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123 Days PF And I Think I know Why (Read 448729 times)
Batch
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Re: 123 Days PF And I Think I know Why
Reply #2150 - Feb 5th, 2015 at 5:33pm
 
Hey Slacker,

Thanks for the update... Falling out of remission while on a maintenance dose of 10,000 IU/day vitamin D3 is not uncommon for chronic CH'ers and some episodic types.

We think this is due to competing consumers of vitamin D3 metabolites and the enzymes needed to metabolize them. Our immune system is the likely culprit as it reacts to viral and bacterial infections 7 X 24. 

Infections and allergic reactions happen all the time, but the symptoms may be sub-clinical, so we can have a bug or an allergic reaction and not know it.  A lab test for 25(OH)D at that point would be helpful as a reference point to watch.

The simple solution is a short vitamin D3 loading schedule using a loading dose of 100,000 IU to 200,000 IU of vitamin D3 spread over 3 to 6 days then drop back to a new maintenance dose of 15,000 IU/day vitamin D3.

For example using a 100,000 IU loading dose, take 50,000 IU of vitamin D3 on day one and 25,000 IU on days two and three. 

The 200,000 IU loading dose of vitamin D3 can be spread over 6 days, i.e., take 50,000 IU/day vitamin D3 on day one and two, then take 25,000 IU/day on days 3 through 6.

As you'll see in the following chart developed by Dr. Robert Heaney, MD, et al., in the study titled: 25-Hydroxylation of vitamin D3: relation to circulating vitamin D3 under various input conditions, it takes 1 day for a dose of 100,000 IU of vitamin D3 to reach peak serum concentration and 7 days for the liver to metabolize that dose of vitamin D3 into a peak serum concentration of 25(OH)D.

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If the 25(OH)D serum concentration is low, the 25(OH)D response to a loading dose of 100,000 IU of vitamin D3 is an average gain of 13.6 ng/mL on top of the starting serum concentration.  If your present 25(OH)D serum concentration is around 65 to 75 ng/mL, the 25(OH)D response to a loading dose of 100,000 will be less, around 8 to 10 ng/mL.

Hope this helps.

Take care and please keep us posted.

V/R, Batch
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« Last Edit: Feb 5th, 2015 at 5:46pm by Batch »  

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Re: 123 Days PF And I Think I know Why
Reply #2151 - Feb 5th, 2015 at 7:04pm
 
slacker wrote, Melatonin - Natrol 10 mg slow release before bedtime.

Hi slacker,
Slow release Melatonin is less effective than regular
Melatonin when it comes to getting through the night without that visit from the  Smiley

Cheers, Hoppy.
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Re: 123 Days PF And I Think I know Why
Reply #2152 - Feb 5th, 2015 at 7:08pm
 
Hey Batch,

Thanks for replying.  I've actually been on a maintenance dose of 15,000 IU for awhile now. 

Should I bump it up to 20,000 IU per day?

So I would do a 200,000 IU loading dose over 6 days and then drop down to 20,000 IU?  Or should I stick with 15,000 after the loading dose?

Also, do you still recommend dissolving the loading dose amounts in the side of your mouth before bedtime?
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Re: 123 Days PF And I Think I know Why
Reply #2153 - Feb 5th, 2015 at 7:40pm
 
Hoppy wrote on Feb 5th, 2015 at 7:04pm:
slacker wrote, Melatonin - Natrol 10 mg slow release before bedtime.

Hi slacker,
Slow release Melatonin is less effective than regular
Melatonin when it comes to getting through the night without that visit from the  Smiley

Cheers, Hoppy.


Interesting...I had always heard the opposite.

How many mg and is there any particular brand you recommend?
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Re: 123 Days PF And I Think I know Why
Reply #2154 - Feb 5th, 2015 at 10:21pm
 
Hi slacker,
In the UK you can only get them on prescription from
from your GP, which are the slow release Melatonin, and
By all the reports I've come across they are ineffective when using them to stop that nightly visit from the beast. Here downunder you can only get low dose regular ones over the counter. I get mine online from the Biovea website 5mg tablets. You need to take 5-15mg before bed.

