Vitamin D regimen

[jimmyogden]

Followed the regimen to the letter even the same brand. After load dose d serum was 56 ng/ml. Continued taking 25000 units daily for next 5 weeks. Headaches are not gone but drastically better. Took d serum test yesterday and it is 52 ng/ml. Looking for suggestions on getting vitamin d serum into the 80 -100 range

[Dallas Denny]

@Craigo can you help?

[snafu]

are you taking all the co-factors? they are essential for better vitamin d3 absorption. 

are you taking capsules or drops? if you are taking capsules you should always do so after eating some kind of meal which contains healthy fats. again this is crucial for absorption.  this also goes for drops, which are basically some kind of oil to transport the vitamin d3, but not to the same extent. but it is always beneficial to not take these supplements on an empty stomach. for a fat soluble supplement  this is important.

it seems strange that at that dose your levels are dropping. maybe take another test to see if this is really your current serum level.

[jimmyogden]

I appreciate the reaponse. Yes i am taking all of the co-factors. I am taking capsule had trouble getting the drops. But i usually take them midday and not always with food so I will adjust it to be with food

[Dallas Denny]

@jimmyogden I've sent a message to @Craigo who is the protégé of Batch, the clusterhead who came up with the D3 regimen.....however, he's in New Zealand so may be tomorrow before he sees my message but I'm sure he'll have some answers for you.

Dallas Denny

[Craigo]

Greetings to all thanks @Dallas Denny and hey @jimmyogden, great to hear the headaches are better- that is the main signal and a drop in attack frequency even without full remission is a signal the regimen is doing its job. Hopefully with a few tweaks you could get more improvement.

First, @snafu is spot on about the fatty meal. D3 is fat soluble, so a capsule taken midday on an empty stomach can leave a chunk of it unabsorbed. Moving it to right after a meal with some healthy fat is a single easy change and on its own it may lift your numbers.

On the 56 to 52 reading, I would not read too much into the drop. Most D assays carry a 10 to 15 percent margin of error, so 56 and 52 are effectively the same result. You are sitting stable in the low 50s on 25,000iu a day, and that is useful to know. The question is less why is it not increasing and more how do you push it up.

Before I suggest anything I know Batch would ask for a few numbers:

• What was your baseline 25(OH)D before you loaded?
• What was your total loading dose (the standard 600,000 over 12 days, or something else)?
• Roughly your body weight or BMI? D distributes through body fat.
• If you can get them, your PTH and calcium (albumin corrected) from a recent panel.

That's some private info so feel free to tell me to piss off or rather DM or whatever you are comfortable with.

With baseline and total load you can work out roughly how many ng/ml you gained per 100,000iu and from there how much more you need to reach 80 to 100ng/ml.

Options to consider, in the rough order I would try them:

1. Switch to a nano-emulsion or micro D3 drop. These bypass a lot of the GI absorption bottleneck, so you get more into your blood per unit. If absorption is your limiter, this moves you without raising the dose much. Where are you located, perhaps can find a link to suitable product.
2. A partial top up load. As a rough rule of thumb, 100,000iu units shifts serum about 10ng/ml. To go from low 50s to the 80 to 100ng/ml band you are likely looking at something around 300,000, taken over a few days the way you did the original load. For context, that is not an extreme number. Renu Mahtani used 600,000iu loads across her psoriasis case series of around 90 patients, with some staying on 30,000iu a day or more until clinical remission and adjusting from there. And here in NZ, Starship runs stoss therapy at a single 600,000iu dose for deficient kids aged 5 to 18. So an extra 300,000 spread over a few days sits well inside what is done clinically. That said, you would want to see your PTH and calcium and hopefully are able to discuss with your doctor
3. A short course of calcifediol instead of cholecalciferol, then back to D3. Calcifediol is already a step down the activation pathway, so it raises 25(OH)D faster and more reliably, handy if absorption is the issue. A short run could lift you into range, then you revert to normal D3 for maintenance.

Hope that is of some help there mate, again - feel free to DM. Cheers, Craig.

[jimmyogden]

@Craigo

Thank you for your reply. I will def order some drops. Here is my info you requested. Again thank all of you for the help. 

Baseline before loading was 32 normally for me

Loading was the 50000 daily for one week and 40000 daily for one week

Body weight is about 230

Calcium 9.0

PTH, intact 47 pg,ml

 

I have currently imcreased my vitamin D to 25000 units per day

[Craigo]

Hey again there @jimmyogden sure thing. Again I am just a patient that read a few too many studies and followed Batch's work so please take my commentary as exactly that but... reference ranges vary slightly by laboratory, most common ones are:

Serum calcium: 8.6 to 10.2 mg/dL (2.15 to 2.55 mmol/L). Your result was 9.0 mg/dL.

Intact PTH: 15 to 65 pg/mL (some labs use 10 to 65 or 16 to 77 pg/mL). Yours - 47 pg/mL.

If Pete were active I am confident he would say thats a green light to take another loading as your PTH is relatively high and your calcium on the lower side of mid-range. The risk of issue with a further loading dose is minimal and the benefit of further CH improvement is a goal worth aiming for IMHO.

But even increasing to 25,000iu per day for some time I am sure you will see an improvement. I am remiss that I did not mention magnesium in my original reply albeit just made a presumption that you were getting the 400mg or as much as tolerable. Whilst some would say its used up in the conversion of vitamin D3 through its various forms, I know as much as to say it is a necessary cofactor in those enzymatic reactions but just like the starter motor in your car, it isn't consumed each time you turn over the engine but you do need sufficient amounts of magnesium as you increase the demand on the liver to convert the vitamin D3 into its storage form 25(OH)D - the form we measure in the lab test.

Anyway good luck take care keep us posted.

[jimmyogden]

Sorry for the long absents. I have been busy at work. I have increased magnesium to 800 a day a couple weeks ago with no side affects. (Should have mentiond that). After reading what you had responded with at the beginning I increases my vitamin d to 25000 per day. After about 3 days I went into remission I believe. Not sure if it was natural cycle or the increase. Regardless the vitamin d regimen greatly helped lower my pain levels this time. Only wished I would have tried it several years ago. Thank everyome here for there help, knowledge, and resources. 

[Craigo]

Its 6am, just about to make coffee - reading this, man - awesome awesome awesome and may your remission continue long into the future. There is nothing better than reading of a fellow warrior getting pain free. Made my day. Cheers brother Jimmy! Craig.