Leaderboard

Hey J, Off hand, I'd say you're doing great and it appears the vitamin D3 loading schedule worked as advertised. The average gain in 25(OH)D serum concentration during the vitamin D3 loading schedule is 10 to 12 ng/mL for every 100,000 IU of vitamin D3 when starting around 30 ng/mL. Using that formula, you gained roughly 78 ng/mL. Adding that to your starting 25(OH)D serum concentration, we'll assume to be 29 ng/mL we get 107 ng/mL as your new total... That's close enough. At the end of this loading schedule, we drop back to an initial maintenance dose of 10,000 IU/day. 30 days after start of regimen schedule another set of labs with your PCP. You'll need labs for your serum 25(OH)D, total calcium and PTH (Parathyroid hormone). If you're CH pain free at that point taking 10,000 IU/day and your 25(OH)D is 80 to 110 ng/mL, I wouldn't change a thing. Regarding your 25(OH)D being above 100 ng/mL, it's no big deal. The normal reference range for 25(OH)D uses an overly conservative upper limit of 100 ng/mL. As 25(OH)D is a poor biomarker for vitamin D3 toxicity, going above 100 ng/mL to even 150 ng/mL or higher is NOT an indication of vitamin D3 inoxication/toxicity. If there was such a relationship, it would likely be well above 200 ng/mL. There are a number RCTs concluding this to be the case. For reference, I've maintained a 25(OH)D serum concentration over the last three years of 140 ±50 ng/mL. My PCP just looks at my lab results and smiles saying... "Your vitamin D3 is elevated... as usual... but your total calcium is normal and PTH is low so I guess you know what you're doing controlling your CH this way." Accordingly, (for peace of mind if you're still concerned), what I would do is see my PCP for lab tests of serum total calcium and PTH. As long as the serum total calcium is within its normal reference range of 8.5 to 10.5 mg/dL, and PTH is in the lower third of its reference range, there's no vitamin D3 toxicity. Otherwise, I'd wait for 30 days after start of regimen for these lab tests. Prednisone has a slight negative effect on vitamin D3 metabolism. Once you've completed the taper, the shadows should diminish. Good move staying on the Benadryl at 25 mg every 4 hours during the day and 50 mg at bed time. I would do this for at least another week... 3 times a day was not enough for me. I've also taken 12.5 mg of the Children's Liquid Benadryl (Diphenhydramine HCL) allergy medicine and found it just as effective if taken every 4 hours as the tablet form. It also worked great in aborting shadows if you hold the liquid in your mouth and not swallow for 3 to 4 minutes as a buccal (between lower lip and gums) or sublingual (under the tongue) application. That's easy to say as the liquid form is terribly sweet and you'll be tempted to swallow it. You'll know when to taper off the Benadryl when you reach the 5 hour mark between doses and there are no shadows. At that point I extend the dosing interval to every 6 hours for a day or two, then every 8 hours, then 12 hours, then none... As long as there are no shadows at the new dosing interval, press on to the next longer dosing interval. If you remain CH pain free (that includes no shadows) for >24 hours after the last dose of Bendadryl (Diphenhydramine HCL), you'll know that it's the vitamin D3 that's preventing your CH. Again, I think you're doing great! Take care and please keep us posted. V/R, Batch .'