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Coimbra protocol using high-dose Vitamin D is safe – April 2022


Safety Data in Patients with Autoimmune Diseases during Treatment with High Doses of Vitamin D3 According to the “Coimbra Protocol”

Nutrients 2022, 14(8), 1575; https://doi.org/10.3390/nu14081575
Ulrich Amon 1, Raul Yaguboglu 1. Madeleine Ennis 2. Michael F. Holick 3. And Julian Amon 1

  • 1 International Centre for Skin Diseases DermAllegra, Coimbra Protocol Certified Center, Am Markgrafenpark 6, 91224 Pommelsbrunn-Hohenstadt, Germany
  • 2 The Wellcome-Wolfson Institute for Experimental Medicine, Queens University of Belfast, Belfast BT7 1NN, UK
  • 3 Endocrinology, Diabetes, Nutrition & Weight Management, Department of Medicine, Boston University School of Medicine, Boston, MA 02118, USA
Calcium similar before and after, often drops a litte

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PTH drops a lot over time

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Dose size drops over time with MS

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Most patients have multiple Vitamin D gene problems

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Principal Diagnoses: Vitiligo, MS, Psorasis, etc.

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Background: In 2013, the group of Cicero Coimbra, Brazil, reported the clinical efficacy of high doses of vitamin D3 in patients suffering from autoimmune skin disorders (“Coimbra protocol”, CP). However, hypercalcemia and the subsequent impaired renal function may be major concerns raised against this protocol.

Methods: We report for the first time for a broad spectrum of autoimmune diseases in 319 patients (mean age (±SD) 43.3 ± 14.6 years, 65.5% female, 34.5% male) safety data for high doses of orally applied vitamin D3 (treatment period: up to 3.5 years) accompanied by a strict low-calcium diet and regular daily fluid intake of at least 2.5 L.

Results: Mean vitamin D3 dose was 35,291 ± 21,791 IU per day. The measurement of more than 6100 single relevant laboratory parameters showed all mean values (±SD) within the normal range for total serum calcium (2.4 ± 0.1 mmol/L), serum creatinine (0.8 ± 0.2 mg/dL), serum creatinine associated estimated GFR (92.5 ± 17.3 mL/min), serum cystatin C (0.88 ± 0.19 mg/L), serum TSH (1.8 ± 1 mIU/L), and for 24 h urinary calcium secretion (6.9 ± 3.3 mmol/24 h). We found a very weak relationship between the dosage of oral vitamin D3 and the subsequent calcium levels, both in serum and in urinary excretion over 24 h, respectively.

Conclusions: Our data show the reliable safety of the CP in autoimmune patients under appropriate supervision by experienced physicians.
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Discussion

