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Thank you so much I appreciate the d3 recommendation. I’ve been through 2 numerologists and they refuse to give me O2. All I have to fight the beast is Verapamil (2x) A day, lisinopril , and Sumatriptan 100mg. I am currently looking for a nuero that specializes in headaches maybe I’ll have better luck getting O2 or triptan shots. I had to stop taking sumatriptan so much because my body was giving symptoms of a heart attack, but sumatriptan is a double edge sword. The 2 hours of sleep a day is really killing me , I work nights so sleep during the day is a challenge as is, but adding the headaches is just the cherry on top. I have heard that CBD oil and other “drugs” can help with both the pain and ramp up but I don’t have that option my job has me drug tested under federal so that option is a no for me.Thank you For the reassurance I feel less embarrassed about posting on the forums now!

Started the D3 regiment this morning with the verapamil (40 mg x6) and Depakote (250 mg x2). I noticed that the fish oil was a little tough on my stomach, but I'll be better about eating more food. It's honestly hard to eat as much as I feel I need to consume to support this dosage of pills, vitamins, etc... Also working on finding a new neurologist - and more immediately - a script for O2. I bought a can of the boost oxygen from amazon which I imagine will do little, if anything.. But at this point I'm willing to try anything. I'll take your suggestion ChFather, regardless of its effectiveness. Thank you for the suggestion on other ways to get by without O2 - starting to incorporate those into the regiment. I am also identifying new triggers all the time. Perhaps the most consistent trigger - or perhaps more appropriately signal - for me has been extreme neck stiffness. When my neck begins to seize up, I know that a cluster is soon to follow. I also get ear pain, almost like a bad ear ache, when one is on the way.

Ok, I’ll wait for Batch’s responses. Been feeling better and better every day anyways. Taking melatonin and the on day 11 of Vitamin regimen. Some people also had luck with CBD oil so we’ll see. Maybe I can try the indomethacin per the doctors orders, just to confirm it is indeed this. I don’t believe it’s the Continua version because I’m only getting them in bouts of about 4-6 weeks.

I’ve been suffering for the past month or so from a particularly horrible cluster headache cycle and feel completely and utterly drained - emotionally, physically, and mentally. Feeling pretty alone and hopeless. I was diagnosed with episodic cluster headaches my sophomore year in college - little over five years ago - after I experienced a headache I thought would kill me. Ever since then, I have struggled with managing them. Typically once or twice a year I get a cycle, and it lasts for 3-6 weeks. This year, I had a cycle in January and again, most recently, for most of September and all of October. My cycles don’t seem to be linked to any season - I’ve gotten them at all times of the year, in all different places of the globe. The current cycle brings headaches at all times of day - when I sleep and sometimes randomly during the day, like earlier today. I’m on a lot of drugs now which leave me feeling lethargic, dizzy, tired, and sluggish - sumatriptan as needed (100mg pill), verapamil (x6), prednisone (a massive taper), depakote (x2). I also take CBD oil and some “preventatives” such as melatonin, vitamin b2, and magnesium, which I read could be helpful. I’ve also tried acupuncture and other “interventions” as well. The verapamil appeared to work earlier in January, but it isn’t working now, despite an increase in dosage (I now take 6 pills a day vs 2). The sumatriptan can help me get through a night, usually, but I’m limited in how many I have which is a constant source of stress. It also seems to never work fast enough.. As for the other medications listed - Nothing else I take seems to work. Not as far as I can tell, anyways. I’m struggling to deal with the pain. It’s impacting every aspect of my personal and professional life, and I don’t know what treatment I should go to next. Just would be grateful for a friend and some advice. -Blair

Sounds like a good plan you have. I have had and read of people having a reaction to the fillers in some meds. Like a name brand will have Y fillers and the generic will have X fillers. So, some people can take one and not the other. So, you might consider a different multi. Just a thought if changing the fish oil does not solve the issue. Are you taking the Benadryl? Batch is indeed not getting PM's at this point. Not sure why. But, he is very devoted to helping all and will show up when he is available. He never has let anyone down who PMed him to my knowledge. But at the moment that is not an available route to follow. We will wait to see if CHF's mail got to Batch.

Thank you Spiny, and no I am not using the ‘burpless’ one. I think I may actually be getting nauseous from the multivitamin, so it’s going to be a little bit of trial and error to figure that out. Today, I took 10000IUs of the D3, Magnesium and the multivitamin with breakfast and only had about 10 mins of nausea. Going to take the rest with dinner and see if the fish oil is the culprit.

