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Cluster and Migraine headache treatment protocol - Sept 2023


Anti-Inflammatory Regimen Quick Start Guide

For Physicians, Cluster Headache Sufferers and Migraineurs, Pete Batcheller, CDR, USN, (Ret)

Disclaimer

The following Quick Start Guide for the Anti-Inflammatory Regimen Cluster and Migraine Headache Preventative Treatment Protocol is provided for information and educational purposes.  See your Primary Care Physician (PCP) or neurologist whoever has the most knowledge of your general health, any preexisting medical conditions and prescribed medications, to discuss this Quick Start Guide and treatment protocol before starting it.

Introduction

This Quick Start Guide is based on the Anti-Inflammatory Regimen, Cluster and Migraine Headache Treatment Protocol developed and published in 2011.  I  published a revised version on my webpage at vitaminDwiki.com 21 Jan 2017.  Readers of my webpage have downloaded over 85,000 copies of this treatment protocol.

This Quick Start Guide also introduces a new companion treatment protocol we call the Antihistamine Full Monty.  This is a collection of supplements that act as antihistamines to counter the effects of allergic reactions and the release of histamine that makes cluster headaches (CH) and migraine headaches uncontrollable.  Many of these same supplements are also potent antioxidants with antiviral and antibiotic properties.

The following links will take you to video interviews that explain this treatment protocol in detail.
https://www.youtube.com/watch?v=SofbDDhmQUs
https://www.youtube.com/watch?v=U93z9MleSkk
https://www.youtube.com/watch?v=RBD5UUj3d5E

__This is a very safe and healthy treatment protocol that everyone needs to boost their immune systems even if they don’t have headaches.  10,000 IU/day vitamin D3 is very safe.  You can also take one of the Bio-Tech D3-50  50,000 IU Capsule/week.  It is also very safe.  Of course, you’ll also need the cofactors.

PDF of original protocol is at the bottom of this page

Talk to your doctor

~~#000000:See your primary care physician (PCP) or neurologist, whoever has the most recent knowledge of your overall health and any prescribed medications to discuss this treatment protocol and to obtain lab assays for your serum 25-Hydroxy Vitamin D3, a.k.a., 25(OH)D3, Calcium and Parathyroid Hormone (PTH).  This first set of assays will be your baseline values.   In the US, ask that the orders for these labs be sent to the Quest Diagnostics facility nearest your home.  The tests to ask for include the following: QuestAssureD 25-OH Vitamin D (Total), LC-MS/MS.  Test #: 92888, CPT Code 82306.

  • Parathyroid Hormone (PTH) Intact and Total Calcium. CPT codes 83970, 82310.

If you live outside the US, have your doctor or PCP ask for the Liquid Chromatography Dual Mass Spectroscopy (LC-MS/MS) assay for 25(OH)D3.

Start a headache log

If you haven’t already started one, there are several Smart Phone apps like Migraine Buddy that are free to download that run on IOS and Android.  If you don’t have a smartphone, log your headaches on paper

Basic Anti-Inflammatory Regimen Supplements

If you live in the USA, order the following from amazon.com.  If you live outside the US, you may need to order them from iherb.com.  It’s important to order these same brands whenever possible as they have a proven record over the last 10 years producing the best results.  The following photo illustrates the supplements taken in this treatment protocol by brand and maintenance dose.  With the exception of the vitamin D3 which can be taken daily or weekly, all the remaining cofactors are taken daily.
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Basic Anti-Inflammatory Regimen Supplements and Maintenance Doses

VITAMIN D3

  1. Nutrasal Micro D3 Nano Emulsion – 0.5 mL/day used when loading
  2. Bio-Tech D3-50 – 1 or 2 capsules a week as Maintenance dose

COFACTORS

  1. Kirkland Adult 50+ Mature Multi - 1 capsule a day
  2. Nature Made Extra Strength 400 mg Magnesium softgel - 1 capsule a day
  3. Nature Made Omega-3 Fish Oil – 2 capsules a day
  4. Methyl Folate + Vitamin B Complex - 1 capsule a day
  5. LifeExtension Super K with Advanced K2 Complex - 1 capsule a day
Antihistamine “Full Monty” Supplements

We developed the Antihistamine Full Monty as a replacement for Benadryl (Diphenhydramine HCL).   The term “Full Monty” essentially means taking everything but the kitchen sink.  It’s best to start the Antihistamine Full Monty if there’s been no change in CH patterns after five (5) days loading, or any time there’s been an unexplained fall from complete CH remission after months or years of CH pain-free bliss.  The culprit is likely an immune system response to an allergen or allergens in your environment or diet or inflammation from an undiagnosed subclinical infection.  Migraineurs should start the Antihistamine Full Monty at the same time they start the initial vitamin D3 loading schedule.The Antihistamine Full Monty supplements have, among other beneficial properties, the capacity to up-regulate the expression of the Vitamin D Receptor (VDR) and the capacity to act as antihistamines.  These supplements are also frequently recommended for migraineurs. The Full Monty is just as effective in combating the histamine released by allergic reactions yet it has none of the drowsiness or adverse side effects associated with long term use of first-generation antihistamines like Benadryl (Diphenhydramine HCL).  We start the Antihistamine Full Monty with two (2) grams/day loading doses for one week of the first three supplements listed below.  You can drop back to a maintenance dose of one (1) gram/day and stay at that dose until the allergens are gone and you’re experiencing a sustained CH pain free response.
Primary Antihistamine Supplements

  1. 1 to 2 Grams/day Turmeric (Curcumin) with Piperine
  2. 1 to 2 Grams/day Quercetin
  3. 1 to 2 Grams/day Resveratrol
  4. 8 Grams/day vitamin C

