Lipolysis is the break-down of stored triglycerides into simple fatty acids and glycerol. Lipolysis is essential in making energy available to the cells. This process is abnormal in cluster headache patients, especially at night. It is possible that this energy deficit may contribute to both Apnea and the triggering of cluster headaches.

In a 2003 study, researchers at the Karolinska Institute found that the blood of clusterheads at night had only 60 - 70% of the normal levels of glycerol, indicating that fats were not being metabolized properly. This abnormality was found even in people that were in remission. The general pattern was a decrease through the night, with clusterheads showing lowest levels between 2:00 and 6:00 am (peak headache hours). PMID:14610129 (cache).

In a follow-up study in 2006, the same team put forward the idea that perhaps fat cells were resistant to the effects of noradrenaline, a key compound in stimulating fat cells to break down fats. They found the opposite - fat cells from cluster headache patients were ~45% more active than cells from non-CH patients in breaking down fat when they were primed with noradrenaline. The researchers concluded that under most circumstances, there may be a deficit of noradrenaline, and the fat cells seemed to compensate by developing more sensitive noradrenaline beta-receptors. PMID:16776698 (cache)

Dietary Chemicals that Stimulate Lipolysis

Pycnogenol (maritime pine bark extract) has been shown to stimulate lipolysis. It does so by stimulation of the noradrenaline beta-receptors, which (given the 2006 study above) suggests that this compound may be of use in treating cluster headache. Grape seed extract has similar compounds, and would be expected to have the same effect. (abstract (cache))

Green Tea components (EGCG and other catechins) also have been shown to be strong stimulants of lipolysis. (abstract (cache))

Lipolysis, Insulin and Diet

Insulin causes the body to form triglycerides and store them in fat cells; it also inhibits lipolysis. A high carb meal in the evening would increase insulin levels and could theoretically act as a trigger in some people, although this theory has not been tested.

The Detox Diet is a low calorie regimen that some claim can shut off clusters. Calorie restriction is one way to reduce insulin production. Those on low carb diets (like the Atkins Diet and South Beach Diet) report mixed results in terms of preventing clusters, and no research has been conducted on this topic as far as I know.

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