Ilya the vitamins will be a big help. As you know, your D is in the trash and really needs to come up! And I share the Equinox date with you! Many start a cycle at that time of year. Sucks, but at least you have an idea of when it is coming and can prepare to battle if needed! Let us know how breaking them up worked for you! Oh, are you using 'burpless' fish oil? I could not stand the other one. Going 'burpless' helped me a lot. I'll see if I can reach Batch too.

I dont take the fish oil, Just D3 and Vik K part. I do use benadryl 50 mg at night. I imagine Batch gets pounded with questions and comments. The summary of his protocol is available as a pinned post. The fish oil can cause some reflux so taking it with some food may help.

Good to know, I may give that a shot. What did you do to mitigate the nausea with the fish oil? Also I should mention I have allergies, but have been doing the immunotherapy shots for over a year so I don’t know if those are a factor. I’ve read Batch’s responses about taking Benadryl to prevent the histamine reaction. Does he need to be tagged or something to respond?

Personally I found the fish oil to generate nausea. The volume of pills may be contributing to the nausea as well rather than the specific substance. Try dividing the doses instead of taking all at once to see what you might be sensitive to. I would defer to Batch for final suggestions as this is his baby.

Hey Everyone, I'm pretty new to the community - started getting clusters last year, early September. And as all of you, thought they were sinus-related or something else so I had an MRI and CT scan, and everything came back normal. Last year my cycle started and ended earlier. This year it came back around September 22nd. So I started off by seeing my PC doctor. I happened to get my 25 (OH) D tested and it was 23.6 ng/ml. After that I went to see a few neurologists, some thought it was a migraine but most thought it was cluster headaches due to the cyclical nature of the headaches, the location of the pain, and the fact that it was unilateral 95% of the time. I did further research and started reading about the side-effects of CGRPS, Verapamil and other preventative measures and realized those were not for me. I was also placed on a 5 day steroid course which reduced the severity of the attacks and the frequency, but nonetheless they are still happening. My research further lead me to try the D3 loading regimen, with the approval of a few doctors of course. And this is what I have done so far: 10/8/19 - 10/14/19: I did 10k IUs of the D3 along with all the cofactors 10/15/19: I did 20k IUs of the D3 along with all the cofactors 10/16/19: 50k IUs along with all the cofactors 10/17/19: 20k IUs along with all the cofactors I know that this isn't exactly how the loading schedule should be done, but I was scared of taking everything at once so fast. Lately I have been doing the 20k IUs/day and I have been feeling a bit nauseated and dehydrated, so my questions are: How can I reduce this nauseating and dehydrated feeling? Why are the cofactors all necessary even during maintenance periods? Has anyone tried going off of them to any success? Are they purely for absorption? If someone could get Batch involved, he has been a lifesaver thus far and his input would be invaluable. Vitamins taken are: Kirkland Multimitamin, Pure D3 (5000 IU), Magnesium Calcium & Zinc from Walgreen, and a fish oil supplement from Trader Joes Best, Ilya

Hey Bridge, Interesting observation and great question. Over the last 9 years providing outreach on the benefits of vitamin D3 at a minimum of 10,000 IU/day plus Omega-3 fish oil and the vitamin D3 cofactors as an effective CH preventative, we've discovered situations similar to yours. We've found that infections (viral, bacterial and fungal), allergic reactions, trauma and surgery all contribute to an increase in the frequency, severity and duration of CH even when taking vitamin D3 at a dose of 10,000 IU/day. Digging into the causality, it appears that any medical condition that triggers inflammation and activates the immune system, consumes serum 25-Hydroxy Vitamin D3 [25(OH)D3] rapidly frequently leaving too little serum 25(OH)D to prevent CH. The best course of action for bacterial infections is to take an antibiotic. The big problem in doing this is nearly all antibiotics are indiscriminate, so kill off the friendly colonies of bacteria living in our GI tract called the microbiome. As the microbiome plays a key roll in our immune system, keeping it healthy is important. Accordingly, we've found that it's best to start a course of probiotic ASAP after treatment with the antibiotic is complete. We've also found that increasing the vitamin D3 dose in a range from 15,000 IU/day up to 25,000 IU/day elevates serum 25(OH)D sufficiently to counter most viral infections. 6 to 8 grams a day of vitamin C is also helpful in combating viral, bacterial and fungal infections. Hope this helps explain your observation. Take care and please keep us posted V/R, Batch

Okay thank you! I just received the rest of the supplements in the mail. I unfortunately already have the oil based d3 so I will be using that. Can I take the loading dose of d3 with simply the multi vitamin as an appropriate amount of calcium? Or should I be taking pure calcium during the loading dose? Kat

