I’ll be back to posting soon! We had a death in our family but things are returning back to normal as best as they can. I hope you all are enjoying this lovely fall weather. Let me know what topics interest you and that you would like to know more about.
This is the third post on a series about cluster headache.
Cluster headache treatments are similar to migraine treatment is that there are two parts: a preventive and an abortive. However, the rules for taking them are different than for those who have migraine.
Cluster headache preventives should be started as soon as a cycle starts. They don’t do much good taken when not in a cluster cycle and can do more harm than good. Like migraine, there are some herbal preventives as well as prescription preventives. There are people who need high doses and there are people who need a combination of medications to work.
An effective preventive will make the cluster headache sufferer no longer feel their headaches coming on. That doesn’t mean that the cycle is over. If you stop taking your preventives and the cycle isn’t over, you will feel the headaches again. This is a true “masking” of pain. What you have to do, is start tapering slowly after a month of being headache free – and please get your health care provider’s guidance on this! If the headache comes back, you are not out of cycle and should try again a few weeks later. If you don’t get a headache and you have discontinued the medication and do not have any headaches, then great! You are out of cycle. Note the medications and the dose that worked for you and have them ready for the next time that you are in cycle. Again, get your doctor’s help with this!
There is no way to make a cycle “go away”. You can mask it and that is almost like making it go away, but a real “go away” is not being on any medications and not feeling any pain. The cycle will last however long it lasts, typically a few weeks. Then, it will go away as mysteriously as it came. I know that is a bit confusing. What if you did not take a preventive? The cycle will still come and go as it may but you will experience the headaches. The preventives stop you from experiencing the headaches so that you aren’t in pain and you don’t have to treat them.
What are some preventives for cluster headache?
Kudzu (yes, the vine)
Greater occipital nerve blocks with lidocaine/bupivicaine
The other type of medication that is used for cluster headaches are the abortives. These are used when the headache is present to relieve the pain right then and there. If you get cluster headaches, you should talk to your doctor about getting both abortives and preventives. These are commonly:
Oxygen at 8L/min with a non-rebreather mask (you can get this for home use)
Zomig nasal spray
application of White Flower balm at the base of the nostrils
Opioids should be rarely used.
If you are going to see a new headache, TELL the receptionist when you book your appointment that you get cluster headaches. They often have special slots due to the intensity and shorter cycle of a cluster headache.
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In the last post, I discussed what a cluster headache is. But there are some really weird things that scientists have discovered about cluster headaches. They are important, not only to help predict when they might occur, but also who … Read more
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Cluster headaches are a specific type of headache that gets its name because most of the time it occurs in “clusters’. These cluster time periods can occur once or twice a year or someone could go a few years before … Read more
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Melatonin is a substance that your pituitary makes. It is your internal clock – it cues you when to sleep and when to stay awake. It has also been implicated in migraine in many ways particularly related to sleep associations … Read more
Riboflavin is essential for keeping your cells stable and to produce energy. It is used as a headache preventive at the 400mg dose per day. In the literature, there are a few trials to support it. In fact, there are only two.
In one trial by Schoenen and colleagues, 55 people were divided into two groups. The group that took Vitamin B-2 400mg for 3 months experienced greater than 50% reduction in their headaches. Another study by Maizels and colleagues using 49 people had similar results.
What scientists would like to see are more trials, of course, with larger study groups. However, funding for such trials is very difficult to come by.
Riboflavin should be taken in the morning. Since it gives you energy, that energy would be of best use to you in the daytime. If you take it in the afternoon, you might have problems sleeping. It does also turn your urine fluorescent yellow. It is very well tolerated but rarely, someone may experience stomach upset or diarrhea.
Although it is a vitamin, using it for a headache preventive in pregnancy cannot currently be recommended since the dose effect on the fetus is unproven.
Yoga is a perfect way to stretch, strengthen bones, work out the kinks in your muscles, increase your flexibility, find inner peace and decrease your headaches.
However, not everyone has access to a studio or good teachers due to costs, schedules, childcare, time… and I am sure the list can go on. In my neighborhood, I have access to 4 yoga studios within walking distance but two of them are out of the question because they burn incense which is a powerful migraine trigger for me.
The other two studios are wonderful and do not burn incense. One of them started to but I nicely asked if they would not burn it due to it being a trigger for me and they stopped for good. Unfortunately, I don’t get to go as often as I would like due to my work schedule or my husband’s work schedule.
I have also bought some videos – however, I either did not like the teacher or the pace was not in rhythm with my body. Then I was stuck with them.
This is where an online yoga service is extremely helpful. You pay a monthly fee and for that price, you get access to many different yoga videos, different paces, different teachers, different music. You can find a favorite and watch it again and again or you can find others that you love. If you want to do yoga at 2 am, it is all available to you at that time. MyOnlineYoga costs less than $10 a month for unlimited access. That is less than the cost of one class at most studios! Click the link on my site to go there. They also have a getting started series for beginners.
I would also recommend getting a yoga mat. Without a mat, it is easy to slip and slide around. A mat stops this from happening and also defines your personal space. Yoga mats are inexpensive and can be purchased at many stores including Target or by a yoga mat on the web.
I try to gather anything that involves vitamin D and brains to share with you. It is very important. Remember, sun is best and supplement with vitamin D drops that are high quality and that are only vitamin D and … Read more
There have been at least 8 studies involving migraineurs and Magnesium which show that people who get migraines have low brain magnesium. However, finding your brain magnesium level is impractical. It seems that the best results for magnesium are for perimenstrual migraine prevention and as an acute abortive for migraine with aura. When it is used as an acute abortive, it is used as an IV infusion.
One problem the studies found is that the oral formulations for magnesium differ in the different studies. In addition, those with low levels of magnesium seem to respond better overall as opposed to those with normal blood levels of magnesium but who may have low magnesium in their cells (which can’t be tested).
There are some doctors who recommend a high dose of magnesium such as 600mg a day to be of benefit. Dr. Mauskop of the NY Headache Center, one of these researchers, feels that a daily dose of a chelated or slow-release oral magnesium used for at least 4 months is helpful.
Some other physicians such as Dr. Stephen Silberstein on the Jefferson Headache Center feels that magnesium at doses of 600mg a day are most helpful for migraines in pregnant women and as an additional medication to other medications when given IV to get rid of a bad headache.
The main side effect is diarrhea and some stomach upset which is caused by poorly absorbed magnesium. There are some Magnesium formulations that do not cause diarrhea and also help with constipation and improved sleep.