Craigo

Dude I tried to do this some time ago to this very song!!! Good choice of song for it man. You'd be able to achieve this with AI somehow if you were open to using it for this - there are some amazing open source generators floating around on Github that I had bookmarked to circle back and look at this again. If you want me to jump on and add this to list of projects I'd be more than happy to investigate for you. Let me know bro!

Fellow Kiwi here. Sorry is the first thing I would say, and dang that it has extended this long, I get you'd be feeling a bit down and like when the heck is this going to come to an end. CHFather is right, oxygen - it's key. Were you able to get the GP to write a letter and refer you to your DHB respiratory team for funded supply? If not - push back on the GP hard. They probably don't know the protocol. If respiratory team denied cover, push back again - ask for a reason in writing from your GP and to see the correspondence (and send it to me so I have it on record along with my own tribulations - I am not going to let this rest, we need change in NZ re access to o2 as it is inconsistent and I believe comes down to lack of education). If you can't get it funded and can afford to pay for it, then it would be worth it - all you need is a letter from your GP (if they won't write it up, tell them to get on the phone to the on-call neurologist and seek their advice, that's what they are supposed to do). Send letter to BOC's medical team and they will setup an account and you can go get oxygen or have delivered. You need the Cluster o2 kit for breathing apparatus. Vitamin D3 regimen. Your doctor can prescribe D3 capsules without testing and they are subsidised, ask for 12x 50,000iu - most GP's will just write it up. You can get the lab test you need by going to lab tests and paying for it. You can get most of the other supplies at at pharmacy less the D3 and K2 (order from iHerb - 7 days its here). It's worth asking your doctor to write up the lab for calcium and PTH and most won't know how to interpret the test so just tell them to make sure it's uploaded to your portal - the D3 regimen quick start guide explains how to navigate this. I can't offer medical advice clearly but you can ask me for my opinion by sending me a message with the lab values and any other questions. Starship gives kids the same amount 5-18yrs 600,000iu as a one time dose, no testing (Stoss protocol) so make what you will of that - I suggest be practical and sensible with supplementing D3 but it's nowhere near as dangerous as some would suggest. Busting - do you have supplies and is it an option for you. I needed to do this during my recent cycle, if you need to discuss, DM me. Verapamil, what dose did they start you on and what formulation, extended or immediate release? How many times a day are you taking it? Did you consider a pred taper to see if that would, cross fingers, disrupt the cycle enough to abort it? Try dropping carbs - I am not saying go carnivore, just as the D3 regimen guide calls for anytime you fall from remission or the D3 base regimen doesn't get you pain free, go keto but include whole foods. Consider adding some of the full monty supplements on top of the standard D3 stack being curcumin, resveratrol, melatonin, quercetin. I realize I have thrown shit at you hoping something might stick, please forgive if you have tried any of these and/or any of what I said has been taken the wrong way. If you just want support - message me. I am sorry again, hopefully you are able to find the tools and support to get out of this cycle. Hang in there.

Not related to smell but there was an anecdotal post on a FB group a couple of days back from someone saying that if in the morning they have a particular song playing in their head over and over again, they are guaranteed to have an attack that evening. What happens beneath our conscious awareness where the central nervous system and layers of the mind communicate is absolutely wild. I would attest to the persons comments around often having a particular song stuck in my head first thing in the morning, much to my wifes displeasure as I crank it out on repeat for several coffee cycles, however I do not have a correlation with attacks the same day. Thank-you for sharing this and I am interested to hear more reports, if they are out there. Congratulations, from another with a history of substance abuse, for closing that chapter and may your future be radiant.

I heard a similar story from a CHer in Canada last week whom once a year picks up everyone’s fav coffee, tea or whatever (he has it written down) along with some deluxe pastries and donuts and puts on a morning tea for his oxygen hero’s at the store. They appreciate it and I know he appreciates their very efficient assistance. Love it.

