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CHfather

Smoking and CH

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John Bebee posted this on his Facebook page today. I hadn't seen it before.

http://www.thejournalofheadacheandpain.com/content/14/1/48

The conclusions: >>Patients with episodic CH who are also smokers appear to have a more severe form of the disorder. However, it is unlikely that between CH and smoking there is a causal relationship, as CH patients rarely improve quitting smoking. <<

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the only link i seen discussed is an addictive personality between the two.

tobacco free for 2.5 years now and currently in the worst bout since i stopped taking all meds four years ago

nicotine may play a role in histamine release, histamine is what wakes u up in the morning also.

too many questions, too much pain

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I used to smoke and found that smoking acted as a trigger when in cycle as alcohol does - but smoking made the attacks more severe.

I've also found that I can smell someone smoking in the street from afar - I think again when in cycle I'm super sensative to it.

I still get CH even though I've stopped smoking, just as I do when I stop drinking - it's just that I don't trigger additional attacks during cycles

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There may be different kinds of addictive behavior... but what I believe is happening with me is... there seems to be a deeper motivation, a level of consciousness I don't necessarily see, that is desperately trying to self medicate at the root of the CH. That level is very aware of the effect CH is having on me, even when not under attack. It is an animal, instinctual level, not easily defined or controlled. And, I believe we are permanently altered by our CH 24/7.

Still need to finish that "Pain... the tip of the iceberg" paper I am writing... so many points.

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It's strange. I've just quit smoking (come off patches after 12 weeks) and my cycle starting almost correlated with that.

I've also had some puffs on an e-cig which seemed to trigger an attack (glycerin in the liquid being converted somehow in the body to nitroglycerine maybe?)

However, no attacks (or the very occasional severe CH) when on the patches for an extended duration of time. But the summer I was diagnosed (2012), the patches may have been the reason for the severity of my CH that year.

With me, the nicotine/smoking correlation is hard to discern.

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I don't smoke often maybe once or twice a week. I've never noticed a smoke to trigger an episode but I do occasionally grab a smoke during one. Blowing smoke out of my nose on the affected side and pacing around seems to "help" alleviate the pain.

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I have a theory to explain this which I've called the "wave theory", but I haven't been able to explain that well, so I'll try another analogy based off one my Dr gave me for allergies years ago when those were an issue.

He said your immune system is like a bucket.  Pollens, molds, bacteria, toxins, etc get put into the bucket and you don't have any symptoms unless your immune system bucket overflows.  Any of the items can cause it to overflow.

So here's my CH "bucket theory".  I think we have a CH bucket which is not full during remission periods but overflows during cluster periods.  When the bucket gets near full, there are a number of items that can cause it to overflow, causing CHs. And the more it overflows, the more intense the pain and frequent the CHs.  At max overflow, you have chronic, intense CHs.  When barely overflowing, we have shadows.  The bucket fill level seems to move up and down throughout the day (probably caused by biological and daylight cycles), causing episodes when overflowing and PF when slightly below full.

What causes this bucket to fill up and overflow?  Apparently, the biggest one is caused by rapid changes in daylight, so probably something to do with Tryptamine levels (serotonin, psycedelics, Imitrex, etc).    Other less "filling" items include smoking, low vitamin D levels, low blood sugar levels, alcohol, low testosterone, stomach gas, etc.  Perhaps low oxygen levels could be another since O2 generally helps.   Any one of these can cause your CH bucket to overflow which is why different people can have different triggers.  And when your bucket is not near full, you can drink, smoke, etc and not get CHs, leading people to believe these are not triggers.

So to bust a cluster cycle, you have to try eliminating as many of the common triggers as possible to lower the bucket level.  And it seems that psychedelics are able to improve the tryptamine levels (or whatever it is) which is the #1 contributor associated with the changing daylight cycles.  And I think this is why shrooms, seeds, etc seem to work for most people - because they attach the bucket's primary content - whatever that is.