Hey Kat, I'll echo CHfather's comment to start the anti-inflammatory regimen now. You'll need a round of labs for your serum 25(OH)D, calcium and PTH after 30 days on this regimen anyway. We can reverse engineer your 25(OH)D3 results to come up with an estimate of your starting concentration. I'm in the process of updating the posted version of this treatment protocol on my webpage at VitaminDWiki at the following link with a change in the suggested type/brand of vitamin D3 from the oil-based liquid softgel 5,000 IU vitamin D3 formulations to the Bio-Tech D3-50 50,000 IU water soluble vitamin D3 capsules. http://www.vitamindwiki.com/tiki-download_wiki_attachment.php?attId=7708 I and many other CHers have found the Bio-Tech D3-50 to be faster acting with a higher bioequivalence than the liquid softgel formulations at the same dose. What this means is more CHers respond faster to this treatment protocol. The following photo illustrates the supplements I take. You can order these supplements from amazon.com and iherb.com whichever has the best price. I'd like to point out that at 22 cents per capsule taken once a week, the cost of this form of vitamin D3 is ~ 3 cents/day. Two of the 5,000 IU liquid softgels cost 12 cents a day. Dosing with the Bio-Tech D3-50 is different when it comes to the maintenance dose. I've been taking one (1) of the Bio-Tech D3-50 capsules a week. I think this is a good starting maintenance dose after the 12-Day accelerated vitamin D3 loading schedule illustrated in the following notional graphic. As you can see, the 12-Day vitamin D3 loading schedule at 50,000 IU/day for 12 days elevates serum 25(OH)D far more rapidly than just taking a maintenance dose of 10,000 IU/day which can take a month or more to elevate your 25(OH)D to a therapeutic level capable of preventing your CH. Taking the 12-Day accelerated loading schedule means you elevate your serum 25(OH)D to a therapeutic level faster for the expected reduction in CH frequency or complete cessation of CH symptoms. You may need to lower the vitamin D3 maintenance dose following the 30 day labs by adding an additional day or more between doses from one 50,000 IU capsule a week to one capsule every 8, 9 or 10 days. The key is frequent lab tests until you reach a stable dose and 25(OH)D response as you'll see in the following charts of my labs for 25(OH)D, calcium and PTH over the last 3 years. My PCP has no problems with my 25(OH)D3 concentrations this high as long as my serum calcium remains within its normal reference range. As you can see, it has. It's normal for PTH to be at the low end of its normal reference range when serum 25(OH)D is above 100 ng/mL. What you need to avoid is taking the PTH to zero by pushing your 25(OH)D too high like > 190 ng/mL. Like anything else, if the parathyroid glands sense there's no need to produce the PTH, they will eventually stop expressing this hormone and that would not be good. Regarding the efficacy of this regimen in preventing the other TACs, I don't have any concrete data. That said, as these TACs share much of the same pathogenesis with Calcitonin Gene-Related Peptide (CGRP) and Substance P (SP) playing major roles in neurogenic inflammation and nociception (pain) common to All TACs including CH, it's not unreasonable to expect vitamin D3 and its cofactors will help lower the frequency, severity and duration of the other TACs like it does for CH by down-regulating the expression of these two neuroactive peptides. There's really no harm in trying. Regarding the anti-inflammatory regimen acting as a CH abortive, it's really a matter of response times. We expect abortives like subcutaneous sumatriptan succinate to abort a CH in a matter of 5 to 10 minutes and nasal spray of same in 10 to 20 minutes. A single oral dose of 50,000 IU of vitamin D3 can produce a marked reduction in CH frequency in as little as 12 hours so it's more a preventative than abortive. That said, several of us are working on an inhaled formulation of micellized (water soluble) vitamin D3 nano mist or nasal spray as a potential abortive. It's too soon to tell, but I suspect this method of administration will be faster acting in terms of reducing CH frequency and possibly aborting CH. I hope this covers your questions. Please keep us posted as you start this regimen. Take care, V/R, Batch

