Autoimmune and high-dose vitamin D (Dr. Coimbra) - Dr. Mahtani video and transcript - Nov 2020

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DR. RENU MAHTANI

COIMBRA PROTOCOL: VITAMIN D THERAPY FOR AUTOIMMUNE DISORDERS
   - EXPLAINED BY DR. RENU MAHTANI MD FMNM 33 minute video
A very brief introduction to Dr. Coimbra high-dose vitamin D protocol by VitaminDWiki
He has been using high-dose vitamin D (with other nutrients) very successfully on many autoimmune diseases since about 2005
The diseases have included: Parkinson's. Psoriasis, Vitiligo, and Multiple Sclerosis
The dose size is adjusted until the PTH is substantially reduced
The doses can range from 20,000 IU daily to 140,000 IU daily
It is doubtful that a standard Randomized Controlled Trial will be run with the protocol, as "one size" does not fit all
Facebook has over 20,000 people in MS forums for Dr. Coimbra protocol in 13+ languages
There are over 200 doctors using the Coimbra protocol - mainly for Multiple Sclerosis

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A few of the slides

Slide 5 (time = 3:35)

Slide 10

Slide 18 she was trained in Brazil by Dr. Coimbra

Slide 19

“Replenishing vitamin D in the doses required to achieve its beneficial effects implies restoring a natural mechanism, which allows patients to
resume a normal life. It’s a mechanism that nature took millions of years to develop, and even if the pharmaceutical industry spent 400 years working on this issue, they would not get close to the benefits that vitamin D can provide to these patients.”

Slide 37

Slide 38 (time = 34:21)