Although the pathophysiological role and the therapeutic implications of vitamin D in autoimmunity are still under debate [6], the pleiotropic non-skeletal functions of vitamin D have been generally recognized for reducing the risk of complex non-communicable diseases (NCDs), including cardiovascular diseases, diabetes mellitus, depression, dementia, cancer, allergies, asthma as well as chronic infections [48-50].
While for most NCDs the putative pathophysiologic role of vitamin D as being an association or a cause-effect relationship is still unclear, recent evidence, using Mendelian randomization studies focusing on the genetic variants of vitamin D metabolism in order to reduce confounders, has confirmed an increased risk at least for MS in patients with vitamin D deficiency [51].
Therefore, MS might be the optimal "model" to study both the effects and safety parameters of the high-dose vitamin D treatment as offered with the CP [19]. To date, the treatment protocol of Cicero Coimbra in Brazil for a variety of autoimmune disorders, e.g., MS, psoriasis, and vitiligo, has only been published as pilot study [16], and randomized clinical trials are missing.
Patients with autoimmune diseases, especially MS, often look for holistic and alternative approaches in addition to symptomatic, immune suppressive and disease modifying treatments [52]. Nowadays, very extensive information is available in the World Wide Web [53-55]. There are many websites and personal case reports, which reflect the efficacy of CP as seen in social media by the patients [53-55].
Since the increasing interest in treatment with vitamin D and even ultra-high doses [7,56] results in the possible consequences of self-administering highly concentrated food supplements, we here primarily focus on the safety aspects of the CP.
In the pilot study of Coimbra's group published in 2013 [16], assessing the effect of the prolonged administration of high daily doses of vitamin D on the clinical course of vitiligo and psoriasis, nine patients with psoriasis and sixteen patients with vitiligo received vitamin D3 35,000 IU once daily for six months in association with a consequent low-calcium diet (avoiding dairy products and calcium-enriched foods, such as oat, rice or soya "milk") and reliable hydration (minimum 2.5 L daily). In their study, serum creatinine and calcium (total and ionized) did not change and urinary calcium excretion increased within the normal range [16].
To our knowledge, we in this paper demonstrate for the first time for a broad spectrum of autoimmune diseases in over 300 patients with a treatment period of more than 3.5 years that high doses of orally applied vitamin D3 up to 1000 IU per kg bodyweight are safe in terms of calcium metabolism and renal function, when strict recommendations for diet and fluid intake are followed, up to a treatment period of 3.5 years.
With respect to our population, the mean daily dose of 35,000 IU Vitamin D3 is far higher than usual recommendations [57] and should be a contribution to the debate on the disparity of conclusions on what an "optimal" serum concentration of 25(OH)D is and how much supplementation is required to achieve a sufficient clinical response without long-term side effects.
For many years, we have been following clinically the recommendation of 25(OH)D ranging between 40 and 60 ng/mL being considered to be "optimal" (preferred range) for healthy people [9,58-60]. However, for autoimmune and inflammatory diseases, we have little knowledge about the variations of vitamin D metabolism and recognition, such as VDR polymorphisms, vitamin D binding protein polymorphisms, extrarenal 1 alpha hydroxylase activity, and micro RNAs [61].
Instead of solely focusing on 25(OH)D serum levels, different groups have recently elegantly worked out that, due to epigenetic and genetic differences, the individual immune responsiveness to vitamin D3 is rather complex [19,57,62,63]. Among other factors, this depends on the individual ability to convert vitamin D to its active metabolite 1,25(OH)2D and the interaction with VDR and the response elements [62-64]. Recently, it was shown that there is a dissociation between the calcemic and non-calcemic biologic actions of vitamin D3, especially on functions involved in immune activity [57].
Against this background, the suppression of PTH should be rather favored as a proxy for optimal vitamin D status as well as vitamin D3 treatment [65].
As expected [19], PTH levels dropped over time during CP treatment depending on the dose of vitamin D3 in our population. This confirms the preliminary results of Coimbra's group [16]: during a six month treatment period with a fixed daily dose of 35,000 IU vitamin D3 PTH levels significantly decreased from 57.8 ± 16.7 to 28.9 ± 8.2 pg/mL and from 55.3 ± 25.0 to 25.4 ± 10.7 pg/mL in patients with psoriasis and vitiligo, respectively.
