Will psilocybin prevent cluster headaches?

Q: I’ve had cluster headaches for 20 years. Out of everything I’ve tried, there are only three things that work. To ABORT a headache, I inhale pure oxygen, and without fail, it is gone in five to 10 minutes. It’s a true wonder drug!

Imitrex nasal inhaler also works, but it’s slower than oxygen and extremely expensive.

To PREVENT clusters of headaches, I take several modest doses a year of psilocybin in the form of mushroom tea. I have some minor psychedelic effects, and the next day I have a lasting sense of positive self-confidence. A 2006 study at Harvard showed significant remission of clusters in test subjects using small doses of psilocybin.

I’ve taken psilocybin over 50 times in the past several years. I still have cluster headaches, but they are very few, far less intense and easily stopped with oxygen. Other sufferers in my Facebook group have obtained total relief.

A: Cluster headaches produce excruciating pain so intense that the multiple attacks have been described as suicide headaches. That’s in part because it is impossible to function during a bout of repeated, searing, onesided head pain.

High-flow oxygen is a treatment of choice for cluster headaches. So are triptan-type nasal sprays (Headache, July/August 2016).

Psilocybin is a hallucinogen derived from mushrooms. The Food and Drug Administration considers it a Schedule I drug, meaning that it has no currently accepted medical use and a high potential for abuse. That said, some studies suggest that psilocybin may be beneficial against these killer headaches (Neurology, June 27, 2006; Journal of Psychoactive Drugs, November-December 2015).

Q: I read on your website that you should not drink coffee within one hour of taking a thyroid pill. My endocrinologist disagrees with you. He said I can have coffee right after taking levothyroxine, though I still should wait 45 minutes before eating breakfast.

Since I started taking this medication 15 months ago, my thyroid level has remained the same even though I drink coffee right after taking my pill. Am I just lucky, or is the warning wrong?

A: Years ago, Italian researchers demonstrated that coffee interferes with the absorption of levothyroxine pills such as Synthroid (Thyroid, March 2008). A different formulation, Tirosint, isn’t affected by coffee, although it is pricey (Expert Opinion on Drug Delivery, July 2014).

The most important principle for taking levothyroxine is consistency. Taking it exactly the same way every day allows the physician to adjust your dose to your needs.

Q: I crossed the line a month ago from normal blood sugar to Type 2 diabetes and was put on metformin. I hate taking drugs. What can you tell me about metformin?

A: Metformin is one of the oldest and most wellstudied diabetes drugs. It is inexpensive and effective. It also may have anti-cancer activity.

The most common complication is digestive distress, including diarrhea. To learn more about the pros and cons of metformin and other treatments, read our Guide to Managing Diabetes. Anyone who would like a copy, please send $3 in check or money order with a long (No. 10), stamped (70 cents), self-addressed envelope to: Graedons’ People’s Pharmacy, No. DM-11, P.O. Box 52027, Durham, NC 27717-2027. It also can be downloaded for $2 from our website: www. peoplespharmacy.com. In their column, Joe and Teresa Graedon answer letters from readers. Write to them in care of King Features, 628 Virginia Drive, Orlando, FL 32803, or email them via their website: www. PeoplesPharmacy.com. Their newest book is“Top Screwups Doctors Make and How to Avoid Them.”