The last few weeks have been interesting for me and I just wanted to tell everyone what has been going on. I have been on Batches D3 for a long time now and I think I found my sweet spot towards the end of last month. I take everything on the list and had just upped the vitamin D 20,000 a day. I was down to 1 or 2 low level attacks a day. I had a doctors appointment on the 26th of July to go over my hip replacement and was told to stop taking the fish oil and vitamin K. 4 days later the clusters stopped.. Totally, no shadows, no pressure no nothing just pain free days. On August 5th I went in for the hip replacement crapping my pants that I was going to be hit non stop all day. To my surprise I did not have any clusters at all. I was told after surgery that I needed to stop the rest of the D3 vitamins because of blood clotting issues. I am allowed to take my Verapamil and they added a baby aspirin twice a day. On the 7th I had my first twinge of a cluster comin on so I grabbed my O2 and downed a 5hr energy drink, 10 minutes later it was gone. I was thinking maybe it was all in my mind and I would be fine.. Well every day since I have had 3 Clusters a day, low level pain and the longest one was only 30 minutes but they are coming back and getting stronger with every hit. The hip is doing fine other then the big bruise that feels like I was kicked in the thigh by a horse and I am limping around nicely. I was also told to stop smoking a week before the replacement and continue for 6 weeks after surgery. I was smoking 6 or 7 cigarillos a day and yesterday started back on that but only 1 a day so far. My question is this.. At what point do you think I can get back on the full vitamin D? I think this is what had me pain free for the few days around surgery, Do I take everything except the fish oil and K or do I take it all? Are the few clusters I am now getting due to the interrupted sleep and less stress of the surgery? I know nobody have a solid answer and no two people are the same but maybe someone has had a issue like this before. Any help, criticism or recommendations are welcome.

Hey RSG, CH Father gave you the right link for the anti-inflammatory regimen treatment protocol at http://www.vitamindwiki.com/tiki-download_wiki_attachment.php?attId=7708 I've made a couple changes since I posted that 2017 version. In July of 2018, I switched brands and type of vitamin D3 from the Nature's Bounty oil-based 5000 IU liquid softgels to the Bio-Tech D3-50 50,000 IU water soluble (micellized) vitamin D3. I've found the Bio-Tech D3-50 to be faster acting and more potent in elevating serum 25(OH)D than the oil-based formulations. Data from the online survey of CHers taking this regimen now supports a longer accelerated vitamin D3 loading schedule from 12-Days at 50,000 IU/day vitamin D3 to 14-Days at 50,000 IU/day. This change increases the total loading dose of vitamin D3 from 600,000 IU to 700,000 IU spread over 14 days at 50,000 IU/day for episodic CHers and 16 days for chronic CHers. This also results in a new initial target serum concentration from 80 ng/mL to 90 ng/mL for episodic CHers and from 80 ng/mL to 100 ng/mL for chronic CHers. The initial vitamin D3 maintenance dose of vitamin D3 is now 15,000 IU/day. These loading schedules and maintenance doses apply to the oil-based liquid softgel vitamin D3 formulations, If you follow my lead and that of several other CHers who switched to the Bio-Tech D3-50 50,000 IU vitamin D3 capsules as I have, the loading and maintenance doses will be different as follows. If you're an episodic CHer start this regimen with the 12-Day loading schedule at 50,000 IU/day (one of the Bio-Tech D3-50 capsules a day for 12 days) then fall back to a new initial maintenance dose with the Bio-Tech D3-50 of one (1) capsule a week. If you're a chronic CHer, start this regimen with a 14-Day accelerated vitamin D3 loading schedule (one of the Bio-Tech D3-50 capsules a day for 14 days) then fall back to a new initial maintenance dose with the Bio-Tech D3-50 of one (1) capsule a week. If you do the math, 50,000 IU divided by 7 days comes to roughly 7,000 IU/day as the maintenance dose with the Bio-Tech D3-50. Due to the increased potency of the Bio-Tech D3-50 compared to the oil-based liquid softgel vitamin D3 formulations at the same dose, this equates to an equivalent of 15,000 IU/day of the liquid softgel vitamin D3 formulations. With either type of vitamin D3, if you haven't experienced a favorable response or complete cessation of CH symptoms by the end of the loading cycle, increase the loading period by two days at 50,000 IU/day for two days then drop back to the maintenance dose. If there's still no response, within three days of the additional loading doses, you may be experiencing an allergic reaction to airborne of food borne allergens. These allergic reactions can be subclinical with no outward or obvious symptoms. In this case, start a week to 10-day course of a first-generation antihistamine like Benadryl (Diphenhydramine HCL) at 25 mg every four hours throughout the day. Just be careful and not drive as this much Diphenhydramine will make you drowsy. If you need to drive during the day, wait until you're home for the day then take 50 mg of Benadryl as you walk through the door, and another 50 mg at bedtime. If there's no response to the Benadryl after five days, discontinue as an allergy is not the likely culprit preventing a favorable response to this regimen. It's important to take all of the vitamin D3 cofactors and conutrients illustrated in the following photo. In particular, it's best to double the magnesium dose from 400 mg/day to 800 mg/day while loading vitamin D3. Take 400 mg of magnesium in the morning with breakfast and the other 400 mg in the evening with dinner. Doing this will help avoid osmotic diarrhea. The Kirkland brand Adult 50+ Mature Multi is also very important as it's formulated with most of the vitamin D3 cofactors. It just doesn't have enough magnesium or any vitamin K2 complex (MK4 and MK7). At 22 cents per capsule taken at a maintenance dose of one (1) capsule a week, the Bio-Tech D3-50 is also the least expensive form of vitamin D3 at 3 cents/day. The Nature's Bounty has a price of 6 cents per 5000 IU vitamin D3 liquid softgel or 12 cents/day for the 10,000 IU maintenance dose. It is very important to see your PCP/GP or neurologist for lab tests of your serum 25(OH)D, calcium and PTH 30 days after start of regimen. As long as you're CH pain free or have experienced a significant reduction in the frequency of your CH and your serum calcium concentration is within its normal reference range, your actual 25(OH)D serum concentration doesn't really matter. Hope all this makes sense. I'll be publishing a revised version of this treatment protocol on VitaminDWiki as soon as a few key vitamin D3 experts and physicians have had an opportunity to comment on the new protocol. Take care and please keep us posted. V/R, Batch