Shirvani and co-workers [57] described a plateau in PTH levels in thirty randomized healthy adults at 16 weeks for a vitamin D3 dose of 4000 and 10,000 IU per day, but not for the group that received 600 IU per day, respectively, without changes in serum calcium. Interestingly, they observed a dose-dependent 25(OH)D alteration in broad gene expression with 162, 320 and 1289 genes up- or down-regulated in white blood cells, respectively [57].
However, due to higher oral vitamin D3 dosages in our patients suffering from MS, in our protocol, PTH plateaued at 15 pg/mL at approximately 6 months after start of treatment, which was different from non-MS autoimmune patients (Figure 5).
In comparison to healthy persons in autoimmunity genetic or epigenetic alterations of vitamin D metabolism differs both in quantity and quality of SNPs within genes of the vitamin D system (e.g., in activating enzymes, serum transport, and VDR) responsible for vitamin D status alterations, causing vitamin D resistance and reduced vitamin D responsiveness [7,19]. The influence of vitamin D3 high dose supplementation on genomewide expression in autoimmune patients remains unexplored.
As already stated in the pilot study of Finamor et al. [16], the daily requirements of vitamin D3 for patients with autoimmune disorders should be individually adapted to the profile of genetic polymorphisms of vitamin D metabolism.
The association between VDR, SNPs, and MS risk, for example, has been reported by many groups, whereas other vitamin D-related genes (including CYP2R1, CYP27B1, CYP24A1) have been less investigated [39].
In our population, the most frequent mutations were found in the genes encoding the enzymes 25-Hydroxylase (CYP2R1) and 1alpha-Hydroxylase (CYP27B1) with 75% of all patients, while SNPs in the regions of the VDR (BsmI, TaqI and FokI) were detected less frequently.
As previously shown, the genetic polymorphism of CYP27B1 associated with autoimmunity [66,67] causes a relative resistance to vitamin D requiring a higher level of circulating 25(OH)D3 to achieve biologically active 1,25(OH)2D3, resulting in normalized immune functions [16]. In order to achieve a physiologic rate of product formation in polymorphic enzyme variants, a higher Km (decreased affinity for substrate) and/or a lower Vmax require supra-physiologic concentrations of the substrate [16].
In patients with a combination of polymorphisms within different sections of vitamin D metabolism, this effect is potentiated. Supra-physiologic doses as applied according to CP may compensate for this genetic-related status of relative vitamin D resistance establishing tolerance to auto-antigens and may with respect to our safety data also increase tolerability in patients with autoimmune disorders [16]. This might explain the far lower PTH plateau in our patients in comparison with healthy subjects studied by Shirvani and co-workers [57].
According to Lemke et al. and the hypothesis of Cicero Coimbra of an acquired vitamin D resistance in autoimmune diseases [19], PTH concentrations could be used as a hallmark for individual adaption of oral vitamin D3 dosages. For an optimal physiological response of 1,25(OH)2D3, a low PTH plateau should reached and maintained within the lower third of the reference range [19]. With respect to our own experiences during the last four years, the degree of inflammation in autoimmune processes seem to influence the need to further decrease the PTH level by higher daily doses of vitamin D3.
A seven-year experience of McCullough et al. with oral vitamin D3 up to 50,000 IU per day did not reveal a linear or exponential relationship between vitamin D and calcium blood levels [68]. They did not observe cases of vitamin D3 induced hypercalcemia or any adverse events attributable to vitamin D3 supplementation in any patient.
Historically, many reports were published during the last century describing the successful use of vitamin D3, for example, in treating psoriasis, asthma, or rheumatoid arthritis with daily doses ranging from 60,000 to 300,000 IU [68]. Due to serious concerns following complications from vitamin-D-induced hypercalcemia after the prolonged daily intake of these supra-physiologic daily doses, vitamin D was then labelled as toxic [68].
With our current detailed knowledge about vitamin D metabolism, central cofactors (e.g., magnesium [69]), the influence of SNPs according to (epi)genetic studies [39], and worldwide experience of several thousands of patients treated with the CP from 2012 onwards with daily doses up to 340,000 IU [70], we are able to develop an individualized vitamin D3 treatment for autoimmune patients by the careful planning and determination of reliable mechanisms for regular laboratory controls. Based on our findings, hypercalcemia does not appear to be a first line risk of high-dose vitamin D3 therapy.
