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Successful high dose vitamin D (Coimbra Protocol) should be evaluated – June 2019

Vitamin D supplementation in multiple sclerosis-Can be done something more?

Medical Hypotheses, https://doi.Org/10.1016/j.mehy.2019.109256
José-Carlos Tutor
Grupo de Farmacología, Instituto de Investigación Sanitaria (IDIS), Hospital Clínico Universitario, 15706 Santiago de Compostela, Spain icarlostutor at gmail.com

VitaminDWiki

For years the successful use of high-dose Vitamin D for Multiple Sclerosis and Autoimmune diseases has been ignored by medical professionals. Perhaps because it requires adjusting the doses for each individual, rather the conventional one-size-dose fits all of Randomized Controlled Trials. Or, perhaps, because too many doctors still falsely believe that >2,000 IU can be toxic (still in medical textbooks a few years ago)

Note: A poor Vitamin D Receptor restricts vitamin D from getting to tissues

It is not clear when poor VDR ==> Disease vs when Disease ==> poor VDR
Items in both categories Autoimmune and Vitamin D Receptor are listed here:

Items in both categories Multiple Sclerosis and Vitamin D Receptor are listed here:

Overview MS and vitamin D contains the following summary
Clinical interventions have shown that Vitamin D can prevent, treat, and even cure Multiple Sclerosis, at a tiny fraction of the cost of the drugs now used to treat it, and without side effects.

Summary: lack of consensus on how much to prevent, treat, or cure MS.


Multiple Sclerosis and (lots of) Vitamin D - book by patient on Coimbra protocol - Feb 2016 contains protocol description
Vitamin D Protocol used by Dr. Coimbra for Multiple Sclerosis etc.
Snips as of April 2016 http://www.vitamindprotocol.com/dr.-coimbra-s-ms-protocol.html

  • 1,000 IU's vitamin D per kilogram as a first approximation
    (apparently increased/decreased depending of resulting vitamin D blood level)
  • Vitamin B2, magnesium glycinate, boron, chromium picolinate, Omega 3 DHA, Zinc, Methylcobalamin form of B12, Choline, etc.
  • Lack of B12 may affect 10%–15% of the general population and may be the most prevalent genetic risk factor for several human diseases
  • Discontinue eating or drinking dairy products or calcium enriched foods or beverages, also no Ca supplements
  • Drink as least 2.5 liters [85 ounces] of fluids, preferably water
  • Required Tests:​ Vitamin D, Parathyroid, Blood calcium, urinary calcium


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

Comparing High-dose vitamin D therapies contains the following

Dr. Coimbra
books 2018 2016
Dr. Somerville
Optimal Dose
Dr. GominakMr. BatchellerDr. Bredsen
End of Alz.
Health problem Multiple Sclerosis
autoimmune, PD
sleep, flu, pain,
obesity, etc.
SleepCluster
Headaches
Alzheimer's
Park. being added
Number of people
(2019)
30,000
by 2022
5,000 5,000 1,900>1,000 ?
Vitamin D targetPTH is target
typ: 150ng of D
100-140+ ng 60-80 ngPTH 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-3O-3
Magnesium *MgMg - - - Mg (400 mg) -
Vitamin K2 K2 (no longer?) K2 - - -K2 -
Vitamin B...B2, B9, B12 B3 B50-B100
3 months
B50B12
Zinc *Zn - - - Zn -
Boron *? B - - - B -
Calcium
Minimize rock-based Ca
Decrease Ca - - -Ca-
Vitamin A
avoid extremes
avoid A avoid A - - - A-
OtherCholine
Selenium
Co-Q 10
- - - Co-Q 10--
Loading dose
Days instead of months
- - - - - - - - - Load
"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
As of 2019, none appear to (but probably should)

Vitamin D Cofactors in a nutshell has the following

Importance to Health VDW10426  

Overview Toxicity of vitamin D has the following

Graph of dose vs week


See also VitaminDWiki


VitaminDWiki pages with HIGH-DOSE in title (67 as of Dec 2022)