No, I'm just saying in the years I have helped people around the world with Pete Batcheller's regimen I have found often times they buy a magnesium supplement whereby the 400mg dose is x3 capsules daily, rather than one capsule being 400mg so I considered worth a note - never know whom else may read this, wander over to their supplement box and find - wullah, indeed they had been taking too little. As I found the regimen kept me in remission so long and certainly believe the attacks during this cycle mild to the brain bruising experience of full kip-10's, I decided to throw everything but the kitchen sink so I am on 800mg magnesium per day, one capsule in AM and one with dinner - no stomach upset but also have added inulin as part of an OMG can't believe I found myself in cycle for so long - what can I do to improve my overall health (knowing full well that all the recent literature suggests there is never really a return to normal post an episodic cycle ending). Just to be pain free again anyway - for today, I'll take that. And I wish for you the same streak of luck to continue friend. I'll try and swing back here in a couple months and share with ya'll my updated 25(OH)D, calcium and PTH labs when I get around to taking them. I don't think I want to allow my level to drop to 78ng/mL again, which I'm not attributing to the cause of the cycle (frankly I reackon it was a good dose of life stress in Feb). It was surprising to me that it had dropped that low considering it's only the rare occasion I get lazy and flag the vitamins for the day.

Not a doctor, not medical advice. First, celebrate the win, it’s great to hear you have found it has reduced the intensity of the attacks, hopefully the cycle is short lived. You are correct in principle. With rising 25(OH)D, PTH trends downward due to improved calcium homeostasis however a couple thoughts for you and your lab values. 1. PTH is not a static marker and fluctuates based on circadian rhythm, dietary calcium intake, hydration status, assay variability and even lab timing. I would think a shift from 46 to 55 is fairly small and within normal variability. 2. If dietary calcium is inconsistent or on the lower side, PTH may rise slightly to maintain serum calcium, even in the presence of higher levels of vitamin D. Are you taking a men’s multi with calcium? Any of the doctors at my clinic don’t know much about vitamin D3 apart from that it’s important - they will order the lab tests for me, even right a script for subsidized D3 capsules but I understand they can’t get on board given it isn’t in their practice guidelines. I wouldn’t worry too much about your level, my own would be slightly higher having taken a loading dose with a baseline of 78ng/mL of 800,000iu and anticipate hovering around this level for a wee bit longer (I think I am one week or so out of this unexpected cycle that started mid-March having added MM this time round with success, it seems). Look after your kidneys, hydrate well and ensure you are taking the adequate amount magnesium (often times people miss to get the required magnesium dose often requires 3x capsules per day). Hope it helps, just my 2 cents. PFW - hope cycle ends soon mate. Craig.

Hey Mike, what size tanks do you have and do you have the Cluster O2 Kit for your breathing apparatus? Using that kit and the mouthpiece at 15lpm I am able to abort an attack in about 3-5 minutes, making a point to fully exhale before drawing back the full bag of 02. Once I have aborted the attack I step the reg down to 10lpm, slowing down my breathing but following the same technique and then down to 8 or 6lpm, again using the same technique, in order to conserve oxygen. You may find that others, and I will attest to this myself, say that if you don’t stay on the o2 for a minimum of as long as it took to abort and maybe a few more mins so for me that’s 10-12 mins, then they experience rebound attacks an hour later, staying on the o2 at the lower flow rate may be worth a shot to see if this results in fewer slap backs for you (although I get the feeling of it being counterintuitive as you want to conserve 02 if it’s arduous to replenish or a weekend etc). I also suggest having an easy to use timer, I hate fidgeting with my phone to reset timers during an attack etc, an analog one means I can easily keep an eye on the timer. Is your o2 covered or are you paying for it? I know one or two warriors that have purchased an Invacare o2 concentrator and tank filler unit so they can refill their own tanks and not worry about having to go to suppliers etc, I was and maybe still will consider this. It’s said that the purity is above 90 but less than 100% - from my conversations with those that use it with the Cluster 02 Kit mention it works for them just fine to abort attacks, albeit a bit of a costly setup to get initially. I’m sorry if I missed any other posts but I would ask what preventative meds you are taking? I find the D3 regimen has really helped reduce intensity of the attacks (when it hasn’t kept me pain free completely) and it was originally designed by Batch in an effort to improve his 02 abort times. Hope that helps, we in it together, keep us posted.