Optional As Needed

  1. 2 Grams/day Omega-3 Fish Oil (EPA and DHA)
  2. 250 mcg/day Selenium
  3. 1000 mg/day N-Acetyl Cysteine (NAC)
  4. 5 to 10 mg/day Melatonin (Taken at bedtime)
  5. 200 to 500 mg/day CoQ10
  6. #000000:50 mg Zinc Picolinate*
  7. ­Diamine Oxidase (DO)** 4 mg 2 to 3 times/day with meals

I buy the bulk powdered vitamin C in 2 lb jar as shown below and stir two level teaspoon measures (8 grams) in 12 oz of water.  I drink a gulp of this solution every two hours throughout the day until it is gone by bedtime.  This is the least expensive form of vitamin C at 3 to 4 cents/gram.  The liposomal vitamin C costs 8 to 9 cents/gram.

  • Take the 50 mg zinc with Quercetin if viral infection is suspect or present.
    The 10 mg zinc in the Kirkland Adult 50 may not be sufficient for some viral infections.
    • The Diamine Oxidase is a naturally occurring enzyme that blocks and breaks down histamine.  It is taken for histamine intolerance.

 Image
Nearly all of the CHers following the Antihistamine Full Monty protocol have reported the workhorse supplements that prove most effective in attaining and maintaining a CH pain free response are 2 grams/day of Turmeric (Curcumin), 2 grams/day of Quercetin and 8 grams/day of vitamin C.  They also report skipping these three workhorse supplements for more than a day results in a return of their CH.

Starting the Anti-Inflammatory Regimen

It’s important to start this regimen and treatment protocol with the accelerated vitamin D3 loading schedule for faster headache pain-free response times.  This is done with a total loading dose 600,000 IU (15 mg) vitamin D3 spread over 12 days at 50,000 IU/day or 6 days at 100,000 IU/day. Both schedules are equally effective. For children or adults weighing under 115 lbs (52 Kg) compute the total loading dose at 7500 IU/Kg body weight.  The cofactors are taken daily.At the completion of either loading schedule, drop back to an initial maintenance dose of 10,000 IU/day with the liquid softgel vitamin D3 or 50,000 IU/week with the Bio-Tech D3-50.  Loading schedules like this are fastest way to elevate serum 25(OH)D3 up into a therapeutic target range that will significantly reduce the frequency of your CH, MH or prevent them completely.  If there has been no change in CH patterns after five (5) days of loading vitamin D3 with either schedule, start the Antihistamine Full Monty supplements, but continue the loading schedule.   It’s important to double the Magnesium dose while loading.  Take a 400 mg dose of magnesium with breakfast and a second 400 mg dose with the evening meal.  This provides 12 hours and 12 feet GI tract separation between doses to help avoid osmotic diarrhea.  It’s also important to hydrate with 2.5 liters of water a day particularly while loading and any time the maintenance dose is greater than 10,000 IU/day. Have your Primary Care Physician (PCP) schedule lab assays of your 25(OH)D3, calcium and PTH 15 days after completing the loading schedule at 100,000 IU/day or 30 days after starting the loading schedule at 50,000 IU/day.  What we’re looking for is a gain in the 25(OH)D3 serum concentration of 55 to 60 ng/mL above the baseline value. Serum calcium should be within its normal reference range and PTH lower than baseline.  If there has been no favorable CH response after this first loading schedule, ask your PCP to include the High-Sensitivity C Reactive Protein (hs-CRP) assay and if elevated try to determine the source of the inflammation.
We use a loading dose of 50,000 IU/day for the loading schedules listed below by type headache to reach the initial target 25(OH)D3 serum concentration by type headache:

Target 25(OH)D concentrationLoading Schedule
Episodic CHer 80 to 100 ng/mL. Load at 50,000 IU/day for 12 - 14 days
Chronic CHer 90 to 120 ng/mL.  Load at 50,000 IU/day for 14 - 16 days
Migraineurs 100 to 140 ng/mL.  Load at 50,000 IU/day for 16 - 18 days


It's important to understand these suggested 25(OH)D3 serum concentration target ranges and loading schedules are a starting point for the average ECHer, CCHer and Migraineur with average weight and normal BMI.  Many CCHers and Migraineurs will require a higher 25(OH)D3 serum concentration, a longer period of loading at 50,000 IU/day and a higher maintenance dose to experience and maintain a CH pain-free response. 

In practice, CHers and Migraineurs can start the accelerated vitamin D3 loading schedule at 50,000 IU/day and stay on it until they experience a favorable response or 20 days whichever occurs first then drop back to an initial maintenance dose of one (1) D3-50 a week and obtain assays for serum 25(OH)D3, calcium and PTH.  Some CHers have stayed on this loading schedule for 30 days, a total loading dose of 1.5 million IU of vitamin D3, yet calcium homeostasis maintained their calcium serum concentration within its normal reference range.  Again, it is very important to do loading schedules like this under a physician’s supervision with regular lab assays for serum 25(OH)D3, calcium and PTH at 30 days after start of loading.

If the favorable response occurs before reaching the end of the loading schedule, continue loading until you reach the end of the loading schedule for your type headache. This will build a 25(OH)D3 reserve above the CH threshold serum concentration.  If you haven't experienced a favorable response by the end of the loading schedule, continue loading until you experience a favorable response or you reach 20 days from start of the regimen, whichever occurs first, then drop back to a maintenance dose of one (1) D3-50 a week until you have assay results in hand for 25(OH)D3, calcium and PTH. 

