that for sure 3mg is enough 90-plus percent of the time.  There are ways to get to 2 or 3mg.  One is to take apart the 6mg injector.  doses.  https://clusterbusters.org/forums/topic/2446-extending-imitrex/  Others are to use the 3 or 4mg injector for migraine, whose name I always forget, or to get vials and syringes prescribed and measure your own. The less of this you take, the better off you are (more on this below).

    2. Here's what the Mayo Clinic says about rizatriptan (Maxalt): "Rizatriptan is used to treat acute migraine headaches in adults and children 6 years of age and older. It is not used to prevent migraine headaches and is not used for cluster headaches."  I think some people have had relief from CH with this drug, but it isn't first line.

    3. Here's what a neutral website says about Cambia: "Cambia is used to treat a migraine headache attacks, with or without aura, in adults 18 years of age and older. It is not used to prevent migraine headaches. Do not use Cambia to treat a cluster headache."  https://www.drugs.com/cambia.html  I guess I'd at least want to ask the doc about this and the Maxalt. 

    4. Depending on how often you are using them, you seem to be taking a whole lot of triptans (including the pills), and (again, depending on how often you are using them) it wouldn't be surprising to me if you're having more and worse attacks from triptan overuse.

    5. If you're having any kind of overuse condition -- plus: two cycles of steroids (methylpred) in how long? one a year is recommended -- that could help explain why the O2 isn't working.

    6. It would be good to know more about your O2 setup.  There are other possible explanations for it working/not working. What size and number tanks of O2 do you have?  How high does your regulator go?  Are you sure you have a non-rebreather mask?

    7. You should very seriously consider Batch's vitamin d3 regimen, which has helped hundreds. With regard to helping people with the regimen, his generosity is exceptional.  I'm sure he will have considered its application with women who are pregnant. https://vitamindwiki.com/Cluster+headaches+substantially+reduced+by+10%2C000+IU+of+Vitamin+D+in+80+percent+of+people

    8. I'd suggest you might look over this file. https://clusterbusters.org/forums/topic/6213-basic-non-busting-information/

    9. For all practical purposes, I don't see a real preventive in your list of meds. (Typically, that would be something like verapamil.) Your doctor might see some of what you are taking as preventives, and there might be reasons not to prescribe other ones.  The d3 regimen is a very effective preventive, but it takes time to reach full effectiveness.


  6. If you put the word reishi into the search bar at the top right of any page, I believe you'll find some experiences, including a woman who said she had found relief from her CH with reishi mushrooms.  I don't know what there is about lion's mane, but I remember a guy who kept trying new things and would often have success followed by disappointment.  I think he took lion's mane during one of those experimental periods.

    • Like 1

  7. This file will give you an overview of how CH is treated. It includes a brief description of the busting protocol (the same description of busting that is under the blue banner on each page, "New Users ..."). https://clusterbusters.org/forums/topic/6213-basic-non-busting-information/

    As Vipul says, oxygen and the D3 regimen are things you should be doing. There are other things described in that file that might also help you (Benadryl, caffeine, higher doses of melatonin, "brain freeze").

    Most of us here are not persuaded that microdosing is an effective way to treat CH -- you probably have to get to some threshold dose for it to be effective. 

    I don't think that the Mirtazipine is likely to have brought on your attacks, but others might have a more informed opinion about that. Some antidepressants will block the effects of busting, but I don't know about Mirtazipine.

    It might not seem much like a happy birthday, but I can say that finding this site with its generous and helpful people is a happy thing for you in the longer run.


    • Like 3

  8. 9 hours ago, kat_92 said:

    I’ve had only mild to intense shaddow pain since July 6th every day. No tearing or nasal congestion. She said that is not distinct characteristics for clusters so she thinks it’s chronic migraines.

    FWIW, I know of a person with CH who has resolved all major attacks through busting, but, like you, has mild to intense shadow pain every day.  No question that what he has is CH, not migraine.