Hoppy.
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« Last Edit: Feb 5th, 2015 at 10:56pm by Hoppy »  
 
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Re: 123 Days PF And I Think I know Why
Reply #2155 - Feb 5th, 2015 at 11:56pm
 
Thanks Hoppy...I'll give it a shot.
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Re: 123 Days PF And I Think I know Why
Reply #2156 - Feb 6th, 2015 at 4:32am
 
Slacker,

Good questions...  I'd opt for the 200,000 IU loading dose of vitamin D3 spread over 6 days then drop to a maintenance dose of 15,000 IU/day. Be sure to keep your magnesium intake between 500 and 750 mg/day while loading.  Higher doses of vitamin D3 consume magnesium rapidly.

Your call on how to take the vitamin D3. Popping the liquid softgels between the back teeth and holding the contents between the cheek and gums for 10 to 15 minutes gets the vitamin D3 into the bloodstream a little faster.  I use this method if I sense the beast is lurking and about to jump ugly on me...  the rest of the time I swallow the softgels.

You should be completely pain free by the sixth day so if you get an up-tic in CH, up the daily dose of vitamin D3 from 15,000 IU/day to 20,000 IU/day for a couple weeks then drop back to 15,000 IU/day and see what happens. 

A trip to your PCP would be prudent after a month or so for the lab test of your 25(OH)D.  If it's up over 80 ng/mL your PCP may want to do the serum calcium and PTH lab tests...  No biggie...  In over 4 years with hundreds of CH'ers taking this regimen, we've yet to have any CH'er report his or her serum calcium concentration above its normal reference range.  Your PTH should be in the lower third of its normal reference range.

During the high pollen spring time and fall leaf mold, I need to carry an average vitamin D3 intake of 20,000 IU/day in order to stay pain free.  When it appears the pollen has cleared, i.e., no longer coating my pickup... I drop back to 15,000 IU/day for a couple weeks and then down to 10,000 IU/day as long as there are no burn through hits.

Take care and please keep us posted.

V/R, Batch
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« Last Edit: Feb 7th, 2015 at 11:05am by Batch »  

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Re: 123 Days PF And I Think I know Why
Reply #2157 - Feb 6th, 2015 at 10:58am
 
Hello Batch and all my other friends in clusterville!
It's been a while and I thought it time to check in with an update.

This January marks the fourth year since my last cycle (on average it seems I get these every four years). I've been taking the anti-inflammatory regimen since then; backing off in the summer months when I'm outside in the sun more and increasing the dosage during the long gray days of central Ohio winters.

The last few years around October or November I have had an experience that seems to indicate I'm going to go into cycle but when I upped the D3, that went away.
 
Last September I had my 25(OH)D checked and it was at 83.1. As November rolled around and I started getting the signs associated with maybe getting the beast(?) I upped the vitamin D and all seemed well.

In all honesty, from the middle of December to the middle of Jan this year, I was a bit Cavalier about the regularity of taking the Vit. D and about three weeks ago started experiencing that old familiar feeling.

At that time I also got hit with a decent cold and a week into that had what I could only describe as a bonafide hit from the beast. But...this was a completely different experience from the usual in that there was almost NO pain, just what I could describe as an "annoyance" of very slight pain and an on again, off again tightening of the muscles in my neck and shoulder throughout out the week.
This happened again three days ago wherein I got religious about doing all the supplements recommended.
This morning about 4:00 I had another episode: I was awoken out of a deep dreaming sleep with a "bang" (how the beast usually arrives) and the ramping up of the "annoyance" that lasted about ten to fifteen minutes then subsided; again there was almost no pain but all the other hallmarks of the cluster were there. So, I'm wondering if I'm in a cycle?
Batch, I just read your post about the increased need of D3 when we have an infection (I'm thinking my cold); which is incredible timing that I saw that just now. So, I have decided to up my D3 to the loading dose of which you speak, I start today.