Alternative Loading Schedule.  In mid 2021, many CHers started evaluating an alternative vitamin D3 loading schedule that uses a combination of 100,000 IU/day of the Bio-Tech D3-50 plus 0.5 ml (40,000 IU/day) of the Nutrasal Micro D vitamin D3 nano emulsion taken sublingual (under the tongue).  This combined 140,000 IU dose of vitamin D3 is typically taken for five (5) days for a total vitamin D3 loading dose of 700,000 IU.  At the completion of this loading schedule and you’ve experienced a CH pain free response, drop back to the maintenance dose.

Multiple Loading Schedules.  Some CHers and Migraineurs will need more than one loading schedule to elevate their serum 25(OH)D3 to a therapeutic level that provides a significant reduction in CH frequency or a complete cessation of CH.  Feedback from several CHers indicates their CH threshold for a CH pain free response is above 200 ng/mL (500 nmol/L).  A few CHers have reported they needed to elevate their serum 25(OH)D3 above 300 ng/mL (750 nmol/L).  All reported their serum calcium remained within its normal reference range while following this treatment protocol with frequent assays for serum 25(OH)D3, calcium and PTH.  While the assay requirement for serum 25(OH)D3, calcium and PTH following the first loading schedule is 30 days after start of treatment, subsequent loading schedules require these assays 15 days after completing each loading schedule.  These assays are very important and essential to ensure serum calcium has remained within its normal reference range and PTH has not depressed below its low normal reference range limit.

Vitamin D3 Maintenance Dose. 
The starting vitamin D3 maintenance dose is typically 10,000 IU/day with the oil-based liquid soft gel formulations or 50,000 IU/week with the Bio-Tech D3-50 water soluble 50,000 IU capsules.  While this amount of daily vitamin D3 is sufficient for most CHers and Migraineurs to maintain a headache pain free response, an average maintenance doses of 15,000 IU/day up to 30,000 IU/day to remain CH pain free are not uncommon.  A handful of CHers like me have needed maintenance doses > 50,000 IU/day and one CHer, with a likely histamine intolerance  takes >100,000 IU/day to remain CH pain free under physician supervision.  The ongoing study of CHers following this treatment protocol indicates 13% of the participants taking 10,000 IU/day will still have a 25(OH)D3 response below 50 ng/mL.  Accordingly, if the results of the 30-day assay for serum 25(OH)D3 come back less than 50 ng/mL, a higher vitamin D3 maintenance dose should be taken to maintain the target 25(OH)D3 serum concentration of 80 ng/mL.  For CHers and Migraineurs who fall in this category with a 25(OH)D3 response less than 50 ng/mL (125 nmol/L), 15,000 IU/day of the liquid soft gel vitamin D3 formulation or 100,000 IU/week with the Bio-Tech D3-50 should be sufficient.  Of course, it is essential to take all the cofactors daily.

Missed Maintenance Dose
If you miss a vitamin D3 maintenance dose, take the missed dose as soon as possible, even with the next regular dose.  This guidance applies while dosing with vitamin D3 daily or weekly.

Diet and Exercise

It will also help to start the Atkins-Ketogenic diet. Start this diet with a 24 to 36 hour fast.  This burns through the blood starch (Glycogen) stored in the liver.  After the fast, avoid all sugars, fruit juices and wheat products.  They’re all inflammatory agents.  If you resume eating bread, make sure it’s Non GMO as the glyphosate used on RoundUp Ready GMO grains is a herbicide.  It kills off the friendly colonies of bacteria and biota in the GI tract called the Microbiome.  You also need to avoid all grain and vegetable oils like Crisco, Canola, Mazola as they are high in Omega-6 linoleic acids (LA).  LA oils and fats are also inflammatory agents.  Good oils/fats include organic butter, extra virgin olive oil, avocado oil and my favorite, extra virgin coconut oil.
You can eat all the free range organic meats, poultry and eggs you want. Just avoid high starch carbohydrates.  A couple servings a week of wild-caught fish like Sockeye Salmon, Tuna, Swordfish, Sardines or Halibut are great.  You can eat all the green and colored Non GMO vegetables you want.  Limit fruit to a handful a day of dark berries like Blueberries, Blackberries, Raspberries and Pomegranate.  A good Probiotic can help populate friendly colonies of bacteria in the microbiome,  Be sure to drink 2.5 liters of water a day.

Exercise is also important.  12 to 15 minutes a day fast walking, climbing stairs or working out with weights is a small price to pay for good cardiovascular health.

15-, 30-Day and Annual Lab Tests

15- or 30-days after start of treatment, depending on the loading schedule, no matter if you've experienced a favorable response or not, you will still need to see your PCP/GP for lab assays of your serum 25(OH)D3, calcium and PTH.  Adjust the vitamin D3 dose to keep the PTH serm concentration between 20 and 14 pg/mL and still keep the calcium serum concentration within its normal reference range to obtain the maximum therapeutic effect. Once at a stable vitamin D3 dose, annual labs are sufficient.  It’s important to drink 2.5 liters of water during the 24 hours prior to the blood draw for your labs.  Once you’ve established a vitamin D3 maintenance dose that keeps you CH pain-free, an annual set of assays is sufficient.