This isn't a perfect theory or analogy, but it helps me understand the nature of CH's better.  A wave analogy is probably better since it explains all the cyclical behavior of clusters and episodes, but way too complicated to envision.

Thoughts? 

Alan

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I have episodic cluster headaches. I also smoke. My ch started before I ever smoked. The smoking doesn't trigger my ch but one sip of beer or wine will. I've been goin over in my head day after day what could start mine. I like the bucket theory.  Every time my cycle started I was under large amounts of stress for months once the stress was over that's when my cycle would start. I would also have back pain for weeks before cycle. That left me eating Advil at least 3 times a week if not more. I also start work at 4am n get done at 1230 lunch time. In the winter I don't get much sun. I have always napped for 2 hrs at mid day. The different distances of the moon seem to be related also. I noticed once the weather got nicer my ch would end.

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MoxieGirl's golden rule.

No two cluster suffers are the same, and just as soon as you figure yours out, it changes.

Mentioned above that addictive personality can go with CH. I don't have an addictive personality. I've also never smoked.

Just saying.

MG

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Summer 2012 I attempted to quit smoking (whatever number attempt that was). It was the summer I was properly diagnosed with CH.

I thought the nicotine patches I was using were the cause of my 6-8 attacks a day. And brutal ones at that.

But, last time I tried to quit using patches in cycle, nothing.

It's all very hit and miss.

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No two cluster suffers are the same, and just as soon as you figure yours out, it changes.

Mentioned above that addictive personality can go with CH. I don't have an addictive personality.

MG

Ain't that the truth! 9 years episodic and even my ONE DEFINITE THING that might start a cycle (changes in seasons, cold to hot, hot to cold, hot to humid, humid to dry, etc.) haven't actually remained true.

Once a cycle has started though, there are multiple hit triggers to be found.

I don't buy the "addictive personality."  That's such a blanket term, as is "addiction." Many variables.. social, physical, psychological, and other words we probably haven't discovered or invented yet.

Smoking can't be good, but come on, we have CH and you (Researcher's Conclusion) want to tell patients to stop smoking??? I commend Anna Ferrari for her work though, and hope she does more. We need it.  ::)

Diamondmaker: Can't wait to read that paper! When it's finished let me know!

:)Love you, and yoU, AND YOU! PFWishes! :)

Slim

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I just happened to run into this report tonight, while I was looking for something else. From a 2000 study of 789 people with CH >>Seventy-seven percent of respondents were smokers. Seventy-four percent stopped smoking in an attempt to improve their condition; however, only 3% experienced relief.<<<

http://www.ncbi.nlm.nih.gov/pubmed/11091291

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I have been using e-cigarettes since the 4th of July. When I quit the real thing, I did have major improvement in the sinus area, which is where my CH starts usually. After a few weeks I started feeling like I had the flu. The smart answer to that would be stop the e cigs, however it is important for me to stop smoking. I saw the doctor and he confirmed that. Being highly addicted to nicotine. I know if I quit the e cigs , I will be smoking the same day. So I tried to solve this problem on my own and a couple questions pop up. #1. What does nicotine do to one's PH?

                                                                      #2. What does the chemicals in the e cigs do to PH? Namely the ones that end in hyde? And glycol?

Could the connection between CH and smoking be that the PH gets out of balance and then Batch's D3 program works so well because his first goal was balancing PH?

Maybe there have been volumes written about this, I don't know. I'm so tired of thinking about it. I'm also embarassed to be posting about my smoking again. I had good advice from others here but didn't follow it. CH over rode any other problems. I seem to be in remission now. I'll never say it's gone.

Over the years the medical advice I got right away was, "stop smoking, it causes CH." My first question to any doctor or dentist is, "do you know about CH?" They always say yes, but they admit I know more than they do. Especially if I use the hypothamus word.