Awesome I am happy for you to get pain free and hopefully have broken the cycle. Woohoo. That must feel great! I yearn for the same, I think I’m nearly there with this cycle. For others curious and I am sure it is recorded in other threads on the forum but immediate release melatonin at 10mg before bed has been studied in a small cohort in the 90’s, 10 with and 10 without, of the 10 in the intervention arm, 5 got into remission within a week (all episodic patients). https://pubmed.ncbi.nlm.nih.gov/8933994/ There have been some other case reports of efficacy in chronic CHers as well. Here is a case series of two that was published a few years after the above study and they saw benefit in 48 hours. https://pubmed.ncbi.nlm.nih.gov/11843873/ That being said, a recent thread on Reddit had a similar report of efficacy with melatonin at this dosage but I also noted a number of replies from others that said they found it triggered attacks, so there is that - who knows if those that reported it triggered used immediate release and/or a dose close to 10mg. For the CHer at home considering it, it’s relatively safe - could be something to ask your doctor about. I’d love to see more literature as to its mechanism. I believe whilst it is produced by the pineal gland for sleep, it is also produced directly in mitochondria and scavenges free radicals, up-regulates antioxidant enzymes and stabilizes mitochondrial membranes. Based on a Mendelian randomization study earlier this year which found a number of metabolites elevated in CH patients that showed a causative risk factor for CH, those metabolites are involved in ATP production, both the electron transport chain and the glutathione cycle, and suggests to me that a feature of CH may be disruption / inefficiency in how we produce ATP, the cells energy currency. https://pmc.ncbi.nlm.nih.gov/articles/PMC12988619/ I am curious if this results in a metabolic crisis where, as the body moves from wakefulness into sleep and the energy requirements of cells change, the mitochondria are unable to meet the energy demands for the processes involved in sleep, triggering an attack. I am also curious as to why / how DMT is able to arrest this crisis - is it temporarily boosting ATP production via calcium flux at the endoplasmic reticulum via chaperone receptor S1R - Sigma 1? These are findings they are now investigating in the context of Alzheimer’s. My mind is also curious as to the 2024 thought piece of Jonathan Borkum whom suggests Lee Kudrow's earlier hypothesis of hypoxia in CH may indeed hold some relevance when considered in this context, however as the author suggests, it may not be low oxygen that triggers the crisis (as researchers were able to show and thus the theory was largely left in the 90’s), more rather an issue in the way in which cells sense subtle changes in o2 levels during the sleep / wakefulness cycles and, if I follow his hypothesis correctly, suggests the accumulation of hypoxic inducible factors (HIFs), which are normally continually degraded in the presence of oxygen by enzymes, as somehow being related to this metabolic crisis. https://pubmed.ncbi.nlm.nih.gov/39728749/ There is a PhD that talks about this in a roundabout sort of a way, Chris Masterjohn. Well worth a watch of his presentation on SSRI’s and ATP. Whilst unrelated to CH, many of the aspects touched on above are discussed in more detail in this presentation including melatonin, serotonin, DMT and ATP. He suggests that when we sleep our mitochondrial energy production drops, as does the energy requirements of the cell so that there is always an excess of ATP to meet metabolic demands. https://youtu.be/lkPUHw1oPd8?si=UjadSDEym-V3dAA1 I am sorry I have hijacked this post. Just thought it’d be worth sharing that insight but notwithstanding, long may your remission period continue!

Hi everyone. Dr. Haghdoosts presentation from Sunday evening is below. If you had any questions or insights you'd like to share that may assist in their study design, you'd be welcome to place them as a reply below and I could email them once collated. Thankyou.

