Hey Visperas,

Sorry to hear the beast is giving you problems...  Increasing vitamin D3 intake with loading doses and still getting hit is a sure indication there's something else going on that interferes with vitamin D3's capacity to prevent CH...

Although not new, the concept of allergic reactions being a causal factor and trigger for cluster headache has generally been dismissed in neurological circles as evidenced in the standards of care recommended treatments of CH.  None of the prevailing standards of care recommended medications include an antihistamine...

There are many causes of allergies including food types, pollens, dust mites, animal dander, chemicals and medications. Fall brings on leaf mold and fungal spores here in the Puget Sound area of Washington state. 

Many of these allergens can also trigger sub-clinical allergic reactions.  In other words, you can be free of obvious symptoms of an allergic reaction and still have one.  Talk with your PCP about a good first-generation antihistamine.  So far there are positive results reported after taking Benadryl (Diphenhydramine) and Phenargan (promethazine hydrochloride).

If there's no joy after a few days taking a first-generation antihistamine, there are a few other things to try.  A baking soda tonic, Vitamin C, a good probiotic, and Curcumin (Turmeric).  With the exception of the probiotic where you'll need to take it as indicated on the label until the bottle is empty, try each of the remaining options for at least two days before going to the next.  That way you'll know what is working and what isn't.

You make the baking soda tonic with half teaspoon of Arm & Hammer baking soda in 4 ounces of water.  Take it an hour after each meal and again before bed.  The instructions are also on the box.  This tonic helps elevate systemic pH making it more alkaline.  Too low a systemic pH (too much acid) triggers vasodilation and that makes most CH medications less effective.

Taking a 1000 mg tablet of Vitamin C every two hours for a total of 5 to 6 tablets a day should do.  Vitamin C has anti-viral properties and helps build the immune system.

Most of our immune system resides in the gut in what's called the microbiome, friendly colonies of flora and fauna in the GI tract.  Taking a probiotic helps the immune system by maintaining healthy  microbiome.

400 mg/day Curcumin (Turmeric) acts as a natural anti-inflammatory.  Be sure to take it with a large meal...  That much Curcumin is equal to 3 or 4 curry dinners.

Take care and please keep us posted.

V/R, Batch

Vispares,

YIKES!!!  Sorry to hear you've had a duodenal ulcer.  I had duodenal and peptic ulcers at the same time so know how painful they can be...

If you'll recall an earlier post in this thread where I commented that: "Given the anti-inflammatory regimen is not preventing your CH is an indication of something else cooking... it would be prudent to see your PCP for a checkup... tout suite!"   Well...  that something else was/is the duodenal ulcer...

The bacterial infection and resulting inflammation from the duodenal ulcer have taken first priority or first dibs on the vitamin D3 you've been taking leaving too little to prevent your CH.

For starters, there's nothing I'm aware of in the anti-inflammatory regimen that would cause a duodenal ulcer.  Moreover, the anti-inflammatory regimen should work to prevent your CH...  and when it doesn't, there's usually a reason why...  In your case, it's the infection and inflammation associated with the duodenal ulcer that's keeping or kept this regimen from preventing your CH.

A duodenal ulcer is typically caused by an infection with a germ (bacterium) called Helicobacter pylori.  Your doctor should be treating you with, or has already  treated you with a course of antibiotics plus an acid-suppressing medicine.

If I'm correct, the above treatment should take care of the duodenal ulcer in two to four weeks.  As you've likely been taking one or two antibiotics to treat the ulcer infection, these antibiotics have also killed off the friendly colonies of bacterial living in your gut called the microbiome. As most of our immune system lies in and around the gut, you'll need to start taking a good probiotic to replace these friendly colonies of bacteria.

If the antibiotics and acid-suppressing medicine have not helped the duodenal ulcer to heal and ulcer symptoms are still present, there may be another problem...  You may have gallstones in your gallbladder.  If that's the case, you'll need to have your gallbladder and any loose gallstones removed before the duodenal ulcer will heal.

The reason for the above sequence is simple once you understand the purpose of the gallbladder and pancreas with respect to digestion and their plumbing into duodenum.  The gallbladder is about the size of your thumb under normal conditions.  It holds liver bile that's injected into the duodenum to help breakdown fats we've eaten. 

The pancreas secretes pancreatic juices high in alkaline bicarbonate that's needed to neutralize the stomach's gastric acid (hydrochloric acid) with a pH of 2.0 (strongly acidic) before it leaves the duodenum and enters the small intestine where the pH is 6.0, (weakly acidic)...  (The difference in pH means stomach acid is 10,000 times more acidic than than the chime flowing through the small intestine).