However, since hypervitaminosis D leads to increased calcium absorption via the upregulation of intestinal VDR, a strict calcium-reduced diet is mandatory to protect patients from hypercalcemia. At baseline, patients must be informed in great detail about this central aspect. Restrictions in milk, dairy products and calcium-enriched food stuff have contributed to minimize the calciotropic effects of high daily doses of vitamin D3 in the current study, which confirms the data of the pilot study of Coimbra's group [16]. We strongly recommend that CP is always used in the hands of qualified and experienced physicians and strongly advise against the use of CP by patients themselves based on Internet information.
Among all the chronic inflammatory skin diseases we previously studied (Amon U et al., 2018), the average 25(OH)D serum level was lowest in patients with plaque psoriasis (psoriasis vulgaris), only in patients with severe acute or chronic recurrent skin infections on the skin did we find significantly lower levels. Since the 1930s [71], successful oral substitution of vitamin D in psoriasis patients has been demonstrated in different studies [72]. Since for psoriasis, an increased incidence of other inflammatory comorbidities (e.g., psoriatic arthritis, arteriosclerosis, diabetes mellitus, obesity, non-alcoholic steatohepatitis, inflammatory bowel diseases, and depression) has been described [73], for which—independent of psoriasis—a modulating role of vitamin D has also been discussed in recent publications [74], we strongly recommend that physicians consider using the CP for patients suffering from psoriasis [16].
Perez and co-workers observed an improvement of 88% after oral 1,25(OH)2D3 treatment in 85 patients with psoriasis, with approximately 27% of patients healing completely, 36% having a moderate and 25% showing a slight improvement without causing hypercalcemia [75]. High oral doses of vitamin D3 (35,000 IU once daily) for six months led to a significant improvement of Psoriasis Area and Severity Index (PASI) score in nine patients with psoriasis without significant side effects [75]. Earlier work has also demonstrated a drastic improvement following the oral administration of vitamin D2 in severe cases [71] and following the use of 1a-hydroxyvitamin D3 and 1,25(OH)D3 [76,77].
In our analysis, vitiligo was the dominant diagnosis. Vitiligo is a polygenic autoimmune disease, characterized by localized or generalized depigmentation of the skin as a result of melanocyte destruction by immunologic dysfunction [78]. Two recent metaanalyses identified a significant positive relationship between lower 25(OH)D serum levels and the incidence of vitiligo [79,80]. In our recent study, among 113 patients with vitiligo, 41.2% had a 25(OH)D serum level below 20 ng/mL at baseline before treatment [11].
Zhang et al. performed a meta-analysis with 17 studies on VDR gene polymorphisms (BsmI, ApaI, TaqI, and FokI) in vitiligo, resulting in an increased susceptibility risk of vitiligo only for the Apal polymorphism of the VDR; BsmI, TaqI, and FokI loci had no obvious correlation [80]. In our study, FokI (rs2228570) was most often mutated in comparison to BsmI and TaqI.
When Finamor et al. treated 16 vitiligo patients with daily doses of 35,000 IE vitamin D3 over a period of six months, no repigmentation of the affected areas was observed in only five patients, but the others did develop repigmentation up to 75% without further dermatological treatment [16]. In our center, the combination of CP with topical treatment (calcineurin inhibitors) and/or 311 nm narrow band UVB or 308 nm excimer laser regularly leads to repigmentation in all patients, of course to a varying extent, which will be reported elsewhere. With respect to the data presented here, the vast majority of our vitiligo patients had a daily dose of vitamin D3 not higher than 40,000 IE. For non-inflammatory autoimmune skin diseases (such as vitiligo or alopecia areata), in general, a lower vitamin D3 dose appears to be sufficient for a good clinical response (drop of PTH levels in patients with vitiligo: baseline vs. >365 days p < 0.001, non-vitiligo patients: baseline vs. >365 days p < 0.001), as has been suggested elsewhere [16,19].
Despite our evidence that high-dose vitamin D3 application according to CP is generally well tolerated without signs for long term toxicity, this therapeutic approach of vitamin D3 supplementation should be embedded in a holistic treatment package. Against this background, fascinating new findings from gut microbiome research demonstrated variations in the vitamin D receptor also influence the large functional network of gut microbiota [81].
Finally, further possible significant factors influencing vitamin D sensitivity and metabolism as well as disease activity of autoimmune processes, such as gender differences [82] and the degree of chronic psychoneuroimmunologic impact [83], should be elaborated in further studies, when the clinical efficacy of CP is evaluated in detail. It will be also particularly important to differentiate the clinical effects between the different autoimmune diseases treated by the regimen.