Transcript

0:00:09.0 Dr. Renu Mahtani: By now we all know that there is a global deficiency of vitamin D which is making our health suffer, our immunity suffer, that is one aspect of vitamin D, that yes, we all need Vitamin D to meet the deficiency. But there's another very less explored function of vitamin D, that of an immunomodulator. In fact, it is not an immunomodulator, it is the immunomodulator. It is a very intelligent molecule, and knows where it needs to do what instead of completely suppressing the immunity. So it has a unique function, a unique role to correct the root cause of the problem of autoimmunity rather than just suppressing the manifestations and delaying the progression of a disease which conventional medicines do. So I'm going to start my screen sharing now with you. Alright. So here I am ready to answer your questions regarding vitamin D therapy for autoimmune conditions. And I start with the oath we take as a doctor. Do no harm. This method of treatment is a safe method and it follows this basic principle given to us, by father of medicine called Hippocrates. So when it comes to autoimmune disorders, yeah, we have to know that our... Where is this immune system in the body located? It's not in one organ. It is present everywhere.
0:02:00.7 Dr. Mahtani: The cells of the immune system are moving everywhere in the body, in our gut, our digestive system, our intestines, they host a big proportion of immune system in the form of lymph glands over there. So it's present everywhere, okay? It's difficult to conceptualize. But then it has an effect on every part of the body. So the disorders of immune system could be a poor immunity, a very active immune system, or a misdirected immune system which leads to autoimmune conditions. Means my immune system doesn't know that I am my own self, I'm not foreign, I'm not a bacteria, I'm not an invader, my immune system starts attacking me, some part of my body, hence the name autoimmunity. Few of you have asked that how does vitamin D heal autoimmune conditions? So I thought, "Let me start from here." And the list of autoimmune diseases is exhaustive. 80-100 autoimmune diseases are known till now. So what I'm talking to you now is the mechanism of autoimmunity at the cellular level, whatever the manifestation, it could be a skin, it could be joints, it could be the nervous system, it could be the connective tissue, it could be anywhere, but the root cause we are reaching, we're converging at the cellular cause of the problem, so this mechanism holds true for all, because many of you have asked the question, "How does it work in skin problems?", "How does it work for the gut?"
0:03:35.9 Dr. Mahtani: The mechanism is the same. Because the immune system is present everywhere, and if it goes wild, it can pick any organ of the body and attack any organ of the system to manifest the immune disorder. Now, the conventional treatments that are offered, I'm too an allopathy doctor for the last 30 years, we have been trained into using anti-inflammatories, sorry, steroids, immunosuppressants like methotrexate, and now there are monoclonal antibodies, cell-blocking reagents and so many techniques are there which are overall suppressing the angry immunity, as if that angry monkey is attacking me, so it is being tried to control. But immune system has its good aspects also, they also get suppressed in the process, okay? So in the long run, these therapies do not offer the promise, then the side effect starts popping up, so these conventional therapies, they suppress the manifestations, they help to slow down the progression of disease but do not control it. And they do not correct the root cause, which is a misdirected, misguided or a deviant immune system. So I will be definitely taking one or two slides to make this picture clear, Okay? So look at this central thing, it's called Naive or means the basic immune cell which is very intelligent.
0:05:09.7 Dr. Mahtani: It can become good. It can become bad, right? So now, making it very simple for us to understand, one of the good cells or a good form of this cell is called T regulatory cell which is anti-inflammatory, means it reduces the inflammation in the body. So if you have a good amount of T regulatory cells, things are good, and this cell also helps the body to develop something called as immune tolerance, means don't attack your own cell, come on, understand, I'm my own self, you attack something that is foreign, so that intelligence is there in the T regulatory cells. Now, there is the monkey, the bad one, let's call it. It's called as Th17 cell, and this has been found to be at the root of various autoimmune conditions. So if this is in a good number, the autoimmunity process is high and the T regulatory cell, the good one, poor guy cannot help. There are other aspects also, but I'm not covering it up because I don't want to make it hardcore medical. Let's understand the mechanism through these two, okay?
0:06:21.9 Dr. Mahtani: Now, it will be good if the two are in balance. Th17 should not be too high. The balance has to be maintained. So the good one is T regulatory cell and the bad one is Th17 cell, and when we all who are suffering autoimmune conditions, it is this Th17 cell, which has created the havoc in the body. And now see what this vitamin D can do. It was never thought that vitamin D can be so important. And today we know that vitamin D works actually on every cell of the body, including the immune cells. It's not just for the bones, it is for... See here, vitamin D is an immune modulator. I did not write immune suppressant because it is not an immune suppressant. It is an intelligent molecule, it knows that I have to increase the good guy, the T regulatory cell, and I have to suppress the bad guy, that is Th17 cell. And how does it get this intelligence? God knows. In fact, I always feel that vitamin D is the chemical gift of God's sun to us. Life is not possible without sun, good health is not possible without this vitamin D.
0:07:43.6 Dr. Mahtani: Well, vitamin D suppresses this Th17 cytokine production. I'm not going to show you many publications in this talk today, like I always do, because by now you know that whatever I'm talking is substantiated, and anybody who wants this database literature, you can ask me, and I'll be more than happy to share. So now let's move on to another aspect. So vitamin D works on the immune system, we know how it works, but where in the cell does it work? Where does it go? So this is a cell, there are some receptors, like a lock and key; when you put a key, the lock is like a receptor, and the key is like vitamin D, okay. So, there are many receptors present in a cell, in the content of the cell called a cytoplasm and also in the core of the cell, which is called as the nucleus. So vitamin D has a big reach up to the nucleus as you can see. So the receptors are present in every cell of the body. No wonder vitamin D has important role to play.