I'll be keeping in touch more often with updates on how this is working for me and any other related experiences.  I'm so hoping this is going to be the solution and that I can escape a visit from the damn demon.

Batch, I do want to give you my most sincere appreciation and thanks for keeping this thread going for the past more than four years. I don't post much since I don't get these that often (thank goodness), but I do check in now and again and I am awestruck by your tenacity and research, and by your continued encouragement to all of us.

Sincerely,
Gary
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Re: 123 Days PF And I Think I know Why
Reply #2158 - Feb 6th, 2015 at 12:06pm
 
Batch wrote on Feb 6th, 2015 at 4:32am:
Slacker,

Good questions...  I'd opt for the 200,000 IU loading dose of vitamin D3 spread over 6 days then drop to a maintenance dose of 15,000 IU/day. Be sure to keep your magnesium intake between 500 and 750 mg/day while loading.  Higher doses of vitamin D3 consume magnesium rapidly.


I'll up my magnesium citrate dose from 400 mg to 600 mg for the next 5 days while I take the 200,000 IU loading dose.  I took the first 50,000 IU dose last night before bed.

Thanks Batch...I'll keep you guys updated.
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Re: 123 Days PF And I Think I know Why
Reply #2159 - Feb 7th, 2015 at 10:57am
 
Hey Gary,

Thank you for the update and kind words...  Good on you for connecting the dots between a viral infection and falling out of remission.  I'm confident the course of action you've laid out will be effective in keeping you pain free and clear of the other CH symptoms.

Feedback like yours is very important for all of us as it increases the knowledge base on this regimen.  Finding out what happens when you skip doses of this regimen is also important...  Lessons learned this way tend to stick with us...

As an old hand with this regimen you may have missed the addition of a 3-month course of vitamin B 50.  I added this to the list of supplements over a year ago at the suggestion of Dr. Stasha Gominak, MD, a neurologist in Tyler, TX.

Believe it or not, she's a neurologist who's been prescribing a similar vitamin D3 regimen for her patients with sleep, chronic pain and headache disorders for a lot longer than me.  The only difference between the anti-inflammatory regimen and what she prescribes is a tests for vitamin B12 and the 3-month course of vitamin B 50.

I had a long conversation with her as she explained her history with this regimen.  For the first 2 years after she started prescribing it for her patients, she was on top of the world as nearly all her patients experienced restful sleep and a lasting pain free response to her regimen...

Then over the course of the following year, some of her long-term, very satisfied users of her regimen started calling her saying it was no longer working for them.  She ran the standard labs for 25(OH)D, calcium, PTH and even checked some of the other related labs...  All of them came back indicating 25(OH)D was near 80 ng/mL and the other labs were within their normal reference ranges.

Out of the blue, one of her patients who had reported this regimen was no longer working, called to say it started working again very effectively...  Her patient added the only possible explanation was that she had started taking one of the B vitamins a week earlier...

Dr. Gominack said the light came on bright so she started testing her non-responders for vitamin B12 as an indication of overall B-vitamin status...  Sure enough, most of them had a low vitamin B12 status.  At that point she took the shotgun approach and prescribed the 3-month course of vitamin B 50...  A tablet formulated with 50 mg of each of the seven B vitamins plus 400 mg of Folic acid.  Long story made short... it worked!

I made a change to the list of supplements I take and now suggest swapping out the Kirkland calcium citrate with magnesium and zinc in favor of the Kirkland Mature Multi.  The Mature multi is also formulated with calcium, magnesium, zinc and boron, but adds vitamin A (retinol), all seven B vitamins and Folic acid along with a number of other micronutrients.

I also swapped out the Nature Made 400 mg magnesium  liquid softgels in favor of the Kirkland 250 mg magnesium citrate liquid softgels.  500 to 750 mg/day magnesium during vitamin D3 loading helps.