Take the Survey (after 30 days)

When you have your lab results in hand after the first 30 days treatment, please find the time to take the survey of CHers following this regimen and treatment protocol.  To cick here to start this survey or https://is.gd/clustersurvey

Important Notes

This treatment protocol is not a cure for CH or Migraines.  The vitamin D3 maintenance dose must be taken daily or weekly to sustain a CH pain free response. The cofactors must be taken daily.  If you’ve experienced a lasting CH pain free response while following this treatment protocol for several months or years and you stop taking it, your CH will return.  How fast they return depends on the 25(OH)D3 reserves above the CH threshold.  If the 25(OH)D3 reserve is low, CH will return in a few days.  If the 25(OH)D3 reserve is high, it can take several months for CH to return. The following chart illustrates the results of a 25(OH)D3 burn down test where no vitamin D3 was taken between two assays for serum 25(OH)D3.  The starting 25(OH)D3 assay was 181 ng/mL.  No vitamin D3 was taken until the second assay at 136 ng/mL three months later.  That equates to an apparent raw 25(OH)D3 burn rate of 15 ng/mL per month. 

Image
Vertical axis is Vitamin D in ng/mL
A vitamin D3 dose of 10,000 IU/day is very safe.  Even vitamin D3 maintenance doses of 50,000 IU/day are safe providing you’ve had two assays for serum calcium at least 30 days apart and serum calcium results fall within its normal reference range.  In the 12 years since this treatment protocol was first published, thousands of CHers have started it, yet there have been no reports of hypercalcemia or adverse events requiring medical attention.  Moreover, vitamin D3 is so safe, there have been no deaths directly attributed to it in the history of the FDA’s Adverse Events Reporting System (AERS).

Most CHers and Migraineurs will respond to the basic anti-inflammatory regimen and treatment protocol following the 600,000 IU vitamin D3 loading schedule with a maintenance dose of 10,000 IU/day with the oil-based liquid softgel vitamin D3 formulation or 50,000 IU/week with the Bio-Tech D3-50 water-soluble vitamin D3.    Your 25(OH)D3 assay taken 30 days after start of treatment should fall under the green normal distribution curve.  If you are CH pain free at this point, this assay for serum 25(OH)D3 is very important as it establishes your target 25(OH)D3 serum concentration.

25(OH)D3 assays following the first 600,000 IU loading schedule with a vitamin D3 maintenance dose of 10,000 IU/day for ≥ 30 days are illustrated in the following graphic.  It is based on data from the ongoing study of 313 CHers following this treatment protocol, .257 of these participants (82%) experienced a favorable response with a significant reduction in CH frequency from 3 CH/day down to 3 CH/week.  The p-value essentially indicates the odds are 1 in 10,000 that the gain in 25(OH)D3 from baseline due to the vitamin D3 dose was a coincidence.
Image

 

The following chart illustrates days to a favorable response with a significant reduction in CH frequency after starting the anti-inflammatory regimen and treatment protocol.  Based on study results, 82% of CHers starting this treatment protocol can expect a favorable response in the first 30 days after start of treatment.
Image

 
The following chart illustrates the time in days to a sustained pain free response after start of treatment.  Based on study results, 53% of CHers can expect a sustained CH pain free response in the first 30 days of treatment.  Follow up with many of these CHers indicate this response rate goes up with higher vitamin D3 maintenance doses and increased serum 25(OH)D3 response. 

Image

 
 One of the fascinating results illustrated in these two graphics of time to respond, deals with the number of CHers who responded in the first three days, some within 24 hours.  As it’s unlikely the 25(OH)D3 serum concentration was sufficient to result in a therapeutic response, favorable or CH pain free, it is very likely these responses were due to vitamin D3 in its free hormone state unencumbered by hydroxylation and the vitamin D binding protein (DBP). Over the last 12 years, we’ve also found this treatment protocol boosts the innate and adaptive immune systems resulting in a significant decrease in infections from viral, bacterial or fungal antigens.  There have been many reports it has also resulted in more restful sleep and an improved sense of well-being. Some CHers and most Migraineurs will require a longer loading schedule and higher maintenance doses of vitamin D3 to achieve and maintain a pain free response.  As inflammation from an infection or an immune system response to allergens which  triggers a flood of histamine, they will also need to start the Antihistamine Full Monty and stay on it until the inflammatory or allergen load subsides.  If you suspect inflammation is causing this treatment protocol to be ineffective in controlling and preventing your headaches, see your PCP and ask for the C-Reactive Protein (CRP) assay.  If the CRP assay is elevated, you and your PCP need to find and treat the source of this inflammation. The vitamin D3 maintenance dose will need to change and likely increase over time to remain headache pain free depending on inflammatory and allergen loads.   The following 5-year chart of my assays for serum 25(OH)D3, calcium and PTH illustrate increases in the vitamin D3 maintenance dose that were needed to remain CH pain free during periods of high allergen loads and decreased during periods of low allergen loads.  It also illustrates calcium homeostasis in action and that higher vitamin D3 maintenance doses up to 50,000 IU/day and higher are safe when done under a doctor’s supervision to ensure serum calcium remains within its normal reference range and PTH is depressed near its low normal reference range, but not below. 