This list is automatically updated

Items found: 71
Title Modified
Fracture 4X less likely following kidney transplant if high-dose Vitamin D (100,000 every 2 weeks) – RCT Jan 2023 25 Jan, 2023
High-Dose 18 Jan, 2023
Some pathogens and health problems restrict Vitamin D from being used – Coimbra high-dose protocol – April 2021 18 Jan, 2023
Muscular Dystrophy treated by high-dose Vitamin D - many studies 18 Jan, 2023
Diseases treated by high-dose Vitamin D - many studies 18 Jan, 2023
50,000 IU and other high dose vitamin studies 15 Jan, 2023
Coimbra protocol using high-dose Vitamin D is safe – April 2022 22 Dec, 2022
High dose vitamin D fights Folate gene changes by COVID, autoimmune, CVD, ALZ – Oct 2022 06 Oct, 2022
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
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
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 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

Short URL = is.gd/HighD

 Download the PDF from Sci-Hub via VitaminDWiki

To the Editor
In a recently published article by Berezowska et al (1), they conclude that vitamin D supplementation may be a promising treatment for multiple sclerosis (MS), and represents a reliable background for further exploration of potential benefit regarding clinical improvements. Likewise, they add that a high dose vitamin D supplement intervention may contribute to bettering of physiological mechanisms, especially if baseline plasma levels are at the lower end of normal (1). Häusler and Weber (2) review the vitamin D potentially immune modulating mechanisms, followed by a summary of current and ongoing clinical trials, intended to assess whether vitamin D supplementation positively influences the outcome of central nervous system (CNS) demyelinating disease. However, in this article, it is underscored the fact that high doses of vitamin D could have negative effects in CNS demyelinating disease via T cell-stimulating effect of secondary hypercalcemia (2). Similar precautionary conclusions have been pointed out by other authors (1, 3-6). Although it has been described that following oral vitamin D supplementation, patients with MS have a lesser average increase in serum levels of 25-hydroxy-vitamin D (25-OH-D) than healthy individuals having similar starting concentrations (7), in MS patients vitamin D is usually administered in modest daily doses on the order of 1,000-3,000 IU in association with different disease-modifying therapies. This vitamin D supplementation is increasingly used, providing an added beneficial effect to patients (8).
Frequently, the vitamin D undesirable effects found by Fragoso et al. (9) in some MS patients treated with 8,000-150,000 lU/day (median 100,000 Ul/day) are highlighted; nevertheless, these authors do not indicate what dosing procedure and clinical follow-up had been done in the patients included in this study, and what preventive measures had been taken to avoid the possible side effects of high doses of vitamin D. Other comments about the data and conclusions provided by Fragoso et al (9) can be seen in the paper of Kimball et al (10). Very possibly, the fear to a considered inevitable development of toxic effects, may explain the little attention awakened by some early studies, any published more tan eighty years ago (11, 12), on the possible treatment of autoimmune disorders, concretely rheumatoid arthritis, with massive doses of vitamin D.

