Hey CC,

A 25(OH)D serum concentration of 92 nmol/L (36.8 ng/mL) is high enough to prevent rickets and promote building bone mineral density...  but it won't do diddly to prevent cluster headache... and a lot of other medical problems...

The following chart tells the story you need to understand.

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As you can see, your serum concentration of 25(OH)D at 92 nmol/L has you in the CH red zone.

The 70% CH pain free "green zone" is a raw average over the 25(OH)D serum concentration range of 60 to 100 ng/mL, (150 to 250 nmol/L).  The latest survey data suggests the number of CH'ers experiencing a lasting pain free response increases as the 25(OH)D serum concentration increases across this range.

80 ng/mL, (200 nmol/L) is a good target 25(OH)D serum concentration to shoot for in your first month of taking the anti-inflammatory regimen.  After that, 10,000 IU/day vitamin D3 is a good average maintenance dose that should keep your 25(OH)D serum concentration near 200 nmol/L.

Most CH'ers who have started this regimen in the last year and had their 25(OH)D results come back around 30 ng/mL or less, have used the accelerated vitamin D3 dosing schedule and found it got them pain free faster than taking just the maintenance dose of vitamin D3 at 10,000 IU/day... 

You'll need to start a vitamin D3 loading schedule taking 500,000 IU of vitamin D3 over the first four weeks on this regimen.  The average 25(OH)D response to a total of 100,000 IU vitamin D3 over a four week period is 10 ng/mL, (25 nmol/L).

I know that sounds like a lot of vitamin D3 but it works out to an average daily intake of 20,000 IU/day over the four weeks.  It's best to front load this dosing schedule in order to build 25(OH)D serum concentrations as fast as possible...  and this will help you experience a pain free response as fast as possible.

Start with a single dose of 10,000 IU of vitamin D3 for the first day.  If you haven't had any reaction to the vitamin D3 after 24 hours (allergic reactions are very rare), start the following 22-day vitamin D3 loading schedule while taking all the other supplements in the anti-inflammatory regimen:

2 weeks @ 20,000 IU/day vitamin D3 plus a 50,000 IU loading dose on top of the daily intake once a week for the first two weeks.

8 days @ 15,000 IU/day

On the 23rd day, drop the vitamin D3 intake to a maintenance dose of 10,000 IU/day and try to get another 25(OH)D lab test.  The average response to this loading schedule should be around 125 nmol/L, (50 ng/mL) on top of the starting serum concentration...  This should bring your total 25(OH)D serum concentration up to around 212.5 nmol/L (85 ng/mL).

The "Go To" link with info on all the anti-inflammatory supplements, their doses, drug interactions and contraindications follows:

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The following table represents the latest list of anti-inflammatory regimen supplements and doses:

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I've found the following supplements shown by brand in the photo below are formulated with most of the supplements we need.  I buy them at Costco, but you should be able to find similar formulations at most Vitamin Shoppes, supermarkets, Walmart or over the Internet:

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The vitamin B 50 is not shown.  You’ll need a 3-month course of vitamin B 50 to handle any deficiencies among the seven B vitamins.  Although the Super K with vitamin K2 complex isn't essential in preventing CH, it is needed to handle the increased serum calcium made available by taking vitamin D3 at the doses we take.

There are a growing number of studies finding the super K2 complex helps direct calcium away from soft tissues and arteries directing it instead to bones and teeth improving overall bone mineral density.

There are also a number of studies that have addressed the optimum ratio of calcium-magnesium supplements.  The general consensus is to keep these two supplements at a 1:1 ratio.  Many have found taking 400 mg/day magnesium sufficient.

Take care and please keep us posted.

V/R, Batch

Putter,

Your cluster headache symptoms will continue to decrease as you build your serum concentration of 25(OH)D, but you need to be taking the entire regimen. 

Magnesium is one of the most important vitamin D3 cofactors... start it as soon as possible along with the rest of the anti-inflammatory regimen.

Taking calcium supplements may have an effect on how verapamil prevents cluster headache, but this can be minimized by taking the verapamil in the morning and the calcium supplements 12 hours later in the evening. 

A lot of CH'ers who have found lasting relief from CH by taking the anti-inflammatory regimen with at least 10,000 IU/day vitamin D3 have stopped taking verapamil.

Take care and please keep us posted.

V/R, Batch