Can someone call CBD oil as a drug?

I've had almost the same issues you had, and I also quit smoking weed, and one of the reason why - because a friend of mine recommended me a great alternative which is CBD products. I've found a great producer (here it is: Link removed by admin), that makes this stuff for a long time. From now on, the main question for me, is cbd oil safe enough? I heard that they make even dog food from it.

Funny, I just did a google search and found almost that exact same issue. J DON'T MIX OXYGEN AND OIL-1.pdf

Well I'm now on Day 6 of the Vit D Regimen. I began with only 40,000IU of Vit D/day along with 400mg Magnesium, 1200mg. fish oil (still waiting on Multi-vitamin delivery). CH episodes yesterday where confined to only 4 KP-1's compared to for example 10 visits ranging from KP-4 thru 6. Last night was the first evening and early morning hours that I did not have any episodes. What a relief after a 2 1/2 month ordeal. I'm praying for this relief to continue on so I can get back into my normal retirement regime and get back to my pilate classes, which I miss immensely. The reason I began on only 40,000IU of Vit D daily was because I had not had my blood tested previously. I'll make a phone call today and get that scheduled. Have a great day and thank you so much. Jeff

@ClusterSwarm, don't take it too personally. You don't know what other people went through, what they tried and how much snake oil they been fed over the years. It's only natural that people are touchy about the language used to describe their condition and treatment prospects. There's a huge difference between saying "it works" and "it works for me". I'm also new here, but I', a "Veteran" at clusterheadaches.com, and flaming of newbies with revelations is as old sport. Take care.

So bottom line is, if he’s been taking 15-20k a day of the oil based switching him to the biotec will have a marked improvement in raising his 25(OH)D. I know his primary care doc won’t be happy pushing his D over 100ng/mL. But I’d like to get him as high as possible with out ruffelling feathers. Then presenting this info plus what I get at the conference to his rheumatologist. Dad takes a whole slew of supplements every day but I have to go through them and see if I can get him to add what ever cofactors he’s missing. I know he needs the Kirkland multi w boron. He’s not taking a multi... I’m going to do my best, he can be a bit stubborn... my sister suffers from RA even worse and I’m going to see if she will try it... thanks @Batch