Hi guys. A heads up this Sunday I am privileged to host Dr. Faraidoon Haghdoost via live webinar who will share insights from his recent work in cluster headache research. During the session Dr. Haghdoost will discuss his recently published 2026 study exploring patient perspectives of cluster headache in Australia and provide an overview of the upcoming PEACE trial investigating psilocybin based therapy as a potential treatment for cluster headache. This is an opportunity to hear directly from a researcher studying a treatment approach long recognised by our community. Sunday 22 March New Zealand 6:00 PM NZDT Australia 1:00 PM Perth 3:00 PM Brisbane 3:30 PM Adelaide 4:00 PM Sydney / Melbourne / Canberra / Hobart Register and watch live: https://streamyard.com/watch/eRh3FsriH3x7 Pre-read the study being discussed: Patient perspectives on research gaps in cluster headache https://pubmed.ncbi.nlm.nih.gov/41562498/ More about the PEACE Trial (The Psilocybin Efficacy and Acceptability on Cluster headache Episodes) If you have a question you would like Dr. Haghdoost to answer regarding the above, or feedback, he is very receptive to input from the community. Please send your question or feedback to craigedstewart@gmail.com or submit anonymously here: https://forms.gle/k46Vz5CZigTRn8MJ8 and I will make sure he receives these ahead of time so they can be answered during the presentation. I imagine there are hoops and lengths Dr. Haghdoost and his team need to jump through to get studies like this across the line so I am doing this to help raise awareness and hopefully he will be able to recruit enough participants and garner enough insights from our community to give the study the best shot. Everyone is welcome - if you are interested but do not live in Australia or New Zealand and can accommodate the timing, you are welcome to register and join. Also I will try and make sure it is recorded and shared after. Thanks everyone.

@dhuddly and to all reading. After a sleep I feel I overstepped with my comments above so I wanted to offer an apology and make clear that's my stuff, not his and I should have chosen my words better. Sorry Dhuddly, hope you may be able to accept my apology.

I can work with truck driver vocabulary and your grammar isn't that bad. Books and written to be read and videos to be watched, I'd love to check them out, please feel free to drop links here or send me a DM so I can go check them out. I just read The Headache, Tom Zeller Jr, episodic cluster sufferer and it was an absolutely amazing read. Welcome again to the community @dhuddly, if that's what you were after then certainly you are in the right place, there are some phenomenally good people in the cluster headache community, of that I can say for sure - and the reason I reckon I will be back in Chicago come October for this years conference!