Image

 
The inverse relationship between serum calcium and PTH illustrates calcium homeostasis in action.  In short, as long as serum calcium remains within its normal reference range and PTH is depressed to its low normal range, there is no hypercalcemia no matter how high the vitamin D3 dose and responding 25(OH)D3 serum concentration.  It is also important to note that a 24-Hour Urine collection for calcium and creatinine was started at the same of the blood draw for the last set of assays.  The results for both were normal.One of the most disturbing things that can happen to a CHer while following this treatment protocol is a sudden return of CH.  It can happen, out of the blue, after several months or years of CH pain free bliss faithfully following this treatment protocol.  That warm fuzzy security blanket of CH pain free bliss you’ve enjoyed has now been torn away leaving you back at square one with seemingly uncontrollable CH.  I know how frightening this can be.  Accordingly, knowing why this sudden outbreak of CH has happened and what to do when it does happen is very important.A likely cause of this CH outbreak may be due to a sudden increase in inflammation.  This can be due to a number of reasons including surgery, trauma, an infection (viral, bacterial or fungal), another pathology or a new Rx medication.  All these things create inflammation and our immune system responds by consuming more vitamin D3 and 25(OH)D3.  This causes the available 25(OH)D3 serum concentrations to fall below the CH threshold and when that happens, the CH beast jumps up and ugly. The other more likely cause of this CH outbreak is an immune system response to allergens.  These allergens can be in your environment including pollen, mold spores, and chemicals.  They can also be in your diet.  During an allergic reaction, the immune system’s mast cells are insulted by allergens and degranulate (rupture, spilling their contents).  Mast cells are loaded with histamine and a cocktail of inflammatory mediators as illustrated in the following graphic.  The histamine triggers neurons and glia within the brain and trigeminal ganglia to express the neuropeptides (CGRP, SP, VIP, and PACAP) found elevated in cluster and migraine headaches.  They trigger the neurogenic inflammation and the pain we know as cluster and migraine headaches

Image

 
 The best course of action when CH outbreaks like this occur is to start a 600,000 IU vitamin D3 loading schedule, taking 100,000 IU/day of vitamin D3 for six (6) days.  If you haven’t already done so, start the Antihistamine Full Monty supplements.  If they are not handy, a course of a first-generation antihistamine like Benadryl (Diphenhydramine HCL) at 25 mg four times a day for at least a week will help while obtaining the Antihistamine Full Monty supplements.  These supplements help block the histamine H1 receptors on immune cells, neurons and glia and this helps reduce the allergic response. Most CHers begin responding to this additional 600,000 IU vitamin D3 loading schedule after four to five days of loading.  Continue this loading schedule until you complete the full 600,000 IU of vitamin D3 then drop back to an initial vitamin D3 maintenance dose of 100,000 IU/week. If there’s been no response after six days, taper the loading dose to 50,000 IU/day and stay at that dose until you experience a complete cessation of your CH or 30 days whichever occurs first.  At that point drop back to an initial vitamin D3 maintenance dose of 100,000 IU/week and call your PCP to schedule lab assays of your serum 25(OH)D3, calcium and PTH.  If CH is still present and serum calcium is within its normal reference range and PTH is not too low, proceed with another loading schedule then test again.The rationale for higher vitamin D3 doses and higher resulting 25(OH)D3 serum concentrations can be found in the study titled, "Disassociation of Vitamin D’s Calcemic Activity and Non-calcemic Genomic Activity and Individual Responsiveness: A Randomized Controlled Double-Blind Clinical Trial." https://www.nature.com/articles/s41598-019-53864-1

While the title of this study may be confusing, the results are very clear.  Higher doses of vitamin D3 activate higher numbers of vitamin D3 genes.  Specifically, this study found a clear 25(OH)D3 dose response to progressively higher maintenance doses of vitamin D3 in terms of the number of genes activated:

IU of Vitamin D/dayGenes activated
600 IU/162 genes
4,000 IU/ 320 genes
10,000 IU1289 genes


The authors of this study commented they should have used even higher vitamin D3 doses of 20,000 IU/day and 30,000 IU/day to activate even more genes.  The results of this study provide another piece of the puzzle in answering how vitamin D3 controls and prevents cluster and migraine headaches. In this case it is clear that higher doses of vitamin D3 at 10,000 IU/day are effective preventing CH for 82% of CHers while vitamin D3 doses <5000 IU/day are ineffective.   Moreover, there are several case studies of CHers following this protocol who didn’t respond to a vitamin D3 maintenance dose of 10,000 IU/day, but started responding with a cessation of CH following additional vitamin D3 loading schedules, elevating serum 25(OH)D3 > 150 ng/mL and higher maintenance doses ≥ 20,000 IU/day with normal serum calcium concentrations.  The bottom line is this study provides a logical and rational basis for multiple vitamin D3 loading schedules, higher maintenance doses and resulting higher 25(OH)D3 serum concentration when needed as indicated in this Quick Start Guide.
If you have any comments or questions about this Quick Start Guide, please shoot me a note on my webpage at VitaminDWiki.com or a PM on clusterheadaches.com at http://www.clusterheadaches.com/C or clusterbusters at http://www.clusterheadaches.com/wwwboard2/index.html.  My screen name is “Batch.” 


VitaminDWiki - Using this protocol will probably also reduce the risk of many 56+ other health problems : __

ADHD,  Anxiety,  Asthma,  Autism,  Back Pain,  BPH (prostate),  Cancer - Breast,  Cancer - Colon,  Cancer - Prostate,  Cardiovascular,  Chronic Obstructive Pulmonary Disease,  Cognitive Decline,  Colds,  COVID,  Depression,  Diabetes,  Endometriosis,  Falls,  Fibromyalgia,  Hashimoto's Thyroiditis,  Hay Fever,  Heart Failure,  Hives,  Hypertension – Pulmonary,  Immune System,  Infant,  Inflammatory Bowel Syndrome,  Influenza,  Kidney Disease,  Knee-Pain,  Lupus,  Migraine,  Multiple Sclerosis,  Muscles - women, Obesity,  Pain - Chronic,  Pain - Growing,  PMS,  Preeclampsia,  Premature Birth,  Respiratory Tract Infection,  Schizophrenia,  Sleep-Poor,  Sleep Apnea,  Smoking,  Sports Performance,  Stroke,  Surgery,  Tonsilitis,  Tuberculosis,  Ulcerative Colitis,  Ulcers – Venous,  Urinary Tract Infection   click here for proof


Diseases treated by high-dose Vitamin D - many studies
50,000 IU Vitamin D weekly is often recommended
Low cost vitamin D Blood Tests
Supplements taken by the founder of VitaminDWiki
Vitamin D Cofactors in a nutshell
Nanoemulsion Vitamin D is faster and better - many studies
   Nano form of vitamin D is far better than the regular form for people with poor guts
Headache contains

48 Headache pages

Cluster Headache, etc.