0:08:51.7 Dr. Mahtani: Now, when it comes to autoimmune disorders, what is happening when it comes to vitamin D? One, vitamin D deficiency. It is very painful to see patients suffering from autoimmune conditions when they come, they are all desperate, because they have tried many things. And vitamin D levels have not even been checked. It feels so painful. So we see number one, vitamin D deficiency is severe, significant, in people with autoimmune conditions. So pehla, we have to correct the deficiency. Then there are few who are taking vitamin D, so there is no literal deficiency, but they have another issue, and that is called as vitamin D resistance. It is found that people who have autoimmune conditions, they have resistance means they need more vitamin D to get the effect, to get the result. And why is it so? It is because of genetic alterations or genetic polymorphisms in the vitamin D receptor that you saw in this slide. It's genetic. And I'm sure you might have seen how when we talk I ask your family who has the problem, some or the other we get a link of some or the other autoimmune condition in the blood relatives of the family members.
0:10:17.1 Dr. Mahtani: So vitamin D deficiency and then vitamin D resistance as the root cause. Quickly, just a couple of papers see, vitamin D receptor issues in association with psoriasis, in association with what? Multiple sclerosis, in association with all these thyroid-associated problems and there are so many papers, or even lupus and XYZ. So I would like to now share with you my teacher, Dr. Coimbra, who is a neurologist from Brazil and he's a PhD, a doctor of Internal Medicine. And he has been treating people with multiple sclerosis which is a real bad autoimmune condition which attacks the nervous system. But at the same time, if it is tackled with vitamin D early, it can be reversed. So he does that and he has trained not only me from India, but there is a group of many doctors worldwide who are trained to handle this autoimmunity scientifically. I call it natural scientific medicine. Dr. Coimbra crisply says that there is no molecule made by the pharma industry, which can do all the functions that vitamin D can do. So this talks about the intelligence. No wonder vitamin D now is called as a hormone. It is not just a nutritional supplement, it's a must.
0:11:47.2 Dr. Mahtani: So, now we come to this so-called Coimbra protocol. What are the basic tenets of it? Vitamin D has a very potent immunoregulatory role, which we have seen. Autoimmunity is found to be associated with resistance to the effect of vitamin D which we call as vitamin D receptor resistance due to genetic reasons. Now, to compensate for this resistance, what do we need to do? Higher levels of vitamin D or higher, more dose of vitamin D is needed, than the dose given to correct deficiency. And two, vitamin D has to be taken on a daily basis because of the life of vitamin D inside the immune cells is 24 hours, while in the fat cells of the body, the half-life of vitamin D is 15 days. We want the action inside the cells, so daily.
0:12:43.2 Dr. Mahtani: Individual requirement of vitamin D varies based on the degree of vitamin D resistance. So we don't measure just the vitamin D as all of you know we measure PTH parathyroid hormone, and by the way, I have lots of questions from you on Parathyroid hormone and vitamin D dynamics, which I'm going to explain to you in a very simple way, very soon. So we check the PTH and we check the specific calcium that is called as ionized calcium, this is the available calcium in the body, okay, not just the total calcium, which is partially unavailable for actions. So let's come to this solving of your questions, regarding vitamin D and PTH. So they share a see-saw type of a relationship, so when vitamin D is either low or because of the vitamin D resistance, it's not effective, the PTH levels are high, high means, they can even go above the upper limit or they can be... There's a big range of PTH from 15 to 65 generally, so it can be near the upper side, so it means that vitamin D is needed, but when the vitamin D levels are up and the vitamin D is effective means the results are happening.
0:14:05.3 Dr. Mahtani: Then this PTH comes down, and this is what I check when ask you to do your tests because I want to see that alright, with this dose of vitamin D... Okay, how much the PTH came down, can I increase the dose because the aim is to bring the PTH down near its lower limit, means you have beaten the Vitamin D resistance. The vitamin D is working. The effects of Vitamin D are showing on the PTH coming down and that is why PTH is so important. PTH suppression by vitamin D, alone vitamin D has no meaning in this therapy, of course, in the beginning important, because if there is a deficiency, we have to correct it. Here I show you my own report sometime back, see my vitamin D is almost 140, but my PTH is still within the range, 27.9, means I still can take more vitamin D safely because my PTH has not yet come down, it has not come down below the normal range.
0:15:14.5 Dr. Mahtani: How much vitamin D is used by the body is important, rather than how much is just supplemented, it should be showing the effects. If PTH levels are not dropping, the body is not making proper use of Vitamin D due to the resistance, so the dynamics between vitamin D and PTH shows the individual level of vitamin D resistance, and that's why we monitor it. So if the PTH level in the second check is within the reference range, but not yet at the lowest value means the vitamin dose can be increased. Of course, friends, here I'm going to intercept, the clinical improvement, which I hear from you, is a very important deciding factor because if the patient is improving and the PTH level has still not come down to the lowest range, I will not increase the vitamin D okay? So it's not that mathematical, but this is a guideline, the clinical assessment, the feedback from you is very important, okay, then if the PTH has come near its lowest value but still is within the reference range, we maintain that same dose of vitamin D. Okay, things making it simpler. If the PTH level has come down, very down below its normal lowest range means the vitamin D dose has to be reduced.
0:16:43.5 Dr. Mahtani: Okay, so I'm sure by now this vitamin D, PTH dynamics is clear, but there is one more thing to share with you, and here comes the interplay between not just vitamin D and PTH but the calcium levels in the blood. Okay, so I have some diagrams for you to make it, let us say, understandable. Don't get intimidated I'll make it very simple. So one thing is clear that vitamin D has a suppressing effect on PTH means if the vitamin D levels are good and high, it is going to red, means suppress the PTH. This part is clear. At the same time, the vitamin D that we take is doing its functions, what all? One, it is working on the immune system, we saw that also that green, yeah it is beneficial. It is sort of uplifting the good functions of the immune system. Parallelly vitamin D cannot be asked ki bhaiya calcium don't absorb it. It is going to do that because that is its function too, so vitamin D has a function of allowing calcium to get absorbed from the food, okay. Whatever we eat comes to the gut, and then this calcium is in the blood in a certain range, and then it is finally thrown out, from where? Through the kidneys and the urine, so this is how the normal vitamin D mechanisms are happening.
0:18:07.3 Dr. Mahtani: Now, what I want to show you in the next slide is that this blood calcium level is having an influence on the PTH, it's not just vitamin D affecting the PTH, but even the calcium. Don't worry, it's very simple. So when the calcium levels in the blood are low, it stimulates parathyroid hormone. This PTH, parathyroid hormone, is coming not from the thyroid, but para, means near the thyroid, there are four pea-like glands called as parathyroid hormone, which has nothing to do with the thyroid functions. Parathyroid functions to manage calcium in the blood. So whenever the blood calcium levels will come down, the signals are sent and the Parathyroid hormone levels increase in the blood. The body of ours is very dynamic, it's a miracle of creation, it's the5 living body.
