Hoppy,

Sorry to be so slow...  Roughly 600 IU/day goes into building bone mineral density (BMD) where vitamin K2 MK-7 comes into play acting as a catalyst.  Serum calcium concentration is primarily controlled by calcium homeostasis, a physiological control mechanism that maintains serum calcium in a very narrow range.  This is where the parathyroid glands and the Parathyroid Hormone (PTH) comes into play.

As serum calcium is consumed and its concentrations drop, the parathyroid glands sense this condition and release more PTH.  This PTH in turn, signals the kidneys to hydroxylate 25(OH)D3 to 1,25(OH)2D3, calcitriol, the hormonal form of vitamin D3.  Serum calcitriol goes to the gut to pull out calcium and make it available to the bloodstream increasing calcium serum concentration. 

If there's insufficient calcium in the gut, calcium homeostasis pulls it from bones.  This happens all the time in a process of put and take...  What we want in this put and take process is to make sure more calcium is put into BMD than taken out... This is why the anti-inflammatory regimen calls for a minimum of 200 mg/day calcium.  The rest of our daily calcium needs come from dietary sources.

When serum calcium concentration approaches the normal reference range upper limit, the parathyroid glands sense this condition and slow the release of PTH and that maintains serum calcium within its normal reference range.

There's another enzymatic process that prevents too much serum 1,25(OH)2D3 which prevents excess calcium in the bloodstream.  This enzyme hydroxylates 1,25(OH)2D3 a third time to 1,24,25(OH)3D3, an inactive vitamin D3 metabolite that's catabolized (broken down) and eliminated in urine.

Bottom line, it's very difficult to experience vitamin D3 intoxication/toxicity at long term doses up to 40,000 IU/day as long as calcium homeostasis is functioning normally.

Take care,

V/R, Batch

Hey Boriskaz,

Thank you for the great post with your feedback on the anti-inflammatory regimen CH preventative treatment protocol.  I'll use it to reflect over 8 years experience with this regimen, from hundreds of feedback reports like yours and the results from the online survey of CHers taking this regimen to prevent their CH.  This survey has been running continuously since December of 2011.  This information provides us with the following important lessons learned about the anti-inflammatory regimen CH preventative treatment protocol

1.  Lesson learned...  This regimen is not a cure for CH or migraine so it must be taken year round for an optimum CH preventative effect. This applies primarily to episodic CHers.  Chronic CHers don't really have an option. 

Stopping this regimen after an episodic cycle ends means several days to weeks of painful headaches after the next cycle starts while waiting for 25(OH)D serum concentrations to build back up to a therapeutic level that prevents CH.  We're talking roughly 50 cents a day for the basic regimen so what price would you put on avoiding the terrible pain of daily CH when next cycle starts?

2.  Which is more important, the vitamin D3 dose or 25(OH)D serum concentration response?  This is a loaded question as both are important with respect to a favorable CH response or a complete cessation of CH.  I'll define a favorable response as a reduction in CH frequency from an average of 3 CH/day down to 3 to 4 CH/week.

Having been there... we can live with a favorable response and function almost normally in daily work and home environments.  That said, this is not the goal of this treatment protocol.  That goal is a CH pain free existence. 

3.  Lesson learned... It's important to understand that the vitamin D3 dosage and 25(OH)D response will vary for individual CHers as will the 25(OH)D therapeutic response serum concentration that results in either a favorable response or a complete cessation of CH. 

Colds (although rare on this regimen), bacterial and viral infections, allergic reactions, tooth extractions, dental implants, trauma and surgery will all cause a drop in 25(OH)D serum concentrations from 10% to as much as 70% for surgery. If your 25(OH)D serum concentration is at or near the tipping point that keeps you CH pain free... any one of these events will cause your CH to return. 

The lesson learned here is maintain a reserve 25(OH)D serum concentration above the tipping point.  So how much is that?  The answer is it varies from CHer to CHer, but a good starting point is a 25(OH)D serum concentration around 80 ng/mL.

Don't be afraid to take your 25(OH)D higher with a higher vitamin D3 maintenance dose to prevent your CH.  Just work with your PCP/GP while doing this with labs for serum 25(OH)D, calcium and PTH.

I've maintained my 25(OH)D serum concentration between 150 ng/mL (375 nmol/L) and 188 ng/mL (470 nmol/L) through most of 2018.  My PCP is OK with this as long as my serum calcium remains within its normal reference range... and it has.

4.  Lesson learned...  It's important to see your PCP/GP to discuss this regimen and obtain the lab test for 25(OH)D serum concentration.  Knowing your baseline 25(OH)D will give you a good indication of the total loading dose needed to get you to a therapeutic serum concentration sufficient to prevent your CH.

5.  Lesson learned... It's important to start this regimen with the 12-Day accelerated vitamin D3 loading schedule at 50,000 IU/day for 12 days.  The following chart illustrates the difference in 25(OH)D time course response between starting with the 12-Day loading schedule or just taking a maintenance dose of 10,000 IU/day.

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The following chart from the survey of 257 CHers illustrates illustrates the normal distribution curve in green for 25(OH)D lab tests at a vitamin D3 dose of 10,000 IU/day and the cumulative probability curve in blue for CHers responding to the anti-inflammatory regimen.

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The green line illustrates the mean 25(OH)D response to a vitamin D3 dose of 10,000 IU/day is around 80 ng/mL.  The blue S-shaped sigmoid curve tells us there's a greater probability of a favorable response as the 25(OH)D serum concentration rises. 

6.  Lesson learned.  This chart indicates some CHers will need a higher vitamin D3 dose and a higher 25(OH)D serum concentration for a CH pain free response...  and the only way you'll know that is with the lab test of your 25(OH)D serum concentration.

7.  The lesson learned. See your PCP/GP for lab tests of your serum 25(OH)D, calcium and PTH 30 days after start of regimen.  If you're still getting hit... Do Something!  There's almost always a reason or reasons why this regimen is not working to prevent your CH.

  a. Many CHers have found a few days at a 50,000 IU/day loading dose, a higher maintenance dose above 10,000 IU/day and additional magnesium (800 mg/day) can be effective in stopping CH.

  b.  A week to 10 day course of a first-generation antihistamine like Benadryl (Diphenhydramine HCL) can lessen the effects of an allergic reaction.

  c.  Additional supplements can help.  They include:
      1000 mg/day Turmeric (Curcumin)
      300-900 mg/day CoQ10
      4 to 6 grams/day lipophilic vitamin C
      Probiotic
      500 mg/day Quercetin
      500 mg/day Resveratrol

Why are the vitamin D3 conutrients so important?  The following chart gives us an indication why.

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The dashed line normal distribution curve comes from the Grassrootshealth *D Action program with 1500 lab tests for 25(OH)D from people taking 10,000 IU/day vitamin D3 but no conutrients.  The solid line comes from our online survey where CHers took 10,000 IU/day plus the conutrients.  As you can see, the conutrients result in a higher 25(OH)D response of 16 ng/mL (25%) higher than the same dose without the conutrients.

8.  The lesson learned here is take all the conutrients daily.

9.  Lesson learned.  Diet is an important part of the anit-inflammatory regimen.  Atkins or a ketogenic diet will work just fine.  No sugars, no wheat products and limited carbohydrates for starters.  Try to eat organic free range meats, poultry eggs and wild caught fish.  Make sure your veggies are organic and NON GMO. Limit fruits to dark berries and grapes.   Be sure to drink at least 2.5 liters of water a day.