Finally, the question I like to ask CH'ers... "Have you started the rest of your family on this regimen?"

The health benefits of this regimen are hard to ignore.  Besides that, with our healthcare system going down the dumper...  a healthy preventative for a long list of medical conditions costing 35 to 40 cents a day is a prudent move.

Take care and please keep us posted.

V/R, Batch
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« Last Edit: Feb 7th, 2015 at 11:11am by Batch »  

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Re: 123 Days PF And I Think I know Why
Reply #2160 - Feb 7th, 2015 at 5:33pm
 
Batch wrote, I also swapped out the Nature Made 400 mg magnesium  liquid softgels in favor of the Kirkland 250 mg magnesium citrate liquid softgels.  500 to 750 mg/day magnesium during vitamin D3 loading helps.

Hi Batch,
Are you saying you no longer need to take 400mg
of Magnesium citrate /day if you take a Kirkland
Mature Multi 1/day, if your only taking 10,000iu
vitamin D maintenance dose.

Cheers, Hoppy.
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Re: 123 Days PF And I Think I know Why
Reply #2161 - Feb 7th, 2015 at 11:31pm
 
Hey Hoppy,

Not at all...  Even though I switched from the calcium citrate to the Mature Multi, I was still taking at least a 400 mg softgel of the Nature Made Magnesium Oxide.  I just swapped that out for two of the 250 mg magnesium citrate softgels.

Take care,

V/R, Batch
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Re: 123 Days PF And I Think I know Why
Reply #2162 - Feb 7th, 2015 at 11:46pm
 
Hi Batch,
Thanks for clearing that up for me.

Hoppy.
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Re: 123 Days PF And I Think I know Why
Reply #2163 - Feb 8th, 2015 at 12:14pm
 
Thanks Batch!
That is great information to have. I did notice your changes and have followed suit. I was unable to find the B50 when I needed it so I picked up a good multivitamin/mineral which has all the B's etc.
I found a K2 with only MK7, but grabbed it anyway since I was desperate to begin that at the time; so I will look online for the Super K you've suggested.

And...great news! As of day three on the loading dose no further evidence of the beast! Actually almost all the symptoms were gone as of the end of day one. I noticed I'm also sleeping deeper and better; not waking up at four or five and unable to get back to sleep as was happening most of December and January.

I do have a question; since B's are water soluble, why only the three month dose? Just curious.
Thanks!
Gary

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Re: 123 Days PF And I Think I know Why
Reply #2164 - Feb 8th, 2015 at 3:27pm
 
Hey Gary,

Thanks for the fast update and great news. I was confident a short vitamin D3 loading schedule would do the trick.

The 3-month course of vitamin B 50 is basically a loading regimen to take care of any deficiencies among the seven B vitamins.  After that, the typical mature multi formulated with the seven B vitamins at RDA should maintain them in a healthy range.

You've just completed what I call a 25(OH)D burn down test.  I do these tests a couple times during the year by intentionally stopping the entire regimen to see how long it takes to get hit. 

That's a stupid thing to do according to my wife... and she's correct... but it does give me needed information.  For example, the time to first hit after stopping this regimen varies from 8 days down to 2 days depending on the time of the year.  The time back to a pain free state varies with loading dose and time of the year.

I've found that taking one or two 50,000 IU loading doses of vitamin D3 and doubling the maintenance dose for a week or two adequate after one of these burn-down tests.  I'm usually back completely pain free in less than 24 hours during the summer and 48 hours during the winter.  I use the same loading schedule at the first sign a cold or allergic reaction.

There are several studies indicating seasonal variations in serum 25(OH)D concentrations can be as high as 25 ng/mL, (65 nmol/L) between a Fall high and a Spring low.  What we're also discovering is any medical condition that triggers a significant immune system response can cause 25(OH)D serum concentrations to drop by nearly the same magnitude as the seasonal variations.  That makes a winter cold or flu the worse case scenario.