0:19:11.0 Dr. Mahtani: So, if suppose, my vitamin D levels are very low. I'll give you one example, I have very low vitamin D, say there are three-four like we see in today's time when people come, okay? So when the vitamin D is low, whatever calcium I eat or take, it's not going to be absorbed. Okay, so calcium from food is not really getting absorbed, but the blood calcium has to be maintained for proper functioning of your muscles, heart and everything. So the body says, "I'm very intelligent, I will provide you with calcium, by hook or by crook." So what does it do? When the calcium levels are low, PTH is stimulated. And what does this PTH do? The high PTH which we see in the beginning, low Vitamin D, high PTH. Why? Because this PTH is now working on the bones. And what does it do? It pulls the calcium out from the bones and maintains the blood level of calcium, okay. So the blood levels of calcium are maintained, at the cost of the bones. This is what a high PTH is showing. So, you get that idea, how the dynamics are? So if the PTH is high, means my bones are being drained out of the calcium to maintain the blood levels. And vice versa, if the calcium levels in the blood go up, it'll suppress the parathyroid, PTH hormone, and then the... The bone will be preserved, the calcium in the bones will be preserved. So this is how in our body, these three things are having a very dynamic relationship.
0:20:47.2 Dr. Mahtani: So somebody had asked, "If my PTH is very low, what will happen?" Nothing to worry. It is a very dynamic parameter, which is in fact, third, it is also influenced by the magnesium. I'm not going into that right now. So this is clear. So now, when we are treating an autoimmune disorder, we are going to not just depend on sun and food for vitamin D, because waise bhi it is very low in it. We are going to be supplementing calcium, sorry, vitamin D by mouth. So we get good vitamin D, active vitamin D, to work on the immune system so that we do not have the autoimmune condition or we are able to control the process. So vitamin D is given in higher doses to break the vitamin D resistance. Parallelly, calcium is being absorbed, rather more calcium is being absorbed now. That's why we monitor the calcium in the diet, and that's why we monitor the ionized calcium. The ionized calcium should not go above the upper limit. So calcium from food is more, more blood calcium, more drained from the kidney. And obviously, when the calcium is more in the diet, it is going to suppress the PTH, and of course, high vitamin D is also going to suppress the PTH. So this is how the things are monitored, right.
0:22:14.4 Dr. Mahtani: Now, this calcium which is being absorbed in excess, if it is too much in excess, we all know it's a danger sign because it is high calcium that is toxic, and not really high vitamin D. High calcium is what can have a negative effect on our kidneys, alright. So we do not want the calcium to go above the upper range. We don't want the toxicity of calcium, so we limit it in the diet. But friends, at this juncture, let me tell you, if you go on Dr. Coimbra Protocol's website, they are very strict about dairy restriction. You know why? Because in their diet, they have fish everyday. They have lot of greens in their diet, which they chew everyday, so they get lot of calcium from the fish and the greens. In India, where we are a predominantly vegetarian community, we do not eat fish, we honestly do not, are used to taking salads that way. And I have seen that in India, many people have very low calcium, right. They don't land up into high calcium that easily. So we do not say that completely stop your dairy when your calcium is so low, so we try to tell you the diet based on your ionized calcium level. We find that you get the optimal levels of calcium from food.
0:23:33.5 Dr. Mahtani: Yes, we do stop the oral calcium, because that is unnecessary. It is going to create problems of toxicity and kidneys, unless the blood calcium levels are very, very, very low. So now to prevent the problems of calcium, what do we say? Take a moderate calcium or a low calcium diet and drink lots of water. So if there is extra calcium in the body, it is going to get flushed out from the kidneys, and then none of these problems are going to occur. The vitamin D that one is taking in higher than usual doses will continue maintaining the immune system in order, keep the autoimmune process in control, so control the calcium, and you're free from that fear of toxicity because it's the calcium high which is toxic. So here... Oh sorry, there was one more thing I wanted to... Exercise, the value of exercise. So many a times we think, "Oh, I'm doing so much. I'm taking vitamin D, I'm taking supplements." Friends, don't forget exercise.
0:24:39.0 Dr. Mahtani: It's very, very important, because exercise keeps our bones healthy. When we take super high doses of vitamin D, which honestly, in India, I've realized we don't need very high doses, like being used in the West. We respond to lesser doses than what we commonly see happening in the West. So if somebody is taking very high doses of vitamin D, yeah, there are some patients of Dr. Coimbra, who even take more than one lakh international units daily. Okay, that's pretty high because they have such a high degree of vitamin D resistance, more than one lakh, even up to two lakh. So when vitamin D is given in that higher dose, the bones start getting weaker. Yeah, it's another action of vitamin D, but when exercise is done, it keeps the bones strong and healthy. So even with the lower or moderate doses of vitamin D that we are using, exercise is very, very beneficial for the body and the mind. So coming back to that toxicity part, well, friends, I hope by this, the PTH, vitamin D, ionized calcium dynamics has become clear.
0:25:49.4 Dr. Mahtani: And many of your scattered questions must have got answered. Alright, so beautifully said by a vitamin D doctor, Dr. John Cannell, he says, "Worrying about vitamin D toxicity is like worrying about drowning when one is dying of thirst." our body is crying for vitamin D, why are we wearing all these masks 0:26:14.0 fear of COVID? Because we've not cared for this. So, one should not be scared of taking it. The scare or the fear should be of preventing high calcium or hypercalcemia. It's found that elevated levels of vitamin D do not correlate with clinical vitamin D toxicity. I'm not going to cover this right now, you can please watch my video which I've recently shared and it's already there on YouTube, on vitamin D toxicity and all the science behind it. And the blood level which labs quote, that above 100 is toxic, above 150 is toxic, need not be true. No, it's not actually, till, number one, very high calcium, and honestly, vitamin D toxicity is not even seen with 200 ng/mL. It is found that no toxicity is found below 200 ng/mL nanogram per ml of blood levels of vitamin D.