Vitamin D is a powerful regulator of the immune system activity and, in accordance with the neurologist CG Coimbra from the University of Sao Paulo in Brazil, most patients with autoinmune diseases have an increased resistance to the immunomodulatory effects of vitamin D, mainly due to genetic polymorphisms, which requires the administration of massive doses of this prohormone to be clinically effective. It may be interesting to note here, that Henderson et al (13) have recently described the case of a woman with absence of circulating vitamin D-binding protein (VDBP), presenting a severe deficiency of vitamin D that did not respond to supplementation. This congenital deficiency of VDBP resulted in normocalcemia and mild disruption of bone metabolism, however, it was accompanied by a severe autoimmune disease (debilitating ankylosing spondylitis).
From years ago, the so-called "Coimbra protocol" with very high daily doses of vitamin D3 (initial dosage=1,000 lU/kg of weight) has been used in America and Europe for the treatment of MS (more than 30,000 patients) and other autoimmune diseases. The clinical results seem to be good, and the patients themselves treated by Coimbra in Sao Paulo, or by one of the doctors accredited to follow this protocol all over the world (14), recommend this therapeutic protocol with insistence and enthusiasm in their facebook groups (15) and in the books telling his own clinical history (16, 17). According to these patients, with MS and other autoinmune disorders, "we constituted the best clinical trial for the Coimbra protocol validation". Currently some articles on this subject have been published (18, 19), and a recent study conducted in Brazil, shows that MS patients have a high degree of satisfaction with the vitamin D treatment, whether exclusive or complementary (20).
The Coimbra's protocol for autoimmune diseases treatment has not just been recognized, but neither evaluated, in the academic media. It is argued that are necessary more studies to determine the suitable vitamin D dosage, and perform protocolized clinical follow-up, to avoid undesirable toxic effects as the hypercalcemia with all its possible physiopathological complications. Nevertheless, these issues seem to have been resolved by Coimbra itself. Briefly it may be noted that the daily doses of vitamin D are established and adjusted through the serum parathormone (PTH) levels, and not those of 25-OH-D. Likewise, the patients must follow a diet with calcium restriction, magnesium supplementation, and a daily intake of at least 2.5 liters of water, to maintain a urinary calcium concentration below 250 mg/L, for kidney stones and nephrocalcinosis prevention. Another factor of great importance for a good clinical evolution of the patients, is the maintenance of an adequate emotional control, which, depending on the degree of affectation, could be achieved in approximately 90-95% of cases. Periodically analytical controls of, at least, serum calcium, phosphorus, urea, creatinine, PTH, and 25-OH-D, and also calcium in 24-hour urine samples, are performed. The biochemical and clinical monitoring of patients treated with this protocol for years, shows that, although they present very high levels of serum 25-OH-D (frequently greater than 1,000 ng/mL), with very low PTH values around to the inferior reference limit, do not develop hypercalcemia, hypercalciuria, or other toxic effects due to the massive doses administered of vitamin D. More details on this protocol are available in one of the most prestigious online information sources about vitamin D (21).
Although some studies, such as that of Martinsen and Burian (22), are already underway in different European countries, from here, I invite all those involved in the research and/or treatment of MS and other autoimmune diseases, that, free from prejudices, find out about the true therapeutic possibilities of the Coimbra protocol. Then, we can answer to the question raised by Hawkes et al. (23), if for MS patients, vitamin D is "caviar or a dog's dinner".
Disclosure statement. The autor reports no conflicts of interest

