In this case report, a 41-year-old man who had been suffering from cluster headache since the age of 15 years old was treated with high dose vitamin B1 (thiamine). He had been diagnosed with cluster headache at a neurological center in Italy. His first headache occurred at age 15 shortly after a motorcycle accident and they increased in frequency over the years, with acute pain and intensity that significantly compromised his quality of life. Although the patient would experience some headache free months over the years, in January 2016 the headache clusters began occurring daily with no pain-free period for an entire year. The patient had been treated with sumatriptan, a commonly prescribed drug for cluster headache, which did not work. He had also been prescribed prednisone, although this not alleviate the pain either. In December 2016, he was given oral high dose vitamin B1. Initially, the dose was 250mg, then it was increased to 750 mg after a few days. Within 10 days, the headache pain disappeared. He continued the vitamin B1 daily indefinitely.
Interestingly, the neurological center requested that he stop the vitamin B1 in order to test whether the headaches would come back. He refused this request citing his reluctance to re-experience his headache pain. However, in May 2017 (five months after B1 treatment started), the patient forgot his vitamin B1 while on a vacation. Within 48 hours of the last dose, a painful headache occurred. He resumed vitamin B1 therapy after his vacation and was able to reduce the dose to 500mg with no recurrence of headaches to date.
Cluster headache is a painful condition in which very severe headaches occur with little warning and in “clusters” meaning several headaches will occur in a short time period. Patients of cluster headache have very little or no warning when they occur unlike migraine which may gradually build in intensity. Classified as a neurological condition, cluster headache is characterized by very severe and intense pain around the eye, often on only one side of the head. Some researchers suggest that the role vitamin B1 plays in energy metabolism, brain function and pain modulation make it a potential therapy for this rare neurological disorder.
(Case Reports in Neurological Medicine, April 2018)
LINK to ABSTRACT Oral High-Dose Thiamine Improves the Symptoms of Chronic Cluster Headache.