21+ VitaminDWiki pages have MIGRAINE in the title
This list is automatically updated

Items found: 22
Title Modified
Migraine Headache duration and intensity reduced by 50,000 IU vitamin D every two week plus probiotics – RCT Oct 2024 14 Oct, 2024
Cluster and Migraine headache treatment protocol - Sept 2023 29 Sep, 2023
Migraine and Vitamin D 16 Jul, 2023
Migraine risk reduced 30% if have lots of Zinc - Jan 2023 18 Jan, 2023
Migraines have low vitamin D, Migraines plus Restless Leg have far lower vitamin D (no surprise) – Dec 2021 07 Dec, 2021
Migraine Headache association with poor gut – Feb 2020 25 Feb, 2021
Migraine headaches treated by Vitamin D – meta-analysis Jan 2021 16 Jan, 2021
Migraine headaches reduced with 50,000 IU vitamin D weekly – RCT July 2015 14 Jan, 2021
Why Do Multiple Sclerosis and Migraine Coexist – Jan 2020 28 Jan, 2020
Migraines in youths with low Vitamin D wonderfully treated by Vitamin D – June 2019 12 Jul, 2019
Migraines may be due to lack of lack of Magnesium in half of sufferers – May 2012 25 Oct, 2018
Migraine headache 5X less likely if optimal level of vitamin D – Oct 2018 21 Oct, 2018
Migraine headaches cut in half by 4,000 IU of vitamin D – RCT Sept 2018 06 Sep, 2018
Chronic migraine headaches 1.4 X more likely with low vitamin D – July 2018 05 Jul, 2018
Migraines double the risk of strokes (both are associated with low vitamin D) – Jan 2018 01 Feb, 2018
Vitamin D and Migraine – Nov 2010 06 Sep, 2016
Acute Migraine 35 times more likely if low Magnesium levels – May 2016 12 Jun, 2016
Migraine headaches quickly reduced with Magnesium – Meta-analysis Jan 2016 02 Jun, 2016
Childhood migraine in Vitamin D deficient children reduced 6X by addition of daily 5,000 IU and amitriptyline – April 2014 03 Mar, 2015
Migraine in children reduced with vitamin D supplementation – April 2014 10 Apr, 2014
Migraine more common with high vitamin D, perhaps because of low Magnesium – March 2013 04 Aug, 2013
Migraine headaches associated with low vitamin D, 4,000 IU often helps – review Aug 2019 No value for &#039;modification_date_major&#039;

- - - - -
Compared blood levels of 25 people with migraines to 25 people without GreenMedInfo

Metal MigraineNo Migraine Migraine Ratio
Cadmium 0.36 ug0.09 ug 4X MORE if increase
Iron0.97 ug0.48 ug2X MORE if increase
Lead1.48 ug0.78 ug 2X MORE if increase
Magnesium*10.6 ug34.5 ug 3.5X LESS if increase
Zinc* 0.24 ug 5.77 ug 24X LESS if increase
  • Note: Both Zinc and Magnesium increase the activation of the Vitamin D Receptor, which allows more vitamin D into cells

Also

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  • Zinc somewhat reduced Migraine in RCT - Sept 2020

Zinc supplementation affects favorably the frequency of migraine attacks: a double-blind randomized placebo-controlled clinical trial https://doi.org/10.1186/s12937-020-00618-9 FREE PDF


Comparing High-dose vitamin D therapies contains:

Dr. Coimbra
books 2018 2016
Dr. Somerville
Optimal Dose
Dr. GominakMr. BatchellerDr. Bredsen
End of Alz.
Health problem Multiple Sclerosis
autoimmune, PD
sleep, flu, pain,
obesity, etc.
SleepCluster, Migraine
Headaches
Alzheimer's
Park. being added
Number of people
(2019)
30,000
by 2022
5,000 5,000 8,000
(2023)
>1,000 ?
Vitamin D targetPTH is target
typ: 150ng of D
100-140+ ng 60-80 ngPTH is target
typ: 80 ng of D
40-60 ng
Vitamin D daily dose
(K = 1,000 IU)
20K - 200K
1,000 IU/kg
30K 2K + monthly
test increasing
dose until goal
4K - 40K
110 IU/kg
?
Omega-3 * O-3 O-3- - - O-3O-3
Magnesium *MgMg - - - Mg (400 mg) -
Vitamin K2 K2 (no longer?) K2 - - -K2 -
Vitamin B...B2, B9, B12 B3 B50-B100
3 months
B50B12
Zinc *Zn - - - Zn -
Boron *? B - - - B -
Calcium
Minimize rock-based Ca
Decrease Ca - - -Ca-
Vitamin A
avoid extremes
avoid A avoid A - - - A-
OtherCholine
Selenium
Co-Q 10
- - - Co-Q 10-
Loading dose
Days instead of months
- - - - - - - - - Loading
"Cluster Balm"
-