Conclusions

In summary, to our knowledge, our work provides the first long-term documentation of selected critical laboratory parameters during the application of the CP using a high-dose oral vitamin D3 in a broad spectrum of different autoimmune diseases, demonstrating that this procedure is well tolerated with respect to renal function and calcium metabolism. In terms of individualized treatment, we suggest to further use serum levels of PTH as biomarker for an individual response to vitamin D3, the individual ability to convert vitamin D to the active metabolite, the 1,25(OH)2D's interaction with its receptor and the response elements and finally the differential supplementation with vitamin D3. In further studies, possible differences of the clinical outcome of CP treatment should be investigated.


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  • 65. Mendes, M.M.; Hart, K.H.; Lanham-New, S.A.; Botelho, P.B. Suppression of Parathyroid Hormone as a Proxy for Optimal Vitamin D Status: Further Analysis of Two Parallel Studies in Opposite Latitudes. Nutrients 2020,12, 942. [CrossRef]
  • 66. Pani, M.; Regulla, K.; Segni, M.; Krause, M.; Hofmann, S.; Hufner, M.; Herwig, J.; Pasquino, A.; Usadel, K.; Badenhoop, K. Vitamin D lalpha-Hydroxylase (CYPlalpha) Polymorphism in Graves' Disease, Hashimoto's Thyroiditis and Type 1 Diabetes Mellitus. Eur. J. Endocrinol. 2002,146, 777-781. [CrossRef]
  • 67. Sundqvist, E.; Bäärnhielm, M.; Alfredsson, L.; Hillert, J.; Olsson, T.; Kockum, I. Confirmation of Association between Multiple Sclerosis and CYP27B1. Eur. J. Hum. Genet. 2010,18,1349-1352. [CrossRef] [PubMed]
  • 68. McCullough, P.J.; Lehrer, D.S.; Amend, J. Daily Oral Dosing of Vitamin D3 Using 5000 to 50,000 International Units a Day in Long-Term Hospitalized Patients: Insights from a Seven Year Experience. J. Steroid Biochem. Mol. Biol. 2019,189, 228-239. [CrossRef] [PubMed]
  • 69. Deng, X.; Song, Y.; Manson, J.E.; Signorello, L.B.; Zhang, S.M.; Shrubsole, M.J.; Ness, R.M.; Seidner, D.L.; Dai, Q. Magnesium, Vitamin D Status and Mortality: Results from US National Health and Nutrition Examination Survey (NHANES) 2001 to 2006 and NHANES III. BMC Med. 2013,11,187. [CrossRef] [PubMed]
  • 70. Coimbra, C.G.; (University of Sao Paulo, Sao Paulo, Brazil). Personal Communication. 2018. Recording of the lecture at the Congress of Human Medicine, Frankfurt, 14 April 2018. Available online: https://www.youtube.com/watch?v=w1XT0btvVSg (accessed on 31 January 2022).
  • 71. Krafka, J., Jr. Simple Treatment for Psoriasis. J. Lab. Clin. Med. 1936,21,1147-1148.
  • 72. Relhan, V.; Goel, K.; Kochhar, A.; Garg, V.; Wadhwa, B. Vitamin D and Skin Diseases: A Review. Indian J. Dermatol. Venereol. Leprol. 2015, 81, 344. [CrossRef] [PubMed]
  • 73. Takeshita, J.; Grewal, S.; Langan, S.M.; Mehta, N.N.; Ogdie, A.; Van Voorhees, A.S.; Gelfand, J.M. Psoriasis and Comorbid Diseases. J. Am. Acad. Dermatol. 2017, 76, 377-390. [CrossRef] [PubMed]
  • 74. Gröber, U.; Spitz, J.; Reichrath, J.; Kisters, K.; Holick, M.F. Vitamin D. Dermato-Endocrinology 2013, 5, 331-347. [CrossRef]
  • 75. Perez, A.; Raab, R.; Chen, T.C.; Turner, A.; Holick, M.F. Safety and Efficacy of Oral Calcitriol (1, 25 -Dihydroxyvitamin D3) for the Treatment of Psoriasis. Br. J. Dermatol. 1996,134,1070-1078. [CrossRef]
  • 76. Morimoto, S.; Yoshikawa, K.; Kozoka, T.; Kitano, Y.; Imanaka, S.; Fukuo, K.; Koh, E.; Kumahara, Y. An Open Study of Vitamin D3 Treatment in Psoriasis Vulgaris. Br. J. Dermatol. 1986,115, 421-429. [CrossRef]
  • 77. Smith, E.L.; Pincus, S.H.; Donovan, L.; Holick, M.F. A Novel Approach for the Evaluation and Treatment of Psoriasis. J. Am. Acad. Dermatol. 1988,19, 516-528. [CrossRef]
  • 78. Bergqvist, C.; Ezzedine, K. Vitiligo: A Review. Dermatology 2020,236,1-22. [CrossRef] [PubMed]
  • 79. Upala, S.; Sanguankeo, A. Low 25-Hydroxyvitamin D Levels Are Associated with Vitiligo: A Systematic Review and MetaAnalysis. Photodermatol. Photoimmunol. Photomed. 2016, 32,181-190. [CrossRef] [PubMed]
  • 80. Zhang, J.-Z.; Wang, M.; Ding, Y.; Gao, F.; Feng, Y.-Y.; Yakeya, B.; Wang, P.; Wu, X.-J.; Hu, F.-X.; Xian, J.; et al. Vitamin D Receptor Gene Polymorphism, Serum 25-Hydroxyvitamin D Levels, and Risk of Vitiligo. Medicine 2018, 97, e11506. [CrossRef] [PubMed]
  • 81. Wang, J.; Thingholm, L.B.; Skieceviciene, J.; Rausch, P.; Kummen, M.; Hov, J.R.; Degenhardt, F.; Heinsen, F.-A.; Rühlemann, M.C.; Szymczak, S.; et al. Genome-Wide Association Analysis Identifies Variation in Vitamin D Receptor and Other Host Factors Influencing the Gut Microbiota. Nat. Genet. 2016, 48,1396-1406. [CrossRef]
  • 82. Sipos, M.; Gerszi, D.; Dalloul, H.; Banyai, B.; Sziva, R.E.; Kollarics, R.; Magyar, P.; Török, M.; Äcs, N.; Szekeres, M.; et al. Vitamin D Deficiency and Gender Alter Vasoconstrictor and Vasodilator Reactivity in Rat Carotid Artery. Int. J. Mol. Sci. 2021, 22, 8029. [CrossRef]
  • 83. Rogers, M.P.; Fozdar, M. Psychoneuroimmunology of autoimmune disorders. Adv. Neuroimmunol. 1996, 6,169-177. [CrossRef]

VitaminDWiki pages with COIMBRA in title (26 as of April 2022)