Hi @CHfather and @dhuddly. Sorry you find yourself in our company there dhuddly, I haven't been on past couple weeks with some life changes I alluded to above and a number of projects on the go. I would appreciate links to studies you've read, always keen to expand my knowledge of the vitamin D3 literature. Here are the studies and their findings relating to the dopaminergic system in CH published last year for your reading and interest. What I would say above and beyond these studies, the work that has come out over the past number of years in CH space makes it fairly clear that between the active bout periods in episodic CH, the patient does not return to a normal baseline, the attacks may stop but there are perturbations that extend into the interictal periods that give me some level of assurance that I am doing the right thing for myself in terms of staying on the anti-inflammatory regimen 365 days of the year. I also hope that in doing so, I am providing an additional level of protection against developing other disease. I have more recently revisited Dr. Gominak's work (a contributor in part to the regimens inclusion of the B-Vitamins) and believe another reason for the regimens efficacy relates to vitamin D3's influence on the composition of the gut microbiota and the maintenance of epithelial tight junctions. Given nearly every cell expresses the VDR and the lack of formal studies in CH, it would be impossible for us to confirm Pete Batcheller's original hypothesis as to its precise mechanism of action (and as you mention, partial or non-response) but I think he is on the money with the umbrella thinking that it's underlying mechanism is the up and down regulation of genetic products which have the VDR sequence in their promoter / enhancer or silencer regions on DNA. Dysfunctional mesocorticolimbic circuitry in cluster headache. Ferraro et al. (2025) This fMRI study used a "Monetary Incentive Delay" task to probe the mesocorticolimbic dopaminergic pathways. Chronic CH (cCH): Patients exhibited blunted activity in the Ventral Tegmental Area (VTA) - a central dopaminergic hub - during reward anticipation. They also showed an imbalance in the pathway between the VTA and the medial prefrontal cortex (mPFC). Episodic CH (eCH): Patients showed intact VTA responses but abnormal mPFC activity, which the authors suggest may be an early sign of emerging dysfunction in the VTA-mPFC dopaminergic pathway. Conclusion: The study suggests an abnormal dopaminergic state in chronic patients that is distinct from affective disorders (depression/anxiety). Uncovering the neurological substrates underlying restlessness in cluster headache - A functional MRI study Chen et al. (2025) This study investigated the neural correlates of restlessness/agitation, a core clinical feature of CH. Substantia Nigra (SNpc): Patients experiencing restlessness showed increased functional connectivity between the Substantia Nigra pars compacta (SNpc) - a dopamine-producing nucleus - on the pain side and the Locus Coeruleus (noradrenergic) on the non-pain side. Frontal Inhibition: The study found decreased connectivity between the pain-side SNpc and the superior frontal gyrus, suggesting a disruption in top-down inhibitory control contributes to motor restlessness. Neurotransmitter Imbalance in Cluster Headache: A Systematic Review of Mechanisms and Therapeutic Targets Pellesi et al. (2025) This review aggregates data from multiple biochemical studies regarding dopamine levels in CH. Platelet Levels: Citing D'Andrea et al. (2006), the review notes that platelet dopamine levels were significantly higher in patients with episodic CH during both active bouts and remission compared to healthy controls. Plasma Levels: Citing D'Andrea et al. (2017), the review reports that patients with chronic CH exhibited higher plasma levels of dopamine compared to controls. Cerebrospinal Fluid (CSF): Citing Strittmatter et al. (1996), the review notes that CSF levels of dopamine were not significantly different between CH patients and controls, though norepinephrine was reduced. Autonomic dysfunction in patients with episodic cluster headache during remission period López-Bravo et al. (2025), This study summarizes previous biochemical findings in CH. It cites D'Andrea et al. (2017) regarding Abnormal Tyrosine Metabolism: Chronic CH patients show increased levels of dopamine and its precursor tyrosine in plasma. The authors interpret this anomaly in tyrosine metabolism as a potential predisposing factor for the chronification of episodic CH. Thesis: Felicia Jennysdotter Olofsgård (2025) Jennysdotter Olofsgård (Thesis) Genetics: A meta-GWAS identified WNT2 as a new risk locus for Cluster Headache. The author notes that WNT2 is known to be involved in dopaminergic neuronal development. What is seldom discussed in our community is the psychological and personality dimension of CH and how that relates to this topic. Kudrow and Graham were notably candid in the 1970s. I hesitate to be quite so direct, yet many of the personality characteristics they described feel uncomfortably familiar, as though my name might as well have been written beside them. If I may delicately say @dhuddly, from your posts and your manner of written expression, you come across as highly intelligent, thoughtful and kind. You have also mentioned being a full stack developer (I saw that response on a possible CB app - thank-you!), someone your friends describe as operating at extraordinary speed. I want to be clear that I am not attempting to analyse or explain you, rather, those observed qualities deeply resonate with me and provide a useful reference point for describing how I have come to interpret similar tendencies in my own life, over-achievement, high intelligence, tendency to work at a million miles an hour to name but a few. So... here's my story and my take on those qualities in the context of my life journey and CH. My father died before I was born. Throughout childhood I struggled to understand, let alone regulate, the emotions associated with that absence. In adolescence this unresolved grief drifted into substance abuse. Later, the same undercurrent appeared to transform into an intense drive for achievement, knowledge, and ultimately explanation. A life organised around such a pursuit rarely tolerates stillness. Pausing to enjoy simple pleasures can mean confronting emotions one has never properly learned to process. I am still learning how to do that. My sense, shaped by both experience and reading, is that unprocessed anger, grief, and guilt can sustain a chronic autonomic bias toward fight or flight, with downstream effects across our physiology. Viewed through that lens, it is perhaps unsurprising that my nervous system, which has otherwise been remarkably resilient, shows points of vulnerability. I cannot claim definitive evidence that CH, or another unique and uncommon disorder I am afflicted with - vocal cord dysfunction, arises from such experiences. This remains an interpretation, not a conclusion. The closest conceptual framework I have encountered is found in the work of Dr Allan Abbass, particularly his writing on overcoming emotional resistance through Intensive Short Term Psychodynamic Therapy. I feel his work and this topic deserves more discussion, as confronting as these topics can be. Link. Anyway, I pray I have not overstepped and I welcome you here with open arms. I am glad to connect. Craig.

See you there

Faraidoon is the headache researcher whom is leading the Psilocybin Efficacy and Acceptability on Cluster headache Episodes (PEACE) Trial.