0:27:11.2 Dr. Mahtani: And since this slide is open in front of me, I will repeat a point that many labs check vitamin D in a unit nanomole. Okay, so when I'm saying the level should be 100, it means nanogram which is the usual language of world global communication about vitamin D. But if the lab is measuring in nanomoles, you have to divide this value by 2.5, and then it comes in nanogram. So don't be scared if your report is, say 200 nanomoles, no, divide it by 2.5, it is lesser than 100. Okay, this is one important point to note. And then dose-wise, there is no toxicity below taking up to even 30,000 IUs daily, vitamin D toxicity is not seen. In fact, there's a very nice review article by the Mayo Clinic which is a very recognized medical organization, and no other than Dr. Michael Holick has given this review. It says that vitamin D is not as toxic as was once thought. Those interested must read this paper.
0:28:21.4 Dr. Mahtani: And what does it say? Vitamin D toxicity is the rarest medical condition, and is typically due to intentional or inadvertent intake of extremely high doses, and not just this, more important than the dose 50,000 to one lakh units for months to years without monitoring for hypercalcemia. So if hypercalcemia is monitored, which Dr. Coimbra does and has taught to all the doctors he has trained, even these doses, he is giving safely to the patients who need it to beat the high degree of vitamin D resistance. So to avoid toxicity, other problem, what do we do? We no longer monitor PTH, we monitor ionized calcium as I just mentioned. So the ionized calcium should not cross the upper limit. At the same time it should not be very low below its normal range also. And we balance it, we balance the calcium with magnesium. Magnesium is very important to keep the calcium fluid, it doesn't allow it to get precipitated plus magnesium is so crucial in this therapy because magnesium is a cofactor. Without magnesium, vitamin D does not get adequately activated in the body, so we are just taking it, but the results are not happening. So magnesium is important. Magnesium, which salt is taken, which quality is taken is important.
0:29:54.0 Dr. Mahtani: Once again, friends, magnesium separate video is there. And it has to be actually individually monitored by the treating doctor, because we all are different. Our gut habits are different, so one very important mineral in this therapy is magnesium. We see so many people who come to me taking higher doses of vitamin D without all these things, and they do not get the result. So magnesium, and to prevent high calcium, we also use something called as Vitamin K2. It was not readily available in our country, a couple of years back, but now we have it, and we have some very good products of K2 and I'm sure many of you know that we're using it. I'll talk to you about K2 in a moment. We maintain enough hydration and we limit the daily intake.
0:30:40.3 Dr. Mahtani: So what does K2 do? K2 is like a traffic police. It knows where the calcium should be in the body means, suppose there is more calcium coming in the body because of the vitamin D that we are taking. So what K2 will do? It will not allow this calcium to go to the wrong places like the heart, blood vessels, kidneys. We don't want calcium to get deposited there. Okay so what it does, it says. "Come on calcium, you're not supposed to go there." It will pull the calcium, backtrack and take it where? To the bones. This is what K2 does. Okay and how does it do? As you can see here, prevents vascular calcification. Calcium should not be found in the blood vessels, because this is where the plaques start getting deposit. The cholesterol comes later. It's pehle the calcium. First, it's micro-calcium in the blood vessels, and then the cholesterol is heaping on top of it.
0:31:41.0 Dr. Mahtani: So we understand how important it is not to overload the body, and that too with the wrong calcium. So it takes the calcium from there, but it doesn't mean that calcium is bad. You need calcium in the moderate doses for so many functions in the body, and friends diet has enough calcium. Diet does not have vitamin D. So we have to strike the correct balance. So right now since I'm talking to all of you who are taking treatment or are somehow directly, indirectly aware of this methodology, when we treat, we have to monitor the calcium, much more.
0:32:16.4 Dr. Mahtani: For general supplementation, we need not worry. So anyways, this calcium from blood vessels has to be taken where? To the bones, and this is what this dear friend of our does. Some of you who are doctors here, vitamin D enhances two proteins, one is osteocalcin in the bones which enhances calcium in the bones. Plus it enhances another protein which is in the connective tissues of the body, which is called as Matrix Gla protein. And this reduces the calcium, see how intelligent the body is? It doesn't allow calcium to remain in the connective tissue. You can use the word remission, but we also like to say that you are treating the root cause. So chances of recurrence you have really brought it down. Well, so if a person... 60-70% people who respond very well, they have to keep taking the person-specific dose, the appropriate person-specific dose of vitamin D, to maintain that.
0:33:15.2 Dr. Mahtani: Now, friends, I ask you a question, do we take food only once? We wait to starve and then take food? Not really. So vitamin D is not really a medicine; it's food. It's nutrition for the cells. Unfortunately, we are no longer farmers, and we don't get it from food. And thankfully the pharma companies have made it, like a pill, otherwise, what would have happened to the health of humanity with the indoor lifestyles that we lead in today's time? Right, thanks to the pharma industry for making it. So, we get this Prasad or the blessing of God's sun in the form of that pill and that has to be taken. Why only for autoimmune diseases? Even others, general population must maintain their vitamin D levels to at least 50-60 nanogram, this is general purpose friends, okay, for having a optimal health. But for autoimmune disease management, we are not governed by just the blood levels, they do cross 100. We see the PTH as I just mentioned.
0:34:21.6 Dr. Mahtani: So remaining people get partial relief. It's not that it is zero benefit to anyone. Some or the other relief comes and well, what is the worst that can happen on this therapy? No benefit, alright, but one can control the progression of the problem. One can control the reoccurrences, the frequency, the intensity, because we all know that autoimmune diseases have a waxing and waning nature. Anytime there's stress, we breakout. Well, the stress immediately affects the immune system, we can manifest the problem. But the frequency, intensity comes down, or completely in control, if the vitamin D levels are maintained and optimized. All this is scientific, but it also involves an art, which honestly, this grooming in medicine, internal medicine is an art actually because every patient is different. Every human being is different. There is no black and white in human body, lots of gray zones.
0:35:26.6 Dr. Mahtani: So the clinical sense, clinical guidance and the guidance from the supreme I believe in that. So wherever the art of medicine is loved, there is also a love for humanity. Another beautiful statement by Father of medicine called Hippocrates. So I love the art of medicinal practice and I love humanity and I will do my best, I will go out of my way to help you. In case anybody of you listening to me today has either stopped the vitamin D on your own, I would say at least take the basic dose to maintain your blood levels of 50-60. At least do that. Don't stop it completely. If you want any help, we are there to guide you.