Freud, Providing information outreach on RA is a little out of my comfort zone... That said, as it falls in the autoimmune category, RA should respond to vitamin D3 therapy. The only question is how high to take the vitamin D3 dose/25(OH)D response, how much the cofactors need to be increased and any additional conutrients specific to RA that may be needed. The anti-inflammatory regimen is a good place to start, but the target 25(OH)D may be well North of 120 ng/mL, like 180 ng/mL for RA. I say this as I've been there at 188 ng/mL and it depressed my PTH as expected which is good. The only issue is being careful not to depress PTH to zero as we need the parathyroids to continue functioning and not shutdown. The reason for this is simple, we need PTH to maintain calcium homeostasis that maintains serum calcium within its normal reference range. In this case, I pushed my PTH down to 10 pg/mL when the normal reference range is 14 to 64 pg/mL as you'll see in my lab results. This is no different than taking prednisone at too high a dose for too long. The adrenal glands produce the steroids aldosterone and cortisol that are essential for normal healthy physiology. If we take too much prednisone for too long, the adrenals say WTF. Why should I make aldosterone and cortisol when there's so much prednisone floating around... so they shut down. That poses a big problem when you stop taking prednisone and the reason why it is absolutely essential to taper off steroids gradually or only take steroids in short burst doses or week to 10-day tapers. I'm a pragmatist when it comes to preventing CH with vitamin D3 therapy... The expected result of taking the anti-inflammatory regimen is a CH pain free response. Accordingly, I take as much vitamin D3 as needed to stop my CH. This allows me to maintain a very good quality of life, in excellent health, free of terrible CH pain. My lab results for 25(OH)D, calcium and PTH in the following chart are a good example. On the 1st of March, 2018, I increased my vitamin D3 dose to 40,000 IU/day in anticipation of a heavy Alder tree pollen fall in April. On 20 March I had my labs done and my 25(OH)D was 188 ng/mL. As I was CH pain free I dropped the dose to 25,000 IU/day. As you can see, my serum calcium was still within its normal reference range and PTH was low. In early June, I suffered a major insult from mold spores that triggered an onerous allergic reaction (allergic rhinitis) with a flood of histamine. Histamine can make nearly every CH intervention ineffective... so the CH beast jumped ugly. An electrician had ripped out wall board to replace a 50-year-old fuse box in the house in Pelican, AK were we stay while salmon fishing each summer. Unbeknownst to me, there was a half-inch layer of mold in the wall space from years of roof leaks. Within 24 hours of the electrician's work, the stirred up mold spores had the CH beast jumping ugly at night for the first time in many years. Two days of vitamin D3 at 50,000 IU/day and 25 mg of Benadryl (Diphenhydramine HCL) every four hours had no effect. Fortunately, I had welder's oxygen available and I made a couple of my Redneck oxygen reservoir bags out of clean kitchen trash bags, so the CH hits were more of an annoyance that anything else. However, as we were getting up around 04:30 each morning to get an early start fishing, the lack of sleep had me on edge. Rather than trying to sneak up on a therapeutic response taking loading doses of 50,000 IU/day, I took 100,000 IU/day for two days. The night after the second dose of 100,000 IU/day vitamin D3, I slept CH pain free so I dropped the vitamin D3 dose back to 40,000 IU/day for the rest of my two-week stay in Pelican. I estimate my serum 25(OH)D concentration was around 175 ng/mL in June when the CH beast jumped ugly due to the allergic reaction to the mold spores. That should give you an idea how bad an allergic reaction can be to a CHer. On 1 July 2018, I switched to the Bio-Tech D3-50 50,000 IU water soluble (micellized) form of vitamin D3 taking one of the Bio-Tech D3-50 capsules every 5 days (120 hours) for an average daily dose of 10,000 IU/day. When I had my next set of labs on 12 October 2018, I expected my 25(OH)D serum concentration would have dropped from 188 ng/mL to at least 170 ng/mL. When it came back at 181 ng/mL, I was a bit surprised. As I was blissfully CH pain free, I decided it was time for one of by 25(OH)D burn down tests so stopped taking any supplemental vitamin D3, but I continued taking all the cofactors and conutrients. My 25(OH)D serum concentration was 136 ng/mL at my next set of labs on 14 January 2019, 95 days later, for a monthly 25(OH)D burn rate of 14.2 ng/mL.. As I was still CH pain free, I decided to try taking one Bio-Tech D3-50 water soluble capsules a week for an average daily vitamin D3 intake of 7,142 ng/day. At my next set of labs a little over 3 months later on 26 April 2019, the results came back at 152 ng/mL, so it was very clear the Bio-Tech D3-50 was more potent in terms of elevating/maintaining 25(OH)D serum concentration at the same dose as the oil-based liquid softgel vitamin D3 formulations. I'll cover a lot more about this regimen at the Patient Conference in Dallas. Looking forward to seeing all of you there. V/R, Batch

