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CHfather

"Comorbidities"

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The question here, as I understand it, was what medical conditions tend to occur simultaneously with CH and migraine, and which are more typical of CH.  The answer (full text of the abstract is below):

>>>>>Chronic sinusitis (p = 0.001), malignancy (p = 0.012), diabetes mellitus (p = 0.021), glaucoma (p = 0.038), as well as another primary headache disorders were more frequently present in patients with cluster headache (p = 0.001), than in migraine patients. In the multivariate analysis, chronic sinusitis (OR = 7.6, p = 0.001) and diabetes mellitus (OR = 4.2, p = 0.035), adjusted by gender, age and duration of headache, are more frequently associated with CH than with migraine. Comorbid disorders in CH patients were frequent and similar to those noticed in migraine patients, except chronic sinusitis and diabetes mellitus.<<<<<

Batch was kind enough to inform me about this study in a reply to my first-ever post over at ch.com, and I will tell you what he had to say about it:

>>>>>The interesting thing about the comorbid disorders we've noted with respect to the anti-inflammatory regimen is they all have the potential to lower arterial pH.

The sinusitis reported by Zidverc–Trajkovi JJ et al. is also of interest as it may be an indication of an inflammatory reaction that could easily encompass the sphenopalatine ganglion and possibly spread to the trigeminal ganglion as the two nerve bundles are directly connected to each other by a branch of the trigeminal nerve.

What all this points out to me, is that as cluster headache sufferers, we need to make sure a more holistic approach is taken in treating our disorder to include looking at other comorbid disorders that can easily prevent CH medications from working effectively.  In short, unless the comorbid disorders are treated at the same time, it's entirely possible the medications prescribed for our CH will not have the desired therapeutic effect.<<<<<

In part, he's trying to sort this out in relationship to his D3/O-3/CC-based regimen, which (along with the lemonade) is partly aimed (as I understand it) at lowering arterial pH.

His post is at http://www.clusterheadaches.com/cgi-bin/yabb2/YaBB.pl?num=1299970139/7#7

Comorbidities in cluster headache and migraine

2011, N° 1 (Vol. 111/1) p.50-55

Jasna J. Zidverc-Trajkovic, Tatjana D. Pekmezovic, Ana L. Sundic,Aleksandra P. Radojicic1 and Nadezda M. Sternic

Headache Center, Institute of Neurology and Institute of Epidemiology Clinical Center of Serbia, Faculty of Medicine,University of Belgrade, Belgrade, Serbia

Abstract:

The aim of this study was to investigate the most frequent comorbid diseases occurring in patients with cluster headache (CH) and, for comparison, in migraine patients. Over a period of eight years 130 patients with CH and 982 patients with migraine were diagnosed according to ICHD-II criteria. In all patients the presence and type of different diseases were assessed from medical records and coded by the ICD, X revision. Odds ratios (OR) with corresponding 95% confidence intervals (95%CI) were calculated by logistic regression analyses. Comorbid disorders were present in 56.9% patients with CH and in 56.7% migraine patients. Chronic sinusitis (p = 0.001), malignancy (p = 0.012), diabetes mellitus (p = 0.021), glaucoma (p = 0.038), as well as another primary headache disorders were more frequently present in patients with cluster headache (p = 0.001), than in migraine patients. In the multivariate analysis, chronic sinusitis (OR = 7.6, p = 0.001) and diabetes mellitus (OR = 4.2, p = 0.035), adjusted by gender, age and duration of headache, are more frequently associated with CH than with migraine. Comorbid disorders in CH patients were frequent and similar to those noticed in migraine patients, except chronic sinusitis and diabetes mellitus.

http://www.actaneurologica.be/acta/article.asp?id=15021〈=en&mod=Acta

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Here's the complete daily anti-inflammatory and buffering regimen along with doses which are suggested to be taken.

3000-3600 mg. Omega 3 Fish Oil (dose depends on brand if three (3) softgels are taken - some are 1200 mg. liquid softgels like Nature Made others are 1000 mg.)

10,000 I.U. vitamin D3 (cholecalciferol)

2-3 of the Calcium Citrate tablets formulated with vitamin D3, magnesium and zinc

An 8 oz. glass of lemonade with lunch, dinner, or both meals

I get all of the above at Costco as shown in the photo in the attachment

These brands at Costco have the best bang for the buck and the cost of dosing with this regimen is less than 25 cents/day. 

The Nature Made Omega 3 Fish Oil also has one of the highest concentrations of the Omega 3 fatty acids EPA, DHA and other Omega 3 at 720 mg per serving of two liquid softgel capsules.

The Kirkland brand of calcium citrate also contains more vitamin D3 along with the magnesium and zinc that are needed with the vitamin D3. The calcium, magnesium and zinc also act as a buffer when taken with juices high in citric acid...  i.e., fresh lemonade, limeade or... I've also found that Baja Bob's sugar free margarita mix works well as it's fortified with additional citric acid.

The assay for two of the Kirkland brand of these tablets follows:

Vitamin D3 800 I.U.

Vitamin B6 10 mg

Calcium 500 mg

Magnesium 80 mg

Zinc 10 mg

Manganese 1 mg

Sodium 1 mg

Boron 1 mg

If folks can't get the Kirkland brand of calcium citrate tablets, Citracal Plus Bone Density Builder™ has a similar formulation, but it has a mix of calcium citrate and calcium carbonate. 

Some folks find they need to take calcium carbonate with meals to help prevent tummy distress...

Regarding the 10,000 I.U. therapeutic dose of vitamin D3, I've attached a paper by Dr Peter J Lewis, MD from down under...  It provides a good coverage of therapeutic dosing along with a suggested maintenance dose at 5,000 I.U.

Info courtesy of Batch

Wishbone

Vitamin_D_deficiency.pdf

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