  9. Batch is the man for D.  He is emphatic about his preference: >>The most significant change occurred in July of 2018 with the switch from the oil-based liquid softgel vitamin D3 formulations to the Bio-Tech D3-50 50,000 IU water soluble vitamin D3.  Several of us found it faster acting with a higher bioequivalence in elevating serum 25(OH)D3 than the same dose of the oil-based liquid softgel vitamin D3 formulations. <<  More here: https://clusterbusters.org/forums/topic/6807-new-to-this-forum-–-cast-iron-until-hit-by-ch/?tab=comments#comment-67520

  10. I guess we kind of knew this, but it's still sad to me to see it confirmed.  https://www.docguide.com/phase-3-randomized-placebo-controlled-study-galcanezumab-patients-chronic-cluster-headache-results-3?tsid=5

    Phase 3 randomized, placebo-controlled study of galcanezumab in patients with chronic cluster headache: Results from 3-month double-blind treatment; Dodick D, Goadsby P, Lucas C, Jensen R, Bardos J, Martinez J, Zhou C, Aurora S, Yang J, Conley R, Oakes T; Cephalalgia 333102420905321 (Feb 2020)

    • OBJECTIVE To report efficacy and safety of galcanezumab in adults with chronic cluster headache.

    BACKGROUND Galcanezumab is a humanized monoclonal antibody that binds to calcitonin gene-related peptide and inhibits its biological activity.

    METHODS This study comprised a prospective baseline period, a 12-week double-blind, placebo-controlled treatment period, and a 52-week open-label period. Up to six protocol-specified concomitant preventive medications were allowed if patients were on a stable dose for 2 months prior to the prospective baseline period. Patients were randomized 1:1 to monthly subcutaneous galcanezumab (300 mg) or placebo. The primary endpoint was overall mean change from baseline in weekly attack frequency with galcanezumab compared to placebo. Key secondary endpoints were ≥50% response rate and percentage of patients meeting sustained response. Results from the double-blind treatment period are reported.

    RESULTS A total of 237 patients were randomized and treated (120 placebo; 117 galcanezumab). At baseline, the mean age was 45 years and 63% were using ≥1 preventive drug. The primary endpoint was not met; mean change in weekly attack frequency was -4.6 placebo versus -5.4 galcanezumab ( p  = 0.334). Key secondary endpoints also were not met. Injection site-related treatment-emergent adverse events were more common in the galcanezumab than the placebo group, with significantly more injection site erythema.

    CONCLUSION Treatment with galcanezumab 300 mg did not achieve its primary and key secondary endpoints. This study underscores the potential distinct biology of cCH as well as the significant unmet need for safe, effective, and well-tolerated preventive treatment. The safety profile of galcanezumab in cCH is consistent with that observed in trials of episodic CH and migraine.

    • Like 1

  11. Good for you for making it happen, Luis!!

    At 15 lpm, the E tank has about 45 minutes worth of O2.  Closer to 35 minutes, realistically.  So now might be a good time to try to get a bigger tank, or more E tanks.

  12. Luis,
    You might want to look over the discussion of oxygen here: https://clusterbusters.org/forums/topic/6213-basic-non-busting-information/

    The guy in this youtube video does a good demonstration of a standard breathing strategy, starting at 3:18. http:// https://www.youtube.com/watch?v=PtFHRIQN17s&t=127s   Your mask will not look like his (he is using the one that is made particularly for people with CH), but yours should have a bag on it that fills as you are breathing out and empties as you breathe in. Many people with CH find that it helps them stop the attack faster if they quickly drink some caffeine or an "energy shot" such as 5-Hour Energy as they are starting on the O2.

  13. I have a question.  It says here, "The diagnostic criteria of episodic and chronic cluster headache (cCH) were recently modified." Does anyone know what the modification was?


    Episodic and Chronic Cluster Headache: Differences in Family History, Traumatic Head Injury, and Chronorisk; Barloese M, Beske R, Petersen A, Haddock B, Lund N, Jensen R; Headache (Dec 2019)

    OBJECTIVE AND BACKGROUND The diagnostic criteria of episodic and chronic cluster headache (cCH) were recently modified, yet pathophysiological differences between the two are still unclear. The aim of this cross-sectional study is to identify and characterize other differences between episodic and cCH.