Hey DM, How much vitamin D3 have you been taking as a maintenance dose? As you'll see in the following graphic a 25(OH)D response of 70 to 74.6 ng/mL is within the average response range for a vitamin D3 maintenance dose of 10,000 IU/day. The 25(OH)D response to dose of 10,000 IU/day vitamin D3 is illustrated in the following graphic of 25(OH)D lab results from the online survey of 257 CHers taking this regimen. It's displayed as normal distribution. If you're still getting hit by CH at this dose, follow the treatment protocol as it says to titrate (incrementally increase) the vitamin D3 dose until you reach a CH pain free status. Rationale: 10,000 IU/day vitamin D3 is sufficient for 80% of CHes in preventing their CH. The other 20% need a higher vitamin D3 dose or they've an infection or allergy cooking away. Infections and allergies consume available vitamin D3 rapidly. This could be the culprit keeping this regimen from preventing your CH. As suggested, taking Benadryl (Diphenhydramine), an antihistamine, can help in some cases if an allergy is the problem. Getting back to the need for a higher serum 25(OH)D concentration and titration... The fastest way to titrate the vitamin D3 dose is with two to four days at a loading dose of 50,000 IU/day then fall back to a maintenance dose of 15,000 IU/day. If there's no joy after two to three days at the new maintenance dose, repeat the loading dose for two more days then drop back to a maintenance dose of 20,000 IU/day. Feedback from several CHers who started taking the Bio-Tech D3-50 50,000 IU water soluble (micellized) form of vitamin D3 indicate this form of vitamin D3 is faster acting and more effective in preventing CH than the oil-based liquid softgel vitamin D3 formulations... Bottom line, it may help you arrive at a CH pain free status by switching to the Bio-Tech D3-50. I've been taking it since July of last year at a dose of one (1) Bio-Tech D3-50 capsule a week. This has maintained my 25(OH)D up around 150 ng/mL. The response rate to this regimen reported by CHers taking the online survey during the first 6 months of 2019 has been impressive. 90% of CHers starting this regimen are experiencing a significant reduction in the frequency of their CH in the first 30 days. If this increase in efficacy from 80% to 90% continues, I'm of the opinion it's the Bio-Tech D3-50 that's responsible. Take care and please keep us posted. V/R, Batch