Most highly successful uses of high-dose Vitamin D have a lot in common
Evolved over a period of 4 - 16 years
60+ ng of vitamin D is needed - see also Is 50 ng of vitamin D too high, just right, or not enough
When increasing Vitamin D, it is important to also increase cofactors: Omega-3, Magnesium, Vitamin K and some B vitamins
The dose size typically varies both with the weight of the adult and individual need
None have generated any clinical trials. Their goal is success, not publication
Also, trials generally require same dose for everyone. with no changing of the dose during treatment
Use a pill containing many B Vitamins B50 (or B100)
   Thiamin, Riboflavin, Niacin, Vitamin B-6, Folic Acid, Vitamin B-12, Biotin, Pantothenic Acid,
     Which apparently is B1, B2, B3, B5, B6, B7, B9, and B12. - at least 50mg of each
As of 2019, none appear to (but probably should)

Vitamin D Cofactors in a nutshell has the following

Importance to Health VDW10426  

Overview Toxicity of vitamin D has the following

Graph of dose vs week


See also VitaminDWiki


78+ VitaminDWiki pages have HIGH-DOSE in the title

This list is automatically updated

Items found: 82
Title Modified
Cofactors are needed when taking high-dose vitamin D - video Nov 2024 07 Nov, 2024
Extremely high-dose Vitamin D not a problem for pregnant mice (60M IU injection, 0.6 M IU oral) – Sept 2024 28 Sep, 2024
3X reduced mortality in one metabolic cluster of ICU patients by high-dose Vitamin D – Nov 2024 21 Sep, 2024
High-Doses (50,000 IU weekly, etc.) if at high risk of Vitamin D deficiency - Aug 2024 12 Aug, 2024
High Dose Vitamin D reduces skin problems during Cancer Treatment - May 2024 20 May, 2024
High-dose Vitamin D reduced inflammation and insulin resistance (obese children) - Dec 2023 02 Jan, 2024
High dose vitamin D (20,000 IU per kg of feed) safe for pigs – Aug 2015 24 Dec, 2023
Coimbra high-dose vitamin D protocol - many studies 10 Nov, 2023
Multiple Sclerosis prevention with high-dose vitamin D (in rats in this case) - July 2023 19 Sep, 2023
Knee Osteoarthritis treated by vitamin D if use more than 2,000 IU daily or non-daily high dose – meta-analysis Aug 2023 21 Aug, 2023
Doctor got MS and was later cured by high-dose Vitamin D - Aug 2023 10 Aug, 2023
Cluster headaches virtually eliminated in 7,000 people with high-dose vitamin D and cofactors - Feb 2022 16 Jul, 2023
Rheumatoid Arthritis pain is reduced by Vitamin D, high doses also reduced inflammation (CRP) – Meta-analysis July 2023 13 Jul, 2023
COVID predicted to be a pandemic that could be stopped by high dose vitamin D - Feb 2020 25 Mar, 2023
Muscular Dystrophy probably treated by high-dose Vitamin D plus muscle rehab 23 Mar, 2023
Fracture 4X less likely following kidney transplant if high-dose Vitamin D (100,000 every 2 weeks) – RCT Jan 2023 25 Jan, 2023
High-Dose 18 Jan, 2023
Some pathogens and health problems restrict Vitamin D from being used – Coimbra high-dose protocol – April 2021 18 Jan, 2023
Diseases treated by high-dose Vitamin D - many studies 18 Jan, 2023
50,000 IU and other high dose vitamin studies 15 Jan, 2023
Coimbra protocol using high-dose Vitamin D is safe – April 2022 22 Dec, 2022
High dose vitamin D fights Folate gene changes by COVID, autoimmune, CVD, ALZ – Oct 2022 06 Oct, 2022
Treat COVID with early high-dose Vitamin D (20th as of June 2022) 16 Jun, 2022
High-Dose Vitamin D puts surplus calories into muscles instead of fat (mice) – May 2022 20 May, 2022
Comparing High-dose vitamin D therapies 04 May, 2022
High-dose Vitamin D safe for children (10,000 IU daily, 600,000 IU bolus) – meta-analysis April 2022 15 Apr, 2022
Several rheumatic diseases treated by high-dose vitamin D, but made worse if Calcium was added – April 2022 28 Mar, 2022
Cluster Headaches treated by high-dose Vitamin D, etc. (interview and transcript) - Feb 2022 23 Feb, 2022
Beyond vitamin D - book of testimonials on high-dose Coimbra Protocol - Aug, 2021 16 Feb, 2022
High-Dose Vitamin D Therapy – book July 2018 11 Feb, 2022
High-dose Vitamin D is safe and effective – review of 10 studies – Sept 2021 08 Feb, 2022
HIV treatment augmented by high-dose vitamin D, daily or weekly – Dec 2021 30 Jan, 2022
High-dose Omega-3 fought COVID in 2 hospital trials (6x reduction in ICU, reduced time) – Masterjohn Oct 2021 14 Oct, 2021
Multiple Sclerosis treated by Vitamin D, recommends investigating high dose Coimbra - Oct 2021 07 Oct, 2021
Those getting high dose vitamin D were 7 X less likely to die of COVID-19 - Dec 11, 2020 30 Sep, 2021
Vitamin D3 better than D2, especially if non-daily or high dose - meta-analysis Sept 2021 23 Sep, 2021
High-dose vitamin D improves health (presentation) - Aug 30, 2021 30 Aug, 2021
High dose vitamin D for Autoimmune diseases - Portuguese - 2019 01 Jul, 2021
High Dose Vitamin D for autoimmune diseases -blog June 13, 2021 20 Jun, 2021
Kidney patients who happened to be getting high-dose Calcitriol were 9X less likely to die of COVID-19 - April 6, 2021 13 Apr, 2021