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Her website (she also does internet consultations in English and Hindi)

Her website

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My journey through Psoriasis... (copied from her website)

Unfortunately and fortunately, I have suffered from psoriasis twice. This became a drive for me to find curative solutions rather than palliative ones. Psoriasis is a stubborn autoimmune problem whose roots lie deeper than the skin. The immune system is mis-directed and erroneously attacking one’s own skin. The root cause is deep and deeper solutions have to be explored.

The search led me to the importance of mindful breathing techniques for cellular heath. While my psoriasis subsided for a good 10 years, it came back with a vengeance along with another autoimmune disease, Lichen Planus Pigmentosa. My face turned really dark overnight and it was a big jolt to me. The available treatments did not bring any significant relief. The search re-began and I had to find an answer to, “How could I suffer despite a reasonably healthy lifestyle?”

I became a student again and did a fellowship from the US in metabolic and nutritional medicine. I realized that a healthy lifestyle works better if the nutritional deficiencies in our cells are corrected. The past 30 years of technology and progress have been very detrimental to health. We look healthy but our cells are starving from lack of vital micronutrients. The hardware has to be made good for any software to work well. Then I was thelucky one to be invited by Prof. Dr. Cicero Coimbra for a hands-on training in Vitamin D Therapy to treat autoimmune diseases. Dr. Coimbra is a neurologist from Brazil who has been internationally treating autoimmune diseases with vitamin D for over 20 years.

Vitamin D is actually a hormone regulating very many cellular processes including immune-modulation. Thousands of scientific, peer-reviewed studies show the relationship between autoimmune diseases and vitamin D deficiency, as well as the benefits of vitamin D supplementation for such conditions. Vitamin D plays a powerful regulatory role by balancing immune responses in the body without side effects. For its proper activation and functioning, vitamin D needs specific pharma-grade nutraceuticals like magnesium, selenium, B2, omega 3 FA too.

The fact of the matter is true medicine evolves with time. This therapy is scientific, safe and natural as nutraceuticals are used to improve specific cellular functions. It is a personalised therapy which needs monitoring and individual fine tuning. It will be my privilege to help the very many psoriatic patients world-wide who are suffering and have given up all hopes. Friends there is hope - Psoriasis can be cured.