Patient perspectives on research gaps in cluster headache Faraidoon Haghdoost, Dilara Bahceci, Candice Delcourt, Tissa Wijeratne, Rigmor H Jensen, Carl Cincinnato, Susan Tomlinson, Bob Wold, Vince Polito, Cheryl Carcel, Usman Ashraf, Bronwyn Jenkins, Anja Sofie Petersen, Jason C Ray, Emmanuelle A D Schindler, Benjamin Tsang, Chris Gianacas, Anthony Rodgers Published in Headache on January 21, 2026 Link: https://doi.org/10.1111/head.70031 Abstract: Objective: This study was undertaken to identify gaps in cluster headache management, highlight patient-prioritized research needs, and assess patient interest in, and preferences for, clinical trial participation.

Most of these studies were posted here on the forum, study by study over the course of 2025. For those wanting to look at some of the studies mentioned they are in my 2025 CH Research Notebook.

2025 Highlights in cluster headache Roemer B. Brandt, Rolf Fronczek Published in Cephalalgia on January 2026 Link: https://doi.org/10.1177/03331024251411870 Abstract: Cluster headache remains enigmatic with a significant unmet treatment need, especially in the chronic form. The steps made in 2025 have taken us further along the road to a true understanding of the still unknown pathophysiology, hopefully leading to a causal treatment.

This is a pretty epic study and I have a lot of questions. I am not even sure I fully understand all of it yet, so I want to check that I am interpreting it correctly. Anyone else have any thoughts, please share. In their bidirectional Mendelian randomization analysis, are they essentially saying that they identified 11 cerebrospinal fluid metabolites that are associated with increased risk of cluster headache, and that among those, three showed the strongest associations, and these key metabolites are involved in pathways linked to mitochondrial energy metabolism and ATP production? Rather than mitochondria in cluster headache fail to produce enough ATP, it appears they are suggesting that ATP production is inefficient and metabolically costly. Do these findings help explain the small ketogenic diet study from 2018, where 11 of 18 refractory chronic cluster headache patients became pain free? There is often discussion about ketone bodies being a more efficient fuel source than glucose metabolism. In the context of this paper, could ketosis be improving ATP yield per unit of oxygen or reducing oxidative and redox burden on already stressed mitochondria, thereby raising the threshold for attack generation? What do these results suggest about the role of the “Full Monty” supplements that are recommended for non-responders to the base Vitamin D regimen? Many of those supplements have antioxidant or reactive oxygen species scavenging properties. Does this metabolite profile support the idea that reducing oxidative stress and the ATP cost of redox maintenance could improve mitochondrial efficiency and help explain why some non-responders improve when these additional supplements are introduced? The paper also references the glutathione cycle. Does the signal around 5-oxoproline and glutathione metabolism suggest that supplementing glutathione might be beneficial in this context? Or is the implication more that excessive glutathione turnover reflects an upstream oxidative burden that needs to be addressed rather than simply supplying more? What do these findings imply about the role of melatonin? Melatonin is synthesized within mitochondria and is known to improve mitochondrial efficiency, reduce oxidative stress, and support electron transport chain function. Could impaired or mistimed melatonin signaling be one of the factors that lowers energetic resilience during vulnerable circadian windows in cluster headache? Finally, do these findings offer any insight into a potential abortive mechanism for DMT? Anyone have any insight in this regard?

NotebookLM Audio Summary. Cluster_Headache_s_Metabolic_Root_Cause_Found.m4a Or just check out the Notebook for yourself. https://notebooklm.google.com/notebook/27364f47-4518-433b-86d9-d3aad07c9f0e?authuser=1