Autoimmune and high-dose vitamin D (Dr. Coimbra) - Dr. Mahtani video and transcript - Nov 2020 11 Apr, 2021
Vitamin D Resistance hypothesis confirmed by Coimbra high-dose vitamin D protocol – April 2021 11 Apr, 2021
Crohn’s Disease reduced for a year by 7 weeks of high dose Vitamin D – RCT March 2021 26 Mar, 2021
COVID-19 and high-dose Vitamin D - Video interview of Dr. Coimbra - May 2020 09 Aug, 2020
High doses vitamin D may prevent or treat COVID-19 - June 2020 31 Jul, 2020
Many doctors believe that high dose vitamin D can fight COVID-19 – BMJ April 2020 14 Apr, 2020
Lowering Calcium Risk when having High Dose Vitamin D3 – Cawley Dec 2019 18 Dec, 2019
The use of high dose Vitamin D (Coimbra Protocol) for multiple sclerosis in Germany – 2019 26 Nov, 2019
Cystic Fibrosis is safely treated by high-dose Vitamin D – Sept 2019 26 Nov, 2019
Rheumatoid Arthritis sometimes helped by very high dose vitamin D2 – 1935 29 Oct, 2019
High-dose Vitamin D for Multiple Sclerosis is OK while pregnant – Sept 2019 10 Sep, 2019
Cardiovascular Prevention with Omega-3 (finally using high doses) – Sept 2019 09 Sep, 2019
Treat autoimmune diseases with high-dose vitamin D – Germany online Aug 24, 25 2019 17 Aug, 2019
Successful high dose vitamin D (Coimbra Protocol) should be evaluated – June 2019 09 Jun, 2019
Hypertension gene expression reduced by high-dose vitamin D (hypertensive rats) – March 2019 27 Mar, 2019
High-dose vitamin D forum – for Multiple Sclerosis and many other diseases – Jan 2019 05 Jan, 2019
Vitamin D nanoemulsion corrected deficiency and improved bones in 1 week (high dose in rats) – Jan 2019 05 Jan, 2019
Multiple Sclerosis - Coimbra Protocol (high-dose Vitamin D) - by one of the 120 doctors of 20,000 patients - Dec 2018 08 Dec, 2018
Problem with vitamin C if high dose Vitamin D for MS and have gene problem – Sept 2018 10 Oct, 2018
Replies to doctor’s comments about high dose Vitamin D for Multiple Sclerosis– Nov 2016 27 Jun, 2018
Guide for patients on high doses of Vitamin D – Coimbra 2017 21 Jun, 2018
Multiple Sclerosis treated when use high doses of vitamin D – meta-analysis May 2018 16 May, 2018
Liver cancer nicely treated by high dose vitamin D for 16 weeks (early stage, in rats) – April 2018 23 Apr, 2018
Gene activation by high dose vitamin D - both quick and long term - April 2015 27 Jun, 2017
ICU cost reduced by at least 27,000 dollars if get high dose vitamin D in first week - April 2017 02 May, 2017
High dose vitamin D to treat Multiple Sclerosis etc. – protocol April 2017 27 Apr, 2017
High dose Omega-3 probably reduces heart problems – American Heart Association – March 2017 18 Mar, 2017
Video by Dr. Coimbra – 95 percent of auto-immune cured with vitamin D in high doses - April 2014 15 Jan, 2017
Caution When Prescribing High Dose Vitamin D (100,000 IU D2 daily for is too much after 4 years) – Nov 2016 26 Nov, 2016
Hospital ICU added high dose vitamin D - malpractice lawsuit costs dropped from 26 million dollars to ZERO - Oct 2016 20 Nov, 2016
70 percent of people with IBS had symptoms relieved with high dose vitamin D – 2012 04 Nov, 2016
Pediatric trials of high dose vitamin D -163 are in a single online database – Feb 2016 07 Aug, 2016
Kidney disease helped by active or high dose Vitamin D - Feb 2014 28 Apr, 2016
Dr. Coimbra explains his treatment with high dose vitamin D for multiple sclerosis – Feb 2015 27 Apr, 2016
High dose vitamin reduced pain of fibromyalgia, osteoarthritis, and rheumatoid arthritis - July 2015 11 Jul, 2015
Brazillian petition to permit high vitamin D doses for autoimune diseases – Aug 2014 08 Feb, 2015
Update on Treating Multiple Sclerosis with high dose vitamin D - Sept 2013 08 Feb, 2015
Video by Dr. Coimbra – auto-immune cures with high-dose vitamin D in Brazil - April 2014 19 Apr, 2014
Response to high dose vitamin D is limited by vitamin A - July 2013 13 Apr, 2014
Liverpool is starting universal supplementation and needs high dose vitamin D – March 2014 26 Feb, 2014
4 clinical trials not find change in disease risk markers with high dose vitamin D – March 2013 13 Apr, 2013
Is High Dose Vitamin D Harmful – Dec 2012 20 Dec, 2012

Short URL = is.gd/HighD


40-150 ng of Vitamin D need to treat health problems

Vitamin D Treats
150 ng Multiple Sclerosis *
80 ng Cluster Headache *
Reduced office visits by 4X *
70 ngSleep *
60 ngBreast Cancer death reduced 60%
Preeclampsia RCT
50 ng COVID-19
T1 Diabetes
Fertility
Psoriasis
Infections Review
Infection after surgery
40 ng Breast Cancer 65% lower risk
Depression
ACL recovery
Hypertension
Asthma?
30 ng Rickets

* Evolution of experiments with patients, often also need co-factors


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Short URL = https://is.gd/cluster2023


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20148 Quick Start Guide - Sept 2023.pdf admin 28 Sep, 2023 449.61 Kb 2196
20147 P8 circle.png admin 28 Sep, 2023 182.93 Kb 3754
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