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Autoimmune in VitaminDWiki

Autoimmune category starts with

• 204 items in Autoimmune category
• Vitamin D and   MS    Asthma    RA    Diabetes    Gut   Allergy    Hay Fever    Lupus    Psoriasis
• Predicted 95% autoimmune cured by HIGH-DOSE vitamin D - 2014
• 10% of the UK have Autoimmune Diseases - Lancet May 2023 PDF is behind a paywall
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  • All 43 references are FREE on-line
• Autoimmune diseases fought by Vitamin D, especially if have more than 40 ng – Sept 2022
• The BEST Nutrient for Autoimmune Conditions (Vitamin D) - video May 2022
• The number 1 Deficiency behind All Autoimmune Diseases (Vitamin D) video - Dec 2023
• Autoimmune disease clusters run in families having low D
• How Vitamin D reduces inflammation, improves immunity and fights autoimmunity – review Dec 2018
• 120 doctors and 20,000 MS patients using high dose Vitamin D Dec 2018
• Vitamin D has treated Multiple Sclerosis and autoimmune diseases for 16 years – Coimbra April 2018
• Vitamin D Receptor is associated in over 58 autoimmune studies
• More autoimmune disease if higher pollution or lower UVB - Feb 2023
• Many autoimmune diseases associated with low vitamin D or poor Vit D genes – July 2019
  

See also web: consensus that ~50 diseases are autoimmune, ~50 more are suspected:

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Dr. Coimbra in VitaminDWiki

• Vitamin D Receptor is associated in over 40 autoimmune studies
• Multiple Sclerosis - Coimbra Protocol (high-dose Vitamin D) - by one of the 120 doctors of 20,000 patients - Dec 2018
• Interview of Dr. Coimbra: MS, Autoimmune, Vitamin D, B2, Ca, Mg, PTH etc. – perhaps 2018
• Vitamin D has treated Multiple Sclerosis and autoimmune diseases for 16 years – Coimbra April 2018
• Dr. Coimbra interview covering Vitamin D, Magnesium, Folate, Vaccines - Oct 2018
• Dr. Coimbra discusses Vitamin D, Magnesium, Folic Acid, B12, Autism, Depression, etc – Sept 2018 radio interview, human translated
• Vitamin D is the real Multiple Sclerosis Therapy, not an alternative therapy – Coimbra July 2018 3 minute
• Multiple Sclerosis Coimbra Protocol with Vitamin D - increased walking - May 2018
• Guide for patients on high doses of Vitamin D – Coimbra 2017
• Multiple Sclerosis Coimbra Protocol stories on Facebook
• Interview and transcript: Vitamin D protocol for Autoimmune diseases – Dr. Coimbra 2016
• Doctor got multiple sclerosis, rejected then embraced Coimbra protocol for herself and patients – Jan 2017
• Multiple Sclerosis and (lots of) Vitamin D - book by patient on Coimbra protocol - Feb 2016
• Interview and transcript: Vitamin D protocol for Autoimmune diseases – Dr. Coimbra 2016
• Video by Dr. Coimbra – 95 percent of auto-immune cured with vitamin D in high doses - April 2014

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Dr. Coimbra on COVID-19 - videos

Dr. Coimbra on Coronavirus and Vitamin D (English transcript) - Jan 2020
Opinion: “Vitamina” D in the prevention and treatment of covid-19 May 2020
   600,000 IU initially followed by 10,000 IU daily for 20 days
COVID-19 and high-dose Vitamin D - Video interview of Dr. Coimbra - May 2020

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VitaminDWiki - 7 items in both categories Books-Videos and Autoimmune

This list is automatically updated

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High-dose Vitamin D in VitaminDWiki

Is 50 ng of vitamin D too high, just right, or not enough
Treat autoimmune diseases with high-dose vitamin D – Germany online Aug 24, 25 2019
Successful high dose vitamin D (Coimbra Protocol) should be evaluated – June 2019
High dose vitamin reduced pain of fibromyalgia, osteoarthritis, and rheumatoid arthritis - July 2015 200K IU monthy

Comparing High-dose vitamin D therapies contains the following

	Dr. Coimbra books 2018 2016	Dr. Somerville Optimal Dose	Dr. Gominak	Mr. Batcheller	Dr. Bredsen End of Alz.
Health problem	Multiple Sclerosis autoimmune, PD	sleep, flu, pain, obesity, etc.	Sleep	Cluster, Migraine Headaches	Alzheimer's Park. being added
Number of people (2019)	30,000 by 2022	5,000	5,000	8,000 (2023)	>1,000 ?
Vitamin D target	PTH is target typ: 150ng of D	100-140+ ng	60-80 ng	PTH is target typ: 80 ng of D	40-60 ng
Vitamin D daily dose (K = 1,000 IU)	20K - 200K 1,000 IU/kg	30K	2K + monthly test increasing dose until goal	4K - 40K 110 IU/kg	?
Omega-3 *	O-3	O-3	- - -	O-3	O-3
Magnesium *	Mg	Mg	- - -	Mg (400 mg)	-
Vitamin K2	K2 (no longer?)	K2	- - -	K2	-
Vitamin B...	B2, B9, B12	B3	B50-B100 3 months	B50	B12
Zinc *	Zn		- - -	Zn	-
Boron *?	B		- - -	B	-
Calcium Minimize rock-based Ca	Decrease Ca		- - -	Ca	-
Vitamin A avoid extremes	avoid A	avoid A	- - -	A	-
Other	Choline Selenium Co-Q 10		- - -	Co-Q 10	-
Loading dose Days instead of months	- - -	- - -	- - -	Loading "Cluster Balm"	-