I didn't mean to complain or hyjack. All I am saying is maybe the connection between CH and smoking is the changes in PH.

Where is spell check? Can you overdose on baseball?                            Leslie

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Here's something I found from a quick look, which includes this paragraph. Doesn't answer your overall pH question (though I do believe that Batch's regimen works in part by creating a more alkaline, as opposed to acidic, pH). http://motherboard.vice.com/blog/harmful-bacteria-are-huge-fans-of-vaping

>>The going hypothesis for why this happens is that inhalation of e-cig vapor dramatically increases the pH of the nasopharynx environment, sending it from 7.4 to 8.4. That's high for both bacteria and for humans, and the result is new stress put upon the MRSA cells, which then go into danger mode. Danger mode for a bacterium looks an awful lot like attack mode from the perspective of a host human. Note that this is a shift in the opposite direction relative to regular cigarettes, which induce a slight drop in pH, to around 7.1.<<

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Wow, thanks CHF,

This is very interesting. I need to read it more and try to understand better. After the first read I believe the PH factor does play a big role in regards to clusters. That would be a good reason for eating "clean" and avoiding our individual triggers. Even though I am not in cycle now, clusters really control too much of my life.

The information on vaping is flat out scary to me. Having COPD and being a smoker, I had high hopes that vaping would help me break away from cigarettes. This article makes me think that vaping is the worst thing "I" could do.

Thanks again for the info.

I'm going into the baseball mode now. Will study this harder tonight.                   Leslie

 

I hope I didn't take this subject too far off track. Smoke might not be the trigger but nicotine could be the relationship. 

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Swedish population study founds that onset on episodic for smokers and drinkers were less intense and early; http://journals.sagepub.com/doi/abs/10.1177/0333102417731773

 

Conclusion;

A majority (66.7%) of the patients reported that attacks appear at certain time intervals. In addition, cluster headache patients who were current tobacco users or had a history of tobacco consumption had a later age of disease onset (31.7 years) compared to non-tobacco users (28.5 years). The Cluster Headache Severity Scale score was higher in the patient group reporting sporadic or no alcohol intake than in the groups reporting an alcohol consumption of three to four standard units per week or more. Maximum severity cluster headache patients were characterised by higher age at disease onset, greater use of prophylactic medication, reduced hours of sleep, and lower alcohol consumption compared to the non-cluster headache maximum severity group.

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So i am experiencing my 5th cycle, mine started before I started smoking i was 15 but my mom was a smoker. I haven't always been a regular smoker but this cycle i havent really wanted to smoke, i barely have for 5 weeks, i probably wouldn't have at all if it wasnt a habitual thing also. I just think its strange and maybe its fear of the beast having a psychological effect but the adversion to nicotine is definitely something i can feel and is related to the cycle

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The new theory still needs to be tested ... but implies that cigarettes might create CH and happens when testosterone is low... (my understanding). 

 

The hypothesis theory will include several principles: (1) the need of double lifetime tobacco exposure, (2) that cadmium is possibly the primary agent in cigarette smoke that leads to hypothalamic‐pituitary‐gonadal axis toxicity promoting cluster headache, (3) that the estrogenization of the brain and its specific sexually dimorphic nuclei is necessary to develop cluster headache with tobacco exposure, and (4) that the chronic effects of smoking and its toxic metabolites including cadmium and nicotine on the cortex are contributing to the morphometric and orexin alterations that have been previously attributed to the primary headache disorder itself.

Linking Cigarette Smoking/Tobacco Exposure and Cluster Headache: A Pathogenesis Theory (https://onlinelibrary.wiley.com/doi/abs/10.1111/head.13338)

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Thank you, Joy'.  Rozen is a serious CH researcher.  Seems like a strange hypothesis to me, but he knows more than I do.  I don't even know what the first principle means -- "the need of double lifetime tobacco exposure" -- but I guess I might understand it if I read the whole document.  Appreciate your posting this.

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