Hey Cocobongo, The photos below illustrate the brands and doses of the anti-inflammatory regimen vitamin D3 cofactors I've taken for nearly 8 years. I'm a chronic CHer and this regimen has kept me CH pain free since I started it in October of 2010. I estimate over 2000 CHers are now taking this regimen. I switched from the Calcium - Magnesium formulation to the Costco Kirkand brand Adult 50+ Mature Multi in 2011. This mature multi is important as it contains nearly all the essential vitamin D3 cofactors. It just doesn't have enough magnesium or any vitamin K2 complex. Readers of my web page at the VitaminDWik link http://is.gd/clustervitd have downloaded 26,445 copies of the anti-inflammatory regimen treatment protocol titled CH Preventative Treatment Protocol for Neurologists - Jan 2017.pdf since I put it up online 21 Jan, 2017. In June of 2018, I switched brands and type of vitamin D3 from Nature's Bounty 5,000 IU liquid soft gels to the Bio-Tech D3-50. This is a 50,000 IU water soluble (micellized) form of vitamin D3. I've found it faster acting and more potent at the same dose than the oil-based liquid soft gel formulations. It's also less expensive. Two of the Natures Bounty 5,000 IU liquid soft gels cost 12 cents/day. If you take one of the 22 cent D3-50 capsules every 5 days (120 hours), the average cost per day is a little over 4 cents/day. As this form of vitamin D3 is more potent, most CHers will be able to take one of these 50,000 IU vitamin D3 capsules a week for an average cost a little over 3 cents/day. CHers tend to respond faster to this regimen if they start it with the 12-Day accelerated vitamin D3 loading schedule. As you can see, the 12-Day accelerated vitamin D3 loading schedule elevates serum 25(OH)D up to a therapeutic range of 60 to 100 ng/mL (80 ng/mL is the initial target serum concentration), in roughly 12 days. It can take a month to two months to elevate serum 25(OH)D into the therapeutic range taking 10,000 IU/day vitamin D3. The rationale for the 12-Day accelerated vitamin D3 loading schedule is simple... The faster you elevate your serum 25(OH)D to a therapeutic level, the sooner you'll experience a CH pain free response. It's best to take all the supplements in this regimen with the largest meal of the day. This helps absorption and also helps avoid any GI tract problems. The exception to this rule is while loading vitamin D3 during the 12-Day accelerated vitamin D3 loading schedule where you take one (1) of these 50,000 IU vitamin D3 capsules a day for 12 days then drop back to a maintenance dose of 10,000 IU/day (one capsule every 5 days/120 hours). During the loading schedule, it's best to take 800 mg/day magnesium split 400 mg with breakfast and 400 mg with the largest meal of the day. Splitting the magnesium dose like this helps avoid osmotic diarrhea. Doubling or tripling the Omega-3 fish oil to 2000 to 3000 mg/day while loading is also a good idea. If you haven't responded to the loading dose with a reduction in the frequency of your CH by the end of the first week, starting a week to 10 day course of Benadryl (Diphenhydramine HCL) may help. Take one 25 mg tablet every 4 hours during the day and at bed time. Just be careful and not drive if possible as this much Diphenhydramine will make you drowsy. If you need to drive during the day wait until you're home for the day then take 50 mg as you walk through the door and another 50 mg at bedtime. If you've still not responded by the 12th day of the accelerated vitamin D3 loading schedule, continue taking the 50,000 IU loading dose for another 4 to 6 days then drop back to the initial maintenance dose of 10,000 IU/day vitamin D3. 30 days after start of regimen, see your PCP/GP for lab tests of your serum 25(OH)D, calcium and PTH. As long as you're CH pain free, your serum calcium is within its normal reference range and your PTH is in the lower third of its reference range, your actual 25(OH)D serum concentration doesn't really matter even if its over 100 ng/mL. For reference, over the last three years I've needed to take between 25,000 and 40,000 IU/day vitamin D3 in order to stay CH pain free due to pollen and mold spore counts. This resulted in my serum 25(OH)D ranging between 150 and 188 ng/mL. My PCP has no problem with vitamin D3 doses and serum 25(OH)D this high as long as my serum calcium remains within its normal reference range... and it has. The reason I went into details on cost is simple. CHers are far better off taking this regimen daily year round, even if they're episodic. That means keeping the daily cost to a minimum is important. As shown in the above photos, the cost of this regimen is roughly 43 cents/day or $157/year. That's less than the cost of two subcutaneous injections of Imitrex (Sumatriptan Succinate). The health benefits over and above preventing CH are huge and hard to ignore. Once you've gotten your CH under control with this regimen, you'll want to get the rest of your family taking it or you'll outlive all of them. For reference, the anti-inflammatory regimen is so safe and healthy for us, I've had my close friends and entire family including 8 grand kids taking this regimen since 2012. None of them have CH or MH. The three youngest grand kids were bathed in maternal vitamin D3 at 10,000 IU/day from conception through breastfeeding. These kids have T-Rex immune systems (they don't get sick) with phenomenal physical, neuromotor and cognitive development. They're young Einstein wunderkinds and all three were speaking a second language at age 2. Diet is a very important part of this regimen as certain food types cause inflammation and this can slow or even prevent a favorable response to this regimen. I suggest an Atkins-Ketogenic diet as there are a number of studies indicating this type of diet helps prevent both cluster and migraine headache. Start this diet with at least a 24 to 36 hour fast drinking only water and taking the regimen supplements. Fasting like this burns up blood starch (glycogen) stored in the liver. This will help shift your body over to a fat burning metabolism that results in the formation of ketones, hence the name "ketogenic." For reference, the human brain runs more effectively consuming ketones than glucose. After the fast, it's a very low carbohydrate diet with zero sugars (no fruit juices either) zero wheat products (gluten) and no dairy products. Wheat products include no bread, pasta, cookies, cakes, crackers or pizza. No grain or vegetable oils like Canola or Corn oil. The best and healthiest fats are organic butter, extra virgin olive oil, avocado oil and my favorite, extra virgin coconut oil. You'll need to avoid carbohydrates and dairy products completely for the first 30 days so no high starch food types like potatoes, sweet potatoes, yams or bananas. You can eat all the free range organic meats, poultry and eggs you want. A serving or two of wild caught fish (Ahi Tuna, Coho or Sockeye salmon) a week is great. You can also eat all the organic Non GMO green and colored veggies you want. Limit fruits for the first month to a handful of dark berries a day like blackberries, blueberries or raspberries. Be sure to drink at least 2.5 liters of water a day. I keep a 2.75 liter bottle of water in the frig and refill every evening prior to bed time. Taking a probiotic can also help push you into a CH pain free response. Take the contents of the probiotic as directed on the label until the bottle is empty. The rationale for this is simple... We have friendly colonies of bacteria and biota in our GI tracts call the microbiome. Taking a probiotic will help ensure we have the right mix of friendly bacteria in our GI tracts. As the microbiome represents a major part of our immune system, taking a probiotic makes for a happy gut and a happy gut is a healthy gut. When you've been on this regimen for at least 30 days, see your PCP/GP for lab tests of your serum 25(OH)D, calcium and PTH (parathyroid hormone). Once you have the lab results in hand, please find the time to take the survey of CHers taking this regimen. To start this survey, click on the following link: http://www.esurveyspro.com/Survey.aspx?id=fb8a2415-629f-4ebc-907c-c5ce971022f6 Take care and please keep me posted. I think you'll find this regimen very effective in preventing your CH. If you have any further questions or problems, please let me know. I'm here to help. V/R, Batch