Most highly successful uses of high-dose Vitamin D have a lot in common
Evolved over a period of 4 - 16 years
60+ ng of vitamin D is needed - see also Is 50 ng of vitamin D too high, just right, or not enough
When increasing Vitamin D, it is important to also increase cofactors: Omega-3, Magnesium, Vitamin K and some B vitamins
The dose size typically varies both with the weight of the adult and individual need
None have generated any clinical trials. Their goal is success, not publication
Also, trials generally require same dose for everyone. with no changing of the dose during treatment
Use a pill containing many B Vitamins B50 (or B100)
   Thiamin, Riboflavin, Niacin, Vitamin B-6, Folic Acid, Vitamin B-12, Biotin, Pantothenic Acid,
     Which apparently is B1, B2, B3, B5, B6, B7, B9, and B12. - at least 50mg of each
As of 2019, none appear to (but probably should)

• Employ ways to increase the response to vitamin D dose
• Use one of the many gut-friendly forms of Vitamin D when needed
• Prescribe weekly or biweekly doses instead of daily which appears to provide higher response and more benefit
• Try to increase Vitamin D in the tissue, rather than just in the blood
  • Using one of more of: Resveratrol, Quercetin, Progesterone, high-intensity exercise and cofactors: Omega-3, Magnesium, Zinc
  • The founder of vitaminDWiki uses 10 of them

Vitamin D Cofactors in a nutshell has the following

 

Overview Toxicity of vitamin D has the following

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See also VitaminDWiki

• Is 50 ng of vitamin D too high, just right, or not enough
• Personalized Vitamin D treatment of Multiple Sclerosis - Michael Cawley
  • Nutritionist who cured his own and others MS with a modified Coimbra Protocol
• Vitamin D Resistance hypothesis confirmed by Coimbra high-dose vitamin D protocol – April 2021
• Poor response to vitamin D supplementation if poor level of B Vitamins (rats in this case) March 2021
• Overview Alzheimer's-Cognition and Vitamin D has a lot of data to support the following
  • PREDICTION: By 2024 high dose Vitamin D, Omega-3, and Magnesium will be found to reverse Alzheimer's in humans

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78+ VitaminDWiki pages have HIGH-DOSE in the title

This list is automatically updated

Short URL = is.gd/HighD

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Dr. Mahtani concerning COVID-19 in VitaminDWiki

• Vitamin D fights many health symptoms, including COVID-19: Dr. Mahtani video and transcript - April 2021
• COMING OUT STRONGER FROM LOCKDOWN WITH VITAMIN D: A VITAMIN D MOVEMENT INITIATIVE Renu Mahtani and 3 others 13 minutes, June 5
  • "It is not an optional supplement, It is a nonnegotiable cellular necessity" 40 ng minimum
  • 
  • "Worrying about Vitamin D toxicity is like worrying about drowning when you are dying of thirst" Dr. Cannell
  • Anecdote: 50,000 IU daily for 10 days given to people who live with person infected by COVID-19 ==> prevented infection
• COVID-19 and Vitamin D 30 minute updated May 12, excellent, Renu Mahtani
  • previous version, taken down by YouTube, had 600,000 views, >2,000 comments
  • for people who have not been taking any vitamin D she recommends Business World May 22
    • Vitamin D 60k IU twice a week for two weeks to be followed by 60k once a week for the next six weeks.
    • or Vitamin D 60k IU daily for three days to be followed by 60k weekly for the total period of two months.

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COVID-19 in VitaminDWiki

Many doctors believe that high dose vitamin D can fight COVID-19 – BMJ April 2020

COVID-19 treated by Vitamin D - studies, reports, videos

• As of March 31, 2024, the VitaminDWiki COVID page had:  trial results,   meta-analyses and reviews,   Mortality studies   see related:   Governments,   HealthProblems,   Hospitals,  Dark Skins,   All 26 COVID risk factors are associated with low Vit D,   Fight COVID-19 with 50K Vit D weekly   Vaccines   Take lots of Vitamin D at first signs of COVID   166 COVID Clinical Trials using Vitamin D (Aug 2023)   Prevent a COVID death: 9 dollars of Vitamin D or 900,000 dollars of vaccine - Aug 2023

5 most-recently changed Virus entries

Short URL =https://is.gd/mahtani