Now for the plumbing... The gallbladder duct and pancreatic duct join in a common duct before entering the duodenum.  If gallstones block that common duct, no pancreatic juices high in bicarbonate can enter the duodenum to neutralize the stomach acid... 

It gets worse... the sphincter muscle at the bottom of the duodenum that acts as a valve to control the flow of digested food and gastric acid (called chime) from the stomach to the upper part of the small intestine will try to stay closed until sufficient pancreatic juices have neutralized the acid content of the chime. 

If there's no pancreatic juice or an insufficient amount of pancreatic juice, this sphincter valve stays closed and this causes an acid buildup, inflammation and deterioration of the duodenum lining...  That's when the bacteria takes over and you get a full blown duodenal ulcer.

I had this exact thing happen to me...  It took two trips to the ER over a 3-day period before they finally diagnosed my intense stomach pain as stomach ulcers brought on by gallstones.  My second trip to the ER had me rolling on the floor of the ER in a fetal position begging for morphine the pain was so bad...

They planned laparoscopy surgery...  However, when they inserted the laparoscope, they found my gallbladder had grown bigger than my fist and was full of stones with some over an inch in diameter...  The photo of my gallbladder looked like a clear plastic sandwich bag full of green stones. 

When the surgeon saw this, he pulled the laparoscope and asked for the long knives...  so I have a 8 in zipper scar running down across my belly. My gallbladder was so big, I called it a big turkey gizzard.  The combination of the enlarged gallbladder and gallstones pinched and blocked the common duct into the duodenum, so no pancreatic juice could make it into the duodenum to neutralize the chime... 

A few hours after they surgically removed my gizzard, they stuck an endoscope down my throat and took some photos of my stomach and duodenum...  I had scars from 2 old ulcers and five active ulcers in the stomach and duodenum...  The lining of my duodenum looked like raw hamburger...

I'm not saying all this to scare you, but rather to make you aware of the possibility of gallstones...  A simple ultrasound procedure should be able to detect any gallstones...  Has your doctor done an ultrasound on your gallbladder area?

I'm confident that once your duodenal ulcer has healed, the anti-inflammatory regimen will start working to prevent your CH.

Take care and please keep us posted.

V/R, Batch

Vispares,

Thanks for the kind words...  Be sure to start a course of probiotics to help recolonize some friendly critters in your GI tract's microbiome.

The inflammation and immune system response to your duodenal ulcer have very likely taken a toll on your vitamin D3 status...  3 to 5 days at a loading dose of 50,000 IU/day should bring your 25(OH)D back up to a therapeutic level sufficient to help prevent your CH.

Take care and please keep us posted.

V/R, Batch

Vispares,

The collective wisdom on the use of probiotics and antibiotics is take them both at the same time.  This came after reviewing several articles and studies on this topic. The probiotic will not reduce the treatment effect of the antibiotics...

Regarding the vitamin D3 loading dose... you need it most right now as it will help heal the ulcer.

Take care and please keep us posted.

V/R, Batch.

Hola Visperas,

Thanks for the update... I'm sorry you're still having a rough time... 

As your 25(OH)D serum concentration is 150 ng/mL, you need to reduce your vitamin D3 intake, try increasing your magnesium and check your multivitamin to see if it contains iron.  If it doesn't, pick up an iron supplement.

Are you still taking the probiotics?  If you took antibiotics for two weeks you should be taking probiotics for at least four times that long or a minimum of two months or longer...  Eating fresh home made sauerkarut or kimchi should help rebuild the gut microbiome.  Loading up on vitamin C at 1,000 mg every two hours might also help.

Please believe me when I say I don't have all the answers... This regimen was preventing your CH and now it's not...  Clearly something has happened.  We still need to connect a few more dots to figure out why it doesn't work for all CH'ers.  Until we get to that point, when cases like yours come up...  taking a standards of care preventative like a verapamil may be the prudent course of action to buy some PF days and nights.

Take care and please keep us posted.

V/R, Batch

Hey Visperas,

Thanks for the update and good question...
The RDA for iron is 19.3–20.5 mg/day.

You can look for an Iron supplement containing 20 to 25 mg/day iron or modify your diet to include iron rich food types.  See the following link for examples:

Multimedia File Viewing and Clickable Links are available for Registered Members only!!  You need to or

I keep mixed nuts and raisins in a jar next to my computer as snacks.

Take care and please keep us posted.

V/R, Batch