References

  1. Berezowska M, Coe S, Dawes H. Effectiveness of vitamin D supplementation in the management of multiple sclerosis: A systematic review. Int J Molec Sci. 2019; 20: 1301  - Download the PDF from VitaminDWiki
  2. Haüsler D, Weber MS. Vitamin D supplementation in central nervous system demyelinating disease- Enough is enough. Int J Molec Sci. 2019; 20: 218
  3. Goischke HK. Vitamin D supplementation as add-on therapy in multiple sclerosis-Balance between benefit and risk?: A comentary on Vitamin D supplementation in central nervous system demyelinating disease-Enough is enough. Int J Molec Sci 2019; 20: 1553.  - Download the PDF from VitaminDWiki
  4. Mclaughlin L, Clarke L, Khalilidehkordi E, Butzkueven H, Taylor B, Broadley SA. Vitamin D in the treatment of multiple sclerosis: A meta-analysis. J. Neurol. 2018; 265: 2893-2905.
  5. Pierrot-Deseilligny C, Souberbielle JC. Vitamin D and multiple sclerosis: An update. Mult Scler Disord. 2017; 14: 35-45.
  6. Zahoor I, Haq E. Vitamin D and multiple sclerosis: An update. In: Multiple Sclerosis: Perspe ctives in Treatment and Pathogenesis . Zagon IS, McLaughlin PJ (editors), Codon Publications, Brisbane. 2017: 71-85.
  7. Bargava P, Steele SU, Waubant E, Revijaran NR, Marcus J, Dembele M, et al. Multiple sclerosis patiens have a diminished serologic response to vitamin D supplementation compared to healthy controls. Mult Scler 2016; 22: 753-60.
  8. Linden J, Granasen G, Salzer J, Svenningsson A, Sundström P. Inflammatory activity and vitamin D levels in a MS population treated with rituximab. Mult Scler J Exp Transl Clin. 2019; 5: 1-10.
  9. Fragoso YD, Adoni T, Damasceno A, de Albuquerque-Damasceno CA, Brito-Ferreira ML, Finkelzsteijn A, et al. Unfavorable outcomes during treatment of multiple sclerosis with high doses of vitamin D. J Neurol Sci. 2014; 346: 341-342.
  10. Kimball S, Hanwell HE, Burton JM, Heaney RP, Holick MF, Hollis B, et al. Vitamin D supplementation in multiple sclerosis: Making a case for clarity. J Neurol Sci 2014; 347: 391-392.
  11. Dreyer I, Reed CI. The treatment of arthritis with massive doses of vitamin D. Arch Phys Therap. 1935; 16: 537-40.
  12. Brohult J, Jonson B. Effects of large doses of calciferol on patients with rheumatoid arthritis. Scand. J. Rheumatol. 1973; 2: 173-176.
  13. Henderson CM, Fink SL, Bassyouni H, Argiropoulus B, Brown L, Laha TJ et al. Vitamin D-binding protein deficiency and homozygous deletion of the GC gene. New Engl J Med 2019; 380: 1150-57.
  14. Coimbra Protocol Doctors (accessed March, 25, 2019): https://www.google.com/maps/d/u/0/viewer?ll=42.16108947061385%2C13.05220517481689&z=5&fbclid=IwAR0R3GFly-tU90-WEeL5PiUI1vxSZId9zPVzTobYduilES7AFjHhgn6vTo&mid=1fATZJUEhOsYYJdBY41h48FBkLaQ
  15. Coimbra Protocol Facebook Groups (accessed March, 25, 2019): https://mfacebook.com/notes/o-tratamento-com-vitamina-d-do-dr-c%C3%ADcero-coimbra-portugal/grupos-e-p%C3%A1ginas-relacionados-com-o-protocolo-do-dr-c%C3%ADcero-coimbra/1722518301305431/
  16. Domene AC. Multiple Sclerosis and (lots) Vitamin D: My eight-year treatment with the Coimbra protocol for autoinmune diseases. CreateSpace Independent Publishing Plattform, 2016.
  17. Butler J. Stop Multiple Sclerosis & Autoimmune Disease with High Dose Vitamin D: The first US patient treated by the first US Coimbra protocol doctor tells her story. Independently Published, 2017.
  18. Finamor DC, Sinigaglia-Coimbra R, Neves LCM, Gutierrez M, Silva JJ, Torres LD et al. A pilot study assessing the effect of prolonged administration of highly doses of vitamin D on the clinical course of vitiligo and psoriasis. Dermato-Endocrinol. 2013; 5: 222-234.
  19. Cadegiani FA. Remission of severe miastenia gravis after massive-dose of vitamin D. Am J Case Rep. –2016; 17: 51-54.
  20. Alves-Reis CF, Pereira-Guimaraes F. Multiple sclerosis patients perception about the use of vitamin D in clinical therapy. Rev Bras Cienc da Vida. 2017; 5 (1): 1-19.
  21. GrassrootsHealth (accessed March, 25, 2019)
  22. Martinsen I, Burian N. Adherence to the Coimbra Protocol in Adults with Autoimmune Disease. Bachelor Thesis, University College Copenhagen. 2019 (accesed March, 25, 2019): https://docs.google.com/document/d/1e4RWNdGJfM8bgBpU9ua9RydSxA1QZxGTwzZX8N5lc/fbclid=IwAR0QAE3mNEszfA0GcF3YOGsHFBTXaKZxzAX2k5gqw3CB9pqS1uMCATrU2OE
  23. Hawkes C, Giovannoni G, Lechner-Scott J, Levy M, Waubant E. Multiple sclerosis and vitamin Caviar or a dog's dinner?. Mult Scler Relat

Created by admin. Last Modification: Wednesday January 18, 2023 18:55:39 GMT-0000 by admin. (Version 14)

Attached files

ID Name Comment Uploaded Size Downloads
12340 Balance between Benefit and Risk.pdf PDF 2019 admin 17 Jul, 2019 10:50 155.29 Kb 368
12339 Effectiveness of Vitamin D Supplementation in the Management of Multiple Sclerosis.pdf PDF 2019 admin 17 Jul, 2019 10:37 412.49 Kb 421
12097 Should evaluate Coimbra.pdf PDF 2019 admin 09 Jun, 2019 15:34 278.14 Kb 508