    METHODS Data from a retrospective, questionnaire- and interview-based study were analyzed with a focus on associated factors including traumatic head injury (THI), familial history, and change of phenotype. Attack patterns were analyzed using Gaussian and spectral modeling.

    RESULTS 400 patients and 200 controls participated. A positive family history was more prevalent in chronic than episodic cluster headache (eCH) (34/146 (23%) vs 33/253 (13%), respectively, P = .008). A history of THI was more common in patients than controls (173/400 (43%) vs 51/200 (26%), respectively, P < .0001) and in chronic compared to eCH (77/146 (53%) vs 96/253 (37%), respectively, P = .004). Patients with a positive family history had a unique diurnal attack pattern with twice the risk of nocturnal attacks as patients who did not report family history. Patients reporting phenotype change had a chronobiological fingerprint similar to the phenotype they had experienced a transition into. A higher attack frequency in chronic patients was the only difference in symptom manifestation across all analyzed subgroups of patients.

    CONCLUSIONS cCH is associated with a positive family history and THI. In familial CH, a peak in nocturnal chronorisk may implicate genes involved in diurnal-, sleep- and homeostatic regulation. The stereoty

  14. This study is further evidence for a theory that has been developing for a while.  It is that in people with CH the brain's pain perception mechanisms, which are associated with the hypothalamus, are messed up ("abnormal functioning of the pain control circuitry").


    Altered Hypothalamic Region Covariance in Migraine and Cluster Headache: A Structural MRI Study; Chong C, Aguilar M, Schwedt T; Headache (Jan 2020)

    OBJECTIVES The hypothalamus plays a key role in both migraine and cluster headache (CH). As brain region-to-region structural correlations are believed to reflect structural and functional brain connectivity patterns, we assessed the structural covariance patterns between the volume of the hypothalamic region and vertex-by-vertex measurements of cortical thickness in patients with migraine and in those with CH relative to healthy controls (HC).

    METHODS T1-weighted images were acquired on a 3T MRI scanner for a total of 59 subjects including 18 patients with CH (age: mean = 43.8, SD = 12.4), 19 with migraine (age: mean = 40.1, SD = 12.2), and 22 HCs (age: mean = 39.1, SD = 8.2). Imaging was collected between attacks (migraineurs) and during out-of-bout phases (CH). Data were post-processed using FreeSurfer version 6.0 and within-group correlations between hypothalamic region volume with cortical thickness were explored using a whole-brain vertex-wise linear model approach. Between-group differences in correlation slopes between hypothalamic region volume and vertex-by-vertex measurements of cortical thickness were interrogated using post-hoc comparisons.

    RESULTS There were no significant between-group differences (migraine vs CH; migraine vs HC; or CH vs HC) for age, sex, total brain volume or volume of the left or right hypothalamic region. For each group, there were significant positive correlations (P < .01) between right and left hypothalamic region volumes with cortical thickness measurements. HC had significant positive correlations between hypothalamic region volume and cortical thickness over large portions of the superior and rostral medial frontal, orbitofrontal cortex and rostral anterior cingulate, and smaller clusters in the superior and middle temporal, posterior cingulate, fusiform, and precentral cortex. Post-hoc analysis showed significant differences in covariance patterns in those with migraine and CH relative to HC, with both migraine patients and CH having weaker structural covariance of hypothalamic region volume with frontal and temporal cortical thickness.

    CONCLUSION Recent evidence suggests hypothalamic region connectivity to frontal and temporal areas to be relevant for regulating pain perception. Thus, the diminished structural covariance in migraineurs and CH might suggest abnormal functioning of the pain control circuitry and contribute to mechanisms underlying central sensitization and chronification of pain.

    • Thanks 1

  15. I think 200mcg = 8,000IU.

    Great results! 

    You are strongly urged to take all the cofactors listed in the full D3 regimen, though, or you could start to have some issues from too much D.