This list is automatically updated

Items found: 36
Title Modified
Coimbra protocol using high-dose Vitamin D is safe – April 2022 10 Apr, 2022
Beyond the Coimbra Protocol - 2020 22 Mar, 2022
Beyond vitamin D - book of testimonials on high-dose Coimbra Protocol - Aug, 2021 16 Feb, 2022
Multiple Sclerosis treated by Vitamin D, recommends investigating high dose Coimbra - Oct 2021 07 Oct, 2021
Some pathogens and health problems restrict Vitamin D from being used – Coimbra high-dose protocol – April 2021 26 Apr, 2021
Autoimmune and high-dose vitamin D (Dr. Coimbra) - Dr. Mahtani video and transcript - Nov 2020 11 Apr, 2021
Vitamin D Resistance hypothesis confirmed by Coimbra high-dose vitamin D protocol – April 2021 11 Apr, 2021
COVID-19 and high-dose Vitamin D - Video interview of Dr. Coimbra - May 2020 09 Aug, 2020
Dr. Coimbra on Coronavirus and Vitamin D (English transcript) - Jan 2020 31 Jan, 2020
The use of high dose Vitamin D (Coimbra Protocol) for multiple sclerosis in Germany – 2019 26 Nov, 2019
Multiple Sclerosis and Vitamin D chapter (Coimbra and Brazil not mentioned) – Oct 2019 30 Oct, 2019
Ex Coimbra Protocol Clinician Warns Vitamin D3 Can Sometimes Make Multiple Sclerosis Worse. - July 2019 06 Aug, 2019
Most of Coimbra Protocol supplements in a capsule taken 4 times a day – June 2019 16 Jun, 2019
Successful high dose vitamin D (Coimbra Protocol) should be evaluated – June 2019 09 Jun, 2019
Multiple sclerosis - Dr. Coimbra Video in Portuguese concerning big pharma - May 2019 10 May, 2019
Multiple Sclerosis and (lots of) Vitamin D - book by patient on Coimbra protocol - Feb 2016 19 Jan, 2019
Multiple Sclerosis - Coimbra Protocol (high-dose Vitamin D) - by one of the 120 doctors of 20,000 patients - Dec 2018 08 Dec, 2018
Interview of Dr. Coimbra: MS, Autoimmune, Vitamin D, B2, Ca, Mg, PTH etc. – perhaps 2018 02 Dec, 2018
Dr. Coimbra discusses Vitamin D, Magnesium, Folic Acid, B12, Autism, Depression, etc – Sept 2018 24 Nov, 2018
Dr. Coimbra interview covering Vitamin D, Magnesium, Folate, Vaccines - Oct 2018 24 Nov, 2018
Multiple Sclerosis Coimbra Protocol stories on Facebook 03 Nov, 2018
Vitamin D is the real Multiple Sclerosis Therapy, not an alternative therapy – Coimbra July 2018 17 Aug, 2018
Guide for patients on high doses of Vitamin D – Coimbra 2017 21 Jun, 2018
How to get lots of Magnesium – especially needed for Coimbra MS and Autoimmune Protocol 30 May, 2018
Vitamin D has treated Multiple Sclerosis and autoimmune diseases for 16 years – Coimbra April 2018 27 May, 2018
Multiple Sclerosis Coimbra Protocol with Vitamin D - increased walking - May 2018 12 May, 2018
10,000 IU of vitamin D during pregnancy resulted in spectacular infant development – Coimbra April 2018 17 Apr, 2018
Multiple Sclerosis is reduced by Vitamin D supplementation (even without Coimbra) – review Dec 2017 19 Dec, 2017
Doctor got multiple sclerosis, rejected then embraced Coimbra protocol for herself and patients – Jan 2017 01 Feb, 2017
Video by Dr. Coimbra – 95 percent of auto-immune cured with vitamin D in high doses - April 2014 15 Jan, 2017
Interview of Dr. Coimbra - Vitamin D protocol for Autoimmune diseases – 2016 13 Nov, 2016
Multiple Sclerosis – one person’s benefit of Vitamin D protocol by Dr. Coimbra 22 Jun, 2016
Dr. Coimbra explains his treatment with high dose vitamin D for multiple sclerosis – Feb 2015 27 Apr, 2016
1000 IU per kg Vitamin D for autoimmune diseases – Coimbra Feb 2015 12 Feb, 2015
1000 IU per kg Vitamin D for autoimmune diseases – Coimbra Aug 2013 11 Feb, 2015
Video by Dr. Coimbra – auto-immune cures with high-dose vitamin D in Brazil - April 2014 19 Apr, 2014

VitaminDWiki pages with HIGH-DOSE in title (62 as of May 2022)

