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Calculate a maintenance dose Vit D?


Nugget
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Is there a way to calculate a personal vit D maintenance dose based on 25(OH)D levels and supplementation? I am guessing it is a ratio involving number of days on the regimen, total quantity of vit D taken during that period, and change in 25(OH)D, but I can't wrap my mind around it. I can share numbers if you know what on earth I'm talking about :D

(BTW: I am ECH. Did not feel like I got benefit from the regimen during my last cycle, but my baseline vit D is low anyway, so I'm willing to try supplementing to see if it pushes out my next cycle!)

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Hey Nugget! Welcome to the group. 

Batch - @xxx is the main guy for the D3 Regimen. If you know that you are low, then start with 10,000/day - minimum. Along with all the other co-factors. They matter!! I would do this for a month and get my levels tested again. What is your D3 currently?

My first try was not perfect either. However, I have been cycle free for years now thanks to the Regimen. :) So, I am big believer in it! And yes, I am sure that it is the the D3 preventing cycles. All that I need to do to check that is to stop for two days and then deal with the hits that follow. Funny, I still check that at least once or twice a year during the normal cycle time for me. 

Hopefully Batch will see the tag and give you a more in depth reply.

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Hey Spiny,

You've done an excellent job of explaining the anti-inflammatory regimen to Nugget.  I'll add that we can estimate an optimum dose of vitamin D3 and time has shown that 10,000 IU/day vitamin D3 is a good starting point.  That said there are a few factors that influence the optimum dose that results in a CH pain free response.  They include total body mass and BMI.  Immune system activity particularly in response to allergens, infections, trauma, and surgery are also a major factors.  Accordingly, the process I now suggest includes the accelerated vitamin D3 loading schedule where you titrate (take progressively higher doses of vitamin D3) to elevate serum 25(OH)D3 more rapidly to achieve a CH pain free response for at least 48 hours, then taper the loading dose to arrive at a maintenance dose that keeps you CH pain free.

The following notional graphic illustrates the 25(OH)D3 serum concentration threshold above which you're CH pain free and below which, the CH beast jumps ugly.  The important thing to understand is the CH threshold and actual 25(OH)D3 serum concentrations go up and down with changes in immune system activity.  That means the maintenance dose that worked yesterday may be insufficient to keep your actual 25(OH)D3 serum concentration above the CH threshold.

ZY9M8Tt.jpgThe green line is the actual 25(OH)D3 serum concentration and the red line represents the CH threshold 25(OH)D3 serum concentration.  As you can see, both vary over time and the single largest factor is the level of immune system activity.  Where you run into problems with the CH beast jumping ugly is when your present 25(OH)D3 serum concentration is below the CH threshold due to an immune system response.  All this means is the CHer needs to be prepared to titrate (incrementally increase) the vitamin D3 intake with loading doses to achieve a CH pain free response, then taper the vitamin D3 dose to maintain an actual 25(OH)D3 serum concentration above the CH threshold as the new maintenance dose.

Intuitively, maintaining a 25(OH)D3 well above the CH threshold results if fewer occurrences of CH burn through.  This is a very safe practice as long as you see your PCP/GP for frequent (every 30 days) labs for 25(OH)D3, calcium and PTH to make sure serum calcium is within its normal reference range and PTH is not too low until you reach a stable vitamin D3 dose that keeps you CH pain free.  The target/optimum PTH serum concentration is between 11 and 22 pg/mL as illustrated in the 4-year chart of my labs for serum 25(OH)D3, calcium and PTH.

tzvBFcB.jpg

My PCP had no problem with my 25(OH)D3 serum concentration up at 277 ng/mL (692.5 nmol/L) as my serum calcium remained within its normal reference range and my PTH wasn't too low.  The reason my 25(OH)D3 was this high was due to a heavier than normal pollen fall from Alder and Big Leaf Maple trees that triggered a higher level of immune system activity in response to the pollen allergens.  Take care and please keep us posted.

V/R, Batch

Edited by xxx
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  • 2 weeks later...

Hey Nugget,

Thank you for the update.  Your 25(OH)D3 response to dose of vitamin D3 is spot on and looking great!

Before I go any further, I need to ask a couple pregnant questions, What was your serum calcium?  If it was within its normal reference range, there is no hypercalcemia (too much serum calcium), a.k.a., vitamin D3 intoxication/toxicity so your actual 25(OH)D3 serum concentration is no worry no matter how high it goes.

Moreover and more importantly, what was the frequency of your CH with a 25(OH)D3 serum concentration of 124 ng/mL?  If you experienced a decrease in the frequency, severity and duration of your CH at this 25(OH)D3 serum concentration, what's not to like about that? 

If there was no change in the frequency, severity and duration of your CH, it's very likely your 25(OH)D3 is still too low as illustrated in the 4-year chart of my labs posted earlier in this thread.  Accordingly, as most CHers have found, increasing their 25(OH)D3 serum concentration with a vitamin D3 loading dose of 100,000 IU/day vitamin D3 until they've experienced a CH pain free response for at least two full days, then taper the vitamin D3 dose back down to a maintenance dose (50,000 IU to 100,000 IU/week, a average vitamin D3 dose of 7100 t0 14200 IU/day is very effective.

It's unfortunate that too many doctors are unfamiliar with vitamin D3 therapy so parrot the school book comment to maintain an optimum 25(OH)D3 serum concentration of 40 to 80 ng/mL.  It's not their fault.  The medical school curriculum contains only a few hours on nutritional medicine and then it's to remain within the RDA for vitamins and minerals.  This is fine for "normal" people with no active pathology.  Guess what -  we CHers are not "Normal." 

The study I've been running with over 313 CHer participants since December of 2011, clearly indicates there's an inverse relationship between CH frequency and the 25(OH)D3 serum concentration.  In short, for CHers, a low 25(OH)D3 serum concentration results in a high frequency of CH, and CHers who elevate their 25(OH)D3 serum concentration up between 80 and 160 ng/mL experience a CH pain free response.  This is clearly illustrated in the following graphic from this study.

7fIH1fP.jpg

CHers have always been their own best advocate.  They know when an intervention works to lower the frequency of their CH and when it doesn't.  They also know about the side effects of these interventions.

How you proceed is up to you and your decision.  You can join thousands of CHers who have followed the anti-inflammatory regimen treatment protocol and control your CH effectively, or you can listen to your doctor and suffer.  The choice is yours.

Take care and please keep us posted.

V/R, Batch

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