A 33 year old male who is a big man 6'7" 267.6 lbs. (BP 148/94, P 67) came in with a major complaint of aching in the back of his head every time he approached orgasm. After his orgasm the headache pulsed and went away in about 15 minutes. He took no sexual enhancing medications. He was in a wonderful relationship with his partner. In fact, she had become pregnant. But both were concerned if there was any underlying health issue with this onset of sexually induced headaches. This phenomenon started only about a week before I saw them. He plays volleyball competitively 4-5 times a week. That activity never triggered a headache. But he does take Advil 800 mg (4 pills) 3-4 times per week for his back, hip and knee pain which he stated was from playing competitive volleyball. Otherwise, he took no other medication. Aside from splitting his forehead before the age of 10 and occasionally getting concussions from fighting in his teenage years his health issues were minimal except for the knee and back pain and occasional shoulder pain which he attributed to playing volleyball so much and getting a little older.
The only other problem he had was alopecia areata (hair loss) in his beard which is an autoimmune disease of unknown origin. But it was mild in its manifestation. He had no known allergies. He was owner of an IT company.
His diet was poor eating a fair amount of junk food, but he was trying to clean it up recently with a smoothie in the morning of mixed berries, water, dragon fruit, jack fruit, almonds, and a green powder. He did have one 160 mg caffeine drink daily. Lunch was many times fast foods like burgers and fries. He was trying to have a more vegetarian dinner. He drank rarely.
PLAN
I told him to eat off my BED Food List for 2 weeks (off essentially all dairy products, wheat and eggs, page 2).
He was eating dairy products regularly. He also stopped the daily highly caffeinated energy drink. He took the following supplements focusing on basics and vascular prevention.
SUPPLEMENTS
Affirm 2/d (nitric oxide booster, dilates blood vessels)
Algal 2/d (omega 3 fatty acids DHA/EPA from sea algae, anti-inflammatory)
Magnesium 400-500 mg/d (dilates blood vessels, relaxes smooth muscle)
Metabolic Synergy 2 2 x day a high potency broad spectrum multivitamin and mineral (covers the basics)
Vitamin C 2000 mg twice daily (immune function, vascular protection, supports adrenal function)
Vitamin D 5000-10,000 IU/d (immune function)
He came in 3 weeks later and his headaches were gone! Pre – and post orgasm. He had cut his Advil down from 4-5 days per week at 800 mg per dose to 800 mg every 2-3 weeks. He cut out his daily energy drink. He pretty much cut out dairy. He kept his coffee. Being off dairy and energy drinks were his two biggest changes. His neck and back pain improved considerably even cutting his Advil dramatically. He cut down his volleyball from 4-5 days per week to 3.
LABS REVIEWED FROM 8/18/22
HgbA1C 5.7 (pre-diabetic-ish!, insulin 15 - hyperinsulinemic-ish!)
His LDLp 1794 and LDLs 857 were elevated. He was Vit D deficient at 25.1 ng/ml. His plaque was "growing" with his LpPla2 being mildly elevated at 150 and he had some inflammation with a hsCRP of 2.8 and oxidation was increased with an OxLDL of 70. His Omega Check (omega 3 fatty acids) was 4.0 which is reasonable. His PULS cardiac score was 1.82 which is very low (good) and his complete blood count and metabolic panels were normal.
MY CONTINUATION PLAN
He needed to lose 20lbs at least... goal 1 lb. per week. Needs to lower his blood pressure (weight loss, food elimination, exercise, nutrients). He is too young to have elevated blood pressure.
EAT OFF KIRK’S BED LIST, page 2 - work on Whole Food Diet; Eliminate dairy products still; Just eat whole grain bread if consumed; Stay off processed carbohydrates (EAT: whole grains, beans, lentils peas, sweet potatoes, potatoes, yams, squash in their whole state); animal food 1 serving per day; 2-3 whole fruits per day; 1-2 palm full of raw nuts or seeds daily; Half his food intake at least should be vegetables. Avoid energy drinks. Could have 1 cup tea or coffee daily.
CONTINUE WITH SAME SUPPLEMENTS
Affirm 2/d (nitric oxide booster, dilates blood vessels)
Algal 2/d (omega 3 fatty acids DHA/EPA from sea algae, anti-inflammatory)
Magnesium 400-500 mg/d (dilates blood vessels, relaxes smooth muscle)
Metabolic synergy 2 2 x day a high potency broad spectrum multivitamin and mineral (cover the basics)
Vitamin C 2000 mg twice daily (immune function, vascular protection, supports adrenal function)
Vitamin D 5000-10,000 IU/d (immune function)
Keep exercising as he is doing.
Prolon (fasting mimicking diet) monthly x 3 months, bimonthly x 6 months – 3-4 times per year thereafter (Prolonfmd.com)
Repeat in 3 months Cleveland Heart Inflammation Panel (recheck specifically oxLDL, LpPla2, CRP, LDLp, sLDL)
GOALS: vitamin D >50 ng/ml and hsCPR <1, A1C <5.6, Insulin <10 preferably < 6, oxLDL gone, LDLp <1000, sLDL < 500)
DISCUSSION
Truthfully, I had never heard of sexually induced headaches. Asking "Dr. Google" described the headaches as not uncommon but as something that is more annoying than a significant health risk.
While this initial treatment was very successfully in getting rid of his two major complaints - sex-induced headaches and back, knee and shoulder pain which I think was mostly related to his high caffeine energy drink and dairy consumption, his long-term issues are reducing his borderline high blood sugar and hyperinsulinism, plaque (artery) growth, and his borderline hypertension. He is too young to have any of these at significant levels. He could reverse these problems within 3 months if he works at them. We will see.
I love seeing simple lifestyle changes (food manipulation and exercise) getting rid of immediate problems and then also prevent the chronic diseases that plague much of the industrialized world - heart disease, hypertension, high blood sugar/type 2 diabetes and weight issues.
Anyone can make an appointment with me for any of those issues (and more) by calling 916-489-4400.
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If you are interested in shock wave (EPAT/ESWT pulsed sound waves) or EMTT (pulsed magnetic fields) for pain management, stimulating healing and/or for erectile dysfunctions make an appointment as well.
I still recommend variations of "Kirk's 21 Day Program" and different fasting regimens (Prolon and Inflamx) for reversal of heart disease, diabetes and overweight issues. If you have concerns about memory, CIRS (Chronic Inflammatory Response Syndrome), and/or mold illness those are also areas of significant interest and study for me.
Be Well,
Kirk
Kirk Hamilton PA-C
Health Associates Medical Group
3301 Alta Arden, Suite 3
Sacramento, CA 95825
(916) 489-4400 (w)
krhammer@surewest.net
www.KwikerMedical.com
www.HealthyLivingforBusypeople.com
www.StayingHealthyToday.com