Bidirectional Mendelian Randomization Analysis of 338 Cerebrospinal-Fluid Metabolites and Cluster-Headache Risk Danhua Yu, Xuewei Yang, Jinli Zhou, Weiwei Chen, Jinhui Song, Weifei Yu & Shaokang Huang Published in Journal of Pain Research on January 8, 2026 Link: https://doi.org/10.2147/JPR.S550160 Abstract: Cluster headache (CH) is a rare but highly disabling primary headache disorder characterized by severe unilateral attacks and autonomic symptoms. The metabolic mechanisms underlying CH remain poorly understood. To investigate the potential causal effects of cerebrospinal fluid (CSF) metabolite levels on CH risk, and to explore possible reverse causal effects of CH on CSF metabolites, using a bidirectional Mendelian randomization (MR) approach. We performed a bidirectional two-sample Mendelian randomization (MR) analysis integrating genome-wide association study (GWAS) data for 338 cerebrospinal fluid (CSF) metabolites and CH (1,833 cases and 498,515 controls from FinnGen release 12). Genetic instruments were selected at P < 1×10−5 (LD r2 < 0.01). The primary causal estimates were derived using the inverse-variance weighted (IVW) method under a random-effects model, complemented by MR-Egger, weighted median, and MR-PRESSO sensitivity tests. Multiple testing correction was performed using both Bonferroni and false discovery rate (FDR) approaches. In the forward MR analysis, 11 CSF metabolites were significantly associated with CH risk (P<0.05). The strongest associations were observed for orotate (β = 0.53, 95% CI: 0.23–0.82, P = 0.0006), betaine (β = 0.47, 95% CI: 0.16–0.79, P = 0.0035), and 5-oxoproline (β = 0.57, 95% CI: 0.17–0.97, P = 0.0053). In the reverse MR analysis, eight metabolites, including lysine (β = 0.015, P = 0.029) and kynurenine (β = 0.025, P = 0.020), were nominally associated with genetic liability to CH. Sensitivity analyses showed no evidence of directional pleiotropy or heterogeneity (all P > 0.05). This bidirectional MR study provides the first genetic evidence linking central metabolic alterations to CH susceptibility. While these results highlight potential metabolic biomarkers and mechanistic pathways, the findings remain preliminary due to modest statistical power and should be replicated in larger and ethnically diverse cohorts.

Your post hits me in the feels. It really does. I would say it is changing lives. I have had one of those days, your post is timely and let me be as real as I can with you on what is a topic that lies close to my heart. At least once, more often several times a week, I receive an email from someone who found www.vitamindregimen.com, come across Clusterbusters, a social site or watched one of the interviews with Pete Batcheller on YouTube. They rolled the dice on the regimen and got pain free. They write to say it changed their life. Even one of those emails is enough to justify every hour of advocacy. It’s worth it. I have spent over a decade now reading obsessively on this topic, not just to understand why and how the regimen may work, but to also understand why a percentage of people do not get fully pain free when applying it. Along the way I have interviewed some of the most amazing people in the vitamin D3 research space and with every interview, every study read, every question asked, I feel like I have moved a little closer to an answer and built upon my knowledge of the subject. I am so grateful Pete opened that door for me. That man is a global treasure. It’s also perplexing because this week alone I have seen cluster headache social media channels suggest ginger, purple cabbage, and today, chewing on a lime. I should have become a fruiterer! I understand the premise behind criticism of the regimen or pushing it to the side as a bunch of simple pills. From the outside, a handful of vitamins can look just as batshit crazy as cabbage when stacked against the sheer terror of CH. I get it. That is the real challenge. How do you communicate the regimen in a way that reaches more people, without overclaiming, without slipping into evangelism and without being lumped into the bucket of folk remedies? How do you communicate something that sits uncomfortably between patient-led discovery and clinical blind spots? I may have an opportunity to do more having just resigned my job today with no intention of continuing on the same path / career. 43, soon to be jobless - very tempting to study and see what further value I may add to this important body of work. Never too old right? Absolutely agree with you, happy for you to have found success with it and pleased to see you here on the CB forums!