As the 50/50 tipping point or 25(OH)D serum concentration threshold for CH is likely in a range around 50 ± 10 ng/mL, (125 ± 25 nmol/L), maintaining an average 25(OH)D serum concentration close to 80 ng/mL, (200 nmol/L) provides an adequate reserve and buffer in most cases. 

Hope this helps.

Take care and please keep us posted.

V/R, Batch
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Re: 123 Days PF And I Think I know Why
Reply #2165 - Feb 8th, 2015 at 3:31pm
 
Batch wrote on Feb 8th, 2015 at 3:27pm:

You've just completed what I call a 25(OH)D burn down test.  I do these tests a couple times during the year by intentionally stopping the entire regimen to see how long it takes to get hit. 

That's a stupid thing to do according to my wife... and she's correct... but it does give me needed information.  For example, the time to first hit after stopping this regimen varies from 8 days down to 2 days depending on the time of the year.  The time back to a pain free state varies with loading dose and time of the year.


Wow...talk about taking one for the team.  You're awesome, Batch.

Btw, is it ok that I started another 90-day round of B-50 after having gone through one between 4/18/2014 - 7/17/2014?
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Re: 123 Days PF And I Think I know Why
Reply #2166 - Feb 8th, 2015 at 5:12pm
 
Slacker,

Trust me...  As a chronic CH'er, I don't like CH pain any more that the next CH'er. Accordingly, I restart this regimen at the first hint of an attack. I pop the first of two 25,000 IU doses of vitamin D3 between my back teeth and hold the contents between my cheek and gums for 10 minutes.  I take the second 25,000 IU dose of vitamin D3 the same way 10 minutes later.  This gets the vitamin D3 absorbed and into my bloodstream as fast at possible.  I also take 750 mg magnesium and the rest of the cofactors in short order.

We're still in uncharted waters with respect to follow up 3-month courses of vitamin B 50.  I don't think a week of vitamin B 50 will cause any problems, but I'll check with Dr. Gominak and let you know what she says.  I do recall she was fairly adamant that the course of vitamin B 50 should be taken daily for no more than 3 months. It might be prudent to get a vitamin B12 lab test to see if it's really needed.

Take care and please keep us posted.

V/R, Batch
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Re: 123 Days PF And I Think I know Why
Reply #2167 - Feb 8th, 2015 at 5:31pm
 
Batch...a question on the B-50 complex. Should it be stopped after the 90 days? Is it not safe or necessary to continue taking it after the 90 day period? While taking the B-50 I felt really good during the day, that's why I ask.

-Andy
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Re: 123 Days PF And I Think I know Why
Reply #2168 - Feb 8th, 2015 at 5:54pm
 
Batch wrote on Feb 8th, 2015 at 5:12pm:
We're still in uncharted waters with respect to follow up 3-month courses of vitamin B 50.  I don't think a week of vitamin B 50 will cause any problems, but I'll check with Dr. Gominak and let you know what she says.  I do recall she was fairly adamant that the course of vitamin B 50 should be taken daily for no more than 3 months. It might be prudent to get a vitamin B12 lab test to see if it's really needed.

Take care and please keep us posted.

V/R, Batch


Thank you...that would be great.  I'll look into getting my B12 levels tested.

I'm currently taking my D3 dose before bedtime while the rest of the regimen is taken with dinner.  I hope that's ok.
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Re: 123 Days PF And I Think I know Why
Reply #2169 - Feb 8th, 2015 at 7:51pm
 
Slacker,

Taking your vitamin D3 before bed is OK.  It still gets absorbed in the same area of the lower small intestine no matter when you take it. 

After doing some additional reading on this topic, it turns out results from studies on vitamin D3 absorption are all over the chart.   Accordingly, there's no clear consensus on when to take vitamin D3 other than at the same time each day so you get into a routine.