This list is automatically updated

Items found: 64
Title Modified
Treat COVID with early high-dose Vitamin D (20th as of June 2022) 16 Jun, 2022
High-Dose Vitamin D puts surplus calories into muscles instead of fat (mice) – May 2022 20 May, 2022
Comparing High-dose vitamin D therapies 04 May, 2022
High-dose Vitamin D safe for children (10,000 IU daily, 600,000 IU bolus) – meta-analysis April 2022 15 Apr, 2022
Coimbra protocol using high-dose Vitamin D is safe – April 2022 10 Apr, 2022
Several rheumatic diseases treated by high-dose vitamin D, but made worse if Calcium was added – April 2022 28 Mar, 2022
Cluster headaches virtually eliminated in 7,000 people with high-dose vitamin D and cofactors - Feb 2022 25 Feb, 2022
Cluster Headaches treated by high-dose Vitamin D, etc. (interview and transcript) - Feb 2022 23 Feb, 2022
Beyond vitamin D - book of testimonials on high-dose Coimbra Protocol - Aug, 2021 16 Feb, 2022
High-Dose Vitamin D Therapy – book July 2018 11 Feb, 2022
High-dose Vitamin D is safe and effective – review of 10 studies – Sept 2021 08 Feb, 2022
HIV treatment augmented by high-dose vitamin D, daily or weekly – Dec 2021 30 Jan, 2022
High-dose Omega-3 fought COVID in 2 hospital trials (6x reduction in ICU, reduced time) – Masterjohn Oct 2021 14 Oct, 2021
Multiple Sclerosis treated by Vitamin D, recommends investigating high dose Coimbra - Oct 2021 07 Oct, 2021
Those getting high dose vitamin D were 7 X less likely to die of COVID-19 - Dec 11, 2020 30 Sep, 2021
Vitamin D3 better than D2, especially if non-daily or high dose - meta-analysis Sept 2021 23 Sep, 2021
High-dose vitamin D improves health (presentation) - Aug 30, 2021 30 Aug, 2021
High dose vitamin D for Autoimmune diseases - Portuguese - 2019 01 Jul, 2021
High Dose Vitamin D for autoimmune diseases -blog June 13, 2021 20 Jun, 2021
Some pathogens and health problems restrict Vitamin D from being used – Coimbra high-dose protocol – April 2021 26 Apr, 2021
Kidney patients who happened to be getting high-dose Calcitriol were 9X less likely to die of COVID-19 - April 6, 2021 13 Apr, 2021
Autoimmune and high-dose vitamin D (Dr. Coimbra) - Dr. Mahtani video and transcript - Nov 2020 11 Apr, 2021
Vitamin D Resistance hypothesis confirmed by Coimbra high-dose vitamin D protocol – April 2021 11 Apr, 2021
Crohn’s Disease reduced for a year by 7 weeks of high dose Vitamin D – RCT March 2021 26 Mar, 2021
COVID-19 and high-dose Vitamin D - Video interview of Dr. Coimbra - May 2020 09 Aug, 2020
High doses vitamin D may prevent or treat COVID-19 - June 2020 31 Jul, 2020
Many doctors believe that high dose vitamin D can fight COVID-19 – BMJ April 2020 14 Apr, 2020
Lowering Calcium Risk when having High Dose Vitamin D3 – Cawley Dec 2019 18 Dec, 2019
The use of high dose Vitamin D (Coimbra Protocol) for multiple sclerosis in Germany – 2019 26 Nov, 2019
Cystic Fibrosis is safely treated by high-dose Vitamin D – Sept 2019 26 Nov, 2019
Rheumatoid Arthritis sometimes helped by very high dose vitamin D2 – 1935 29 Oct, 2019
High-dose Vitamin D for Multiple Sclerosis is OK while pregnant – Sept 2019 10 Sep, 2019
Cardiovascular Prevention with Omega-3 (finally using high doses) – Sept 2019 09 Sep, 2019
Treat autoimmune diseases with high-dose vitamin D – Germany online Aug 24, 25 2019 17 Aug, 2019
Successful high dose vitamin D (Coimbra Protocol) should be evaluated – June 2019 09 Jun, 2019
Hypertension gene expression reduced by high-dose vitamin D (hypertensive rats) – March 2019 27 Mar, 2019
High-dose vitamin D forum – for Multiple Sclerosis and many other diseases – Jan 2019 05 Jan, 2019
Vitamin D nanoemulsion corrected deficiency and improved bones in 1 week (high dose in rats) – Jan 2019 05 Jan, 2019
Multiple Sclerosis - Coimbra Protocol (high-dose Vitamin D) - by one of the 120 doctors of 20,000 patients - Dec 2018 08 Dec, 2018
Problem with vitamin C if high dose Vitamin D for MS and have gene problem – Sept 2018 10 Oct, 2018
Replies to doctor’s comments about high dose Vitamin D for Multiple Sclerosis– Nov 2016 27 Jun, 2018
Guide for patients on high doses of Vitamin D – Coimbra 2017 21 Jun, 2018
Multiple Sclerosis treated when use high doses of vitamin D – meta-analysis May 2018 16 May, 2018
Liver cancer nicely treated by high dose vitamin D for 16 weeks (early stage, in rats) – April 2018 23 Apr, 2018
Gene activation by high dose vitamin D - both quick and long term - April 2015 27 Jun, 2017
ICU cost reduced by at least 27,000 dollars if get high dose vitamin D in first week - April 2017 02 May, 2017
High dose vitamin D to treat Multiple Sclerosis etc. – protocol April 2017 27 Apr, 2017
High dose Omega-3 probably reduces heart problems – American Heart Association – March 2017 18 Mar, 2017
Video by Dr. Coimbra – 95 percent of auto-immune cured with vitamin D in high doses - April 2014 15 Jan, 2017
Caution When Prescribing High Dose Vitamin D (100,000 IU D2 daily for is too much after 4 years) – Nov 2016 26 Nov, 2016
Hospital ICU added high dose vitamin D - malpractice lawsuit costs dropped from 26 million dollars to ZERO - Oct 2016 20 Nov, 2016
70 percent of people with IBS had symptoms relieved with high dose vitamin D – 2012 04 Nov, 2016
Pediatric trials of high dose vitamin D -163 are in a single online database – Feb 2016 07 Aug, 2016
Kidney disease helped by active or high dose Vitamin D - Feb 2014 28 Apr, 2016
Dr. Coimbra explains his treatment with high dose vitamin D for multiple sclerosis – Feb 2015 27 Apr, 2016
High dose vitamin D (20,000 IU per kg) safe for pigs – Aug 2015 08 Aug, 2015
High dose vitamin reduced pain of fibromyalgia, osteoarthritis, and rheumatoid arthritis - July 2015 11 Jul, 2015
Brazillian petition to permit high vitamin D doses for autoimune diseases – Aug 2014 08 Feb, 2015
Update on Treating Multiple Sclerosis with high dose vitamin D - Sept 2013 08 Feb, 2015
Video by Dr. Coimbra – auto-immune cures with high-dose vitamin D in Brazil - April 2014 19 Apr, 2014
Response to high dose vitamin D is limited by vitamin A - July 2013 13 Apr, 2014
Liverpool is starting universal supplementation and needs high dose vitamin D – March 2014 26 Feb, 2014
4 clinical trials not find change in disease risk markers with high dose vitamin D – March 2013 13 Apr, 2013
Is High Dose Vitamin D Harmful – Dec 2012 20 Dec, 2012