Dang, darn and I'm sorry you are getting hit despite the comprehensive approach you've got going on there. Quercetin and resveratrol were two of the primary anti-histamine full monty supplements in the regimen that come to mind, I didn't see that you had incorporated. It also suggests to increase the fish oil dosage. Just listing the items from the QSG below along with the suggested dosages. Primary Antihistamine Supplements A. 1 to 2 Grams/day Turmeric (Curcumin) with Piperine B. 1 to 2 Grams/day Quercetin C. 1 to 2 Grams/day Resveratrol D. 8 Grams/day vitamin C Optional As Needed E. 2 Grams/day Omega-3 Fish Oil (EPA and DHA) F. 250 mcg/day Selenium G. 1000 mg/day N-Acetyl Cysteine (NAC) H. 5 to 10 mg/day Melatonin (Taken at bedtime) I. 200 to 500 mg/day CoQ10 J. 50 mg Zinc Picolinate* K. Diamine Oxidase (DO)** 4 mg 2 to 3 times/day with meals Have you considered putting yourself into nutritional ketosis? In terms of a dietary measure that has some reports in chronic CH albeit was a small cohort 11 of 15 got pain free, the regimen quick start guide recommends it. I take it you have the quick start guide handy, if not it is here. There may be some relevant information there (page 12 onwards describes falling from remission / non-response to regimen). Other reports of nutraceuticals include thiamine which I had seen a few reports recently on Reddit threads of people reporting success but only a single case report in literature using 750mg (tapered). There is busting... a topic well covered on the forums, if an option for you? You probably already know you've got some medication options but just putting it out there, perhaps a short steroid course would be enough to disrupt the cycle and for it not to return after the taper? This was my go to for the first couple of years with the regimen (having not stayed on maintenance thereafter all year round). Or another poster pointed out a monoclonal antibody, there's also verapamil etc. Nothing it seems works for everyone but while you are throwing everything but the kitchen sink at it already I could only but list the options... I've only been in your position once before and at a baseline 100ng/mL and getting hit with attacks. I did another 600,000iu loading dose, all of the full monty supplements (less the melatonin), did NOT do keto and found myself pain free 4 days later - I realize I am lucky. I finished the load and dropped to 20,000iu maintenance for remainder cycle, level increased to 180ng/mL, calcium was okay - understandably becomes a bit nerve racking at these levels. Pete's labs in the guide show he has been higher than this previously - obviously none of us can flat out recommend you do that. Good luck I am sorry again you find yourself in that spot. XXX isn't too frequent here these days, if you DM me I am happy to share his email address should you want to drop him a line - hint, it's also listed on the bottom of the full reference guide.

Advancements in Intranasal Delivery of Drugs for Cluster Headache Treatment using Cubosome-Based Nanocarriers: A Review Preeti Chaudhary, Kirtan Vimal Shah, Darshan Rajendra Bodas, Sanjana Prasad Deshmukh, Akash Milind Solanki Published in Research Journal of Pharmacy and Technology on December 1, 2025 Link: https://doi.org/10.52711/0974-360X.2025.00887 Abstract: Cluster headaches (CH) represent a debilitating neurological disorder characterized by severe, recurrent attacks of pain, often leading to significant impairment in quality of life. Traditional treatments often face issues like delayed onset of action, systemic side effects, and challenges in achieving optimal drug concentrations at the target site. Intranasal drug delivery has emerged as a promising alternative for the management of cluster headaches due to its potential for rapid absorption and direct access to the central nervous system. Among the novel strategies under investigation, cubosome-based nanocarriers have gained significant attention due to their unique structural properties, biocompatibility, and ability to encapsulate a wide range of therapeutic agents. This review highlights recent advancements in intranasal delivery systems, focusing on cubosome-based nanocarriers for the treatment of cluster headaches. It explores the physicochemical characteristics of cubosomes that make them ideal for intranasal administration, including their high surface area, mucoadhesive properties, and ability to enhance drug stability and bioavailability. The review also examines the potential of cubosome-encapsulated verapamil, a calcium channel blocker, as a promising candidate for rapid and effective cluster headache relief. Furthermore, it addresses the challenges and future perspectives in the development and clinical translation of cubosome-based intranasal therapies. By synthesizing current research findings, this review aims to provide insights into the potential of cubosome-based nanocarriers as a transformative approach in the treatment of cluster headaches, paving the way for more effective, patient-friendly therapeutic options.

HNY and right on Jon, exactly - CH is pretty much a stress-test for Helsinki and CIOMS. I can only imagine the complexities of designing CH studies that advance knowledge but always place the well-being of the study participant first, let alone sitting on the ethics committees that have to review and approve them. Check out the below, part 33. World Medical Association Declaration of Helsinki Ethical Principles for Medical Research Involving Human Subjects https://jamanetwork.com/journals/jama/fullarticle/1760318 And the Council for International Organizations of Medical Sciences, guideline 5. https://www.ncbi.nlm.nih.gov/books/NBK614415/ I saw a few posts on socials in recent weeks venting that there isn't enough research on CH and I get it but I also want to acknowledge that like the lead author of this study, we have some amazing researchers in our corner and I am so thankful for that as well as excited to see what happens in 2026. I feel we saw some real advancement in our understanding in 2025. Thank-you for bringing up this very relevant point.