I still recommend taking all the other cofactors on top of the largest meal of the day primarily to prevent an upset tummy from the magnesium, calcium and Omega-3 fish oil that's easy to get if taken on an empty stomach.  Doing this also lessens the probability of osmotic diarrhea from the magnesium.

Take care and please keep us posted.

V/R, Batch
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« Last Edit: Feb 8th, 2015 at 7:55pm by Batch »  

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Re: 123 Days PF And I Think I know Why
Reply #2170 - Feb 8th, 2015 at 8:16pm
 
Thanks Batch...will do.
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Re: 123 Days PF And I Think I know Why
Reply #2171 - Feb 9th, 2015 at 4:27pm
 
Hi Batch and and my special friends!

Just checking in.  Update on me.  I found the "Batch" a couple of years ago and had my bouts aborted quickly using the D3 regimen.  I had not been too fastidious about keeping the regimen going.  However at the end of last year I did and importantly kept testing.  Apologies for the British/European Units.  But at the end of last summer my 25OHD3 serum level was 280, the lab contacted me and asked that i saw my doctor.  I managed to get an appointment 5 weeks later and had been taking the loading dose through the summer and then a 10,000 IU maintenance dose.  My serum level was just over 400 n/mol per litre, I had the calcium checks done and I was fine. My doctor advised me to stop taking the D3 for a period of time but understood why I would not.  I dropped to 5000IU per day with cofactors.  Today I have had another test come back and I am 297.3nmol/L.  I am so pleased as I am normally in the region of just under 100nmol/L now and we all know what that means.  So I have no headaches at the moment, I would normally start in the next month, so I am going to continue on 5K IU per day with a couple of extra once a week and keep my fingers crossed. 
Thanks for the updates on the merged cofactors and the B50, have ordered them and will move to them when they come.  I so hope this will be the first spring in 18 years without you know what, fingers crossed.
Thank you Batch again, the greatest thing we can do is to impact positively on other people's lives, that is what you do my friend.
Ian
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Re: 123 Days PF And I Think I know Why
Reply #2172 - Feb 9th, 2015 at 10:26pm
 
Batch,

Forgot to ask:

With the Kirkland brand Magnesium Citrate gels, the serving size is 2 softgels which amount to 250 mg.  So when you say you take 750 mg while loading, are you taking 6 of these softgels?

Also, is the 11 mg of Zinc in the Kirkland Mature Multi sufficient or do you recommend adding another Zinc supplement to that?  Currently I'm taking the Multi plus another 15 mg of Zinc Oxide.
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Re: 123 Days PF And I Think I know Why
Reply #2173 - Feb 9th, 2015 at 11:03pm
 
Ian,

Thank you for the kind words and great feedback.  As you've pointed out, managing this regimen doesn't take rocket science, but it does help to take a few lab tests and a well kept record of doses...  That's a small price to pay for a wonderful pain free quality of life when you have CH...

It's also comforting to know the risks of vitamin D3 intoxication are very low even if you jack your 25(OH)D serum concentration over 400 nmol/L, (160 ng/mL). It's even more comforting to see 25(OH)D concentrations this high drop nicely when you lower the dose of vitamin D3.

The real Jedi Masters of vitamin D3 therapy opine the lower threshold for vitamin D3 intoxication, as indicated by an elevated serum calcium, is likely between 500 and 750 nmol/L, (200 and 300 ng/mL). 

They'll also tell you running your 25(OH)D serum concentration this high is like running a dragster engine on nitrous oxide...  You're bound to burn a piston if you use too much.

Thank you again for the update.  Take care and please keep us posted.

V/R, Batch
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« Last Edit: Feb 9th, 2015 at 11:05pm by Batch »  

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Re: 123 Days PF And I Think I know Why
Reply #2174 - Feb 9th, 2015 at 11:15pm
 
Slacker,

That lab that you told me about where you get your tests done...which one is it again?

-Andy
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