VitaminDWiki - Multiple Sclerosis (379 studies)

Overview MS and vitamin D
Multiple Sclerosis and (lots of) Vitamin D - book by patient on Coimbra protocol - Feb 2016
Multiple Sclerosis 32 percent less likely among those with more than 32 ng of vitamin D – Dec 2019


VitaminDWiki - Autoimmune category (184 studies)


VitaminDWiki - Genetics category (301 studies)

301 articles in the Genetics category

see also

Vitamin D blood test misses a lot
Blood Test Misses a lot (VDW 3439)

  • Vitamin D from coming from tissues (vs blood) was speculated to be 50% in 2014, and by 2017 was speculated to be 90%
  • Note: Good blood test results (> 40 ng) does not mean that a good amount of Vitamin D actually gets to cells
  • A Vitamin D test in cells rather than blood was feasible (2017 personal communication)
  •    Commercially available 2019
    • However test results would vary in each tissue due to multiple genes
  • Good clues that Vitamin D is being restricted from getting to the cells
    1) A vitamin D-related health problem runs in the family
    2) Slightly increasing Vitamin D show benefits (even if conventional Vitamin D test shows an increase)
    3) Vitamin D Receptor test (<$30) scores are difficult to understand in 2016
    • easier to understand the VDR 23andMe test results analyzed by FoundMyFitness in 2018

    4) Back Pain


Vitamin D Receptor is associated in over 40 autoimmune studies


VitaminDWiki - Some diseases reduce vitamin D getting to blood or cells

Some diseases restrict vitamin D by changing gene activation,
   by one or more of the following

  • Restrict conversion of light into vitamin D in the skin
  • Restrict oral absorption in the gut
  • Restrict semi-activation in the liver
  • Restrict free semi-activated vitamin D from getting to the kidneys
  • Restrict full activation in the kidneys
  • Restrict semi and fully activation in the cells
  • Restrict activated Vitamin D from entering cell mitochondria (VDR)
  • Destroy the vitamin D before it gets to the cells

Some diseases restrict vitamin D without changing genes

  • The disease just uses/consumes the vitamin D
  • The disease upsets the gut, which reduces bioavailability of oral form
    • unless a gut-friendly form is used

References



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