Sorry if this has already been covered, but I was unable to find anything in a search.

My DH has been on the regimen for a good 6 months (and it worked beautifully!), and his doctor now wants him to cut back to 1000 or 2000 IU of D3...which he has no intention of doing. However, being episodic with 2-3 years between episodes, he would like to try cutting back to 5000 iu. The magnesium is not agreeing with his stomach. This seems reasonable, given that he had gone 3 years since his last episode and had been taking only 1000 iu of D3 during that remission.

So if he does that, should he be also be cutting some of the cofactors in half? I think he should keep up on the Mature Multi and Fish Oil (1000 gel)...but could he cut back on the magnesium (currently taking 500 mg). And somehow the Super K which unfortunately comes in a gelcap...I would have to look and see if there is an alternative for that.

For anyone who has weaned down or off the D3 regimen, how did you do that? Thanks in advance for any advice you have!

JMC

Hey JMC,

Thanks for the feedback and good questions...  I like your husband's stand on sticking with his present vitamin D3 dose no matter what his PCP says...  There are so many health benefits and advantages made possible with a serum 25(OH)D concentration around 80 ng/mL plus Omega-3 fish oil and all the cofactors, that going to a lower serum concentration really doesn't make any sense.  That said, nearly all of these benefits are still available, but at a lower probability at a vitamin D3 intake of 5,000 IU/day and 25(OH)D at 60 ng/mL... 

One of the best ways of addressing situations like this is to go in for lab tests of serum 25(OH)D, total calcium and PTH.  As long as serum calcium remains within its normal reference range and PTH stays in the lower third of its normal reference range, the 25(OH)D serum concentration is no worry even if its above 100 ng/mL.

For reference as a chronic CHer. i'm constantly adjusting my vitamin D3 intake to remain CH pain free.  As a result, I've averaged a vitamin D3 dose of 20,000 IU/day over the last 3 years.  Of course that dose has driven my serum 25(OH)D concentration to an average of 140 ±50 ng/mL and it's gone as high as 200 ng/mL. 

I made sure my PCP had a copy of the anti-inflammatory regimen a long time ago so he looks at my labs at my annual physical and smiles...  Then says "Your labs all look great... but your 25(OH)D is elevated as usual... However, as long as your serum calcium remains within its normal reference range and your PTH is low... I've no problem with your serum 25(OH)D as long as it prevents your cluster headache."

The half-life of serum 25(OH)D is roughly two months.  In other words, if your 25(OH)D was 100 ng/mL and you stopped vitamin D3 supplements, it would take two months for your 25(OH)D serum concentration to drop to 50 ng/mL. 

I can confirm that half-life.  It took two months without any vitamin D3 supplements for my serum 25(OH)D to drop from 200 ng/mL to 100 ng/mL.

We all need magnesium... CH or not and particularly if supplementing with vitamin D3 at 5,000 IU/day or higher.  400 mg/day is sufficient for most adults...  If the magnesium is still causing lower GI tract problems, try switching to another magnesium salt.  I try all of them...  Magnesium glycinate and magnesium chloride appear to be less likely to result in osmotic diarrhea.

Hope this helps...  Take care and please keep us posted.

V/R, Batch

Interesting, I didn't know about the half-life.

With DH being episodic, we were thinking it might be good to wean down from 10,000 iu to 5,000 iu or less so he isn't taking quite that handful of pills during the 2-3 years that he is in remission...maybe get down to 2,000 iu IF that works for him. I just don't know if the cofactors need to be adjusted as well as the D3. How important to the effectiveness of the D3 are the Super-K and Magnesium supplements? Should any of these cofactors be decreased or discontinued along with the decrease in D3? Now that I know about the half-life, I assume he could cut back and then get back in the saddle if shadows start showing up again.

He did have serum 25(OH)D concentration tested, it was below 80 (I think it was 69? Initially it was 24 before starting the regimen) but calcium and PTH were not tested.

JMC,

If anything, the Omega-3 and vitamin D3 cofactors are more important if your husband decides to cut back to a vitamin D3 dose of 5,000 IU/day.

With a 25(OH)D serum concentration of 69... I would stay at 10,000 IU/day vitamin D3.  The super K is very important for good cardiovascular health...  As is CoQ10 and Turmeric (Curcumin)...  In short, why increase the risk of heart problems over the inconvenience of taking a handful of pills...

Take care and please keep us posted...

V/R, Batch

Thank you for your answer, Batch! So in keeping with the concerns about Magnesium, I went out shopping and was unable to locate either the glycinate or chloride varieties. I did however find Magnesium Citrate, which if I recall correctly is something a person might take as a part of colonoscopy prep. Not good. I'll try to get some of the other ordered online, and have him break up his daily dose with half at breakfast and half at dinner. Will also push for the calcium and PTH levels being tested at his next visit. I appreciate the advice!

FWIW...Mg oxide goes through me...to quote Patton..."like crap through a goose". I use the Mg citrate with no problems....YMMV.....

Best

Jon

I too find the Magnesium Citrate best for me.

Peter.