Mark,

Stick with the anti-inflammatory regimen and the accelerated vitamin D3 loading schedule.  With a 25(OH)D serum concentration of 45 ng/mL, you're going to need another 350,000 IU of vitamin D3 to get your 25(OH)D serum concentration up to the target of 80 ng/mL.

As long as you're taking at least 400 to 600 mg/day magnesium and the rest of the vitamin D3 cofactors, you should be able to take 20,000 IU/day of vitamin D3 over the next three weeks or 25,000 IU/day of vitamin D3 over the next two weeks without any risk of vitamin D3 intoxication.  Just make sure you see your PCP or neurologist for a lab test of your serum 25(OH)D and total calcium at the end of the loading schedule.

There are several studies where youths and adults with a vitamin D3 deficiency were given a single oral dose of 400,000 IU, 500,000 IU, or 600,000 IU vitamin D3.  In every case, there were no indications of vitamin D3 toxicity indicated by a serum calcium concentration above the normal reference range and PTH concentrations dropped.

See attached file for details of the study where 35 youths were given a single oral dose of 600,000 IU of vitamin D3 elevating their serum 25(OH)D by an average of 60 ng/mL with no adverse reactions.

Loading Dose Guidance:
• Loading = repletion = quick replacement (previously known as Stoss)

• Loading doses range in size from 100,000 IU to 1,000,000 IU of Vitamin D3

• The size of the loading dose is a function of body weight

• Unfortunately some doctors persist in using Vitamin D2 instead of D3, which has been shown to have many problems

• Loading may be done as quickly as a single day, to as slowly as 3 months.

• It appears that spreading the loading dose over 4-20 days is a good compromise - not too fast, not too slow.

• Loading is typically oral, but sometimes by injection (I.M,)

• The loading dose persists in the body for about 3 months

• The loading dose should be followed up with continuing maintenance - typically 4,000 to 10,000 IU daily average

• Unfortunately many doctors fail to follow-up with the maintenance dosing.

• As about 1 in 300 people have some form of mild allergic reaction to vitamin D supplements, it appears prudent to test with a small amount of the exact form of vitamin D before giving a loading dose
   
Causes for a mild allergic reaction appear to be: (in order of occurrence)
    1) lack of magnesium - which can be easily added
    2) allergy to capsule contents - oil (powder does not appear to cause any reaction)
    3) allergy to the tiny amount of D3 itself (allergy to wool) (alternative: D3 made from plants )

See the following link for more details on vitamin D3 loading strategies and the studies involved:

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If you brows around this website, you’ll find that Henry Lahore has created a compendium of all things vitamin D.  It’s loaded excerpts and links to hundreds of RCTs including the most recent and many located behind the “pay to read” door most of us can’t access… 

There’s a column on the left of each page at Vitamin D Wiki that lists a growing number of medical conditions either prevented by taking vitamin D3 or treated with it to a high degree of efficacy…  In short this is where you can look up what ails you and how much vitamin D3 or better yet, the serum concentration of 25(OH)D and vitamin D3 cofactors you need to treat it.

Regarding changes in frequency of CH after starting oxygen therapy…  We conducted a pilot study of the demand valve method of oxygen therapy in 2008 with six men, one women, six chronic CH'ers and one episodic CH'er.

Each CH'er recorded the abort time and pain level at start of therapy for every CH attack over an eight-week period.  In all, they logged data on 366 aborts. 4 participants used demand valves and the other three used 0-60 liter/minute oxygen regulators and clusterO2 kits with an average oxygen flow rate of 40 liters/minute.  As both methods involved hyperventilating with 100% oxygen, it was no surprise that the average abort times at each pain level were the same with either method.

The following chart illustrates the benefits of oxygen therapy at flow rates that support hyperventilation with greater efficacy and lower abort times than a flow rate of 15 liters/minute.

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There are two things you can takeaway from this chart.  The first is oxygen therapy at flow rates that support hyperventilation result in higher efficacy and shorter abort times than a flow rate of 15 liters/minute.

The second is the higher the pain level at start of therapy, the longer it will take to abort the CH.  In other words, if you have oxygen therapy available, get on it ASAP at the first indication of an approaching CH.

We observed an interesting phenomenon where the frequency of CH attacks increased after start of this method of oxygen therapy.  This increase in frequency lasted to the fourth week then dropped rapidly.  By the eighth week, the frequency of CH attacks had dropped to less than at start of therapy.  All seven pilot study participants experienced this same pattern. 

The following chart illustrates this change in CH frequency as experienced by a male chronic CH'er participant.

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It's also interesting to note that the average weekly pain level at start of therapy and average time to abort dropped continuously throughout the 8 weeks of this pilot study.

With only one episodic CH'er in this pilot study, there wasn't enough data to establish any trends regarding a relationship between oxygen therapy and cycle length.  However, based on data reported by CH’ers using the anti-inflammatory regimen to prevent their CH, it appears there are several factors that can affect the time to respond to this regimen.  By inference, it’s also possible these same factors are responsible for the variability or unpredictable nature of CH.

For example, viral and bacterial infections as well as allergic reactions are associated with longer response times to this regimen.  Trauma and surgery have also been associated with longer response times.  All of these factors stimulate the body’s defense mechanisms with inflammation followed by an immune response. 

There are also several studies indicating the immune system is a major consumer of 25(OH)D,  and 1,25(OH)2D3, the active hormonal form of  vitamin D3,  as well as the enzymes needed to metabolize them.  Vitamin D3 deficiencies are also very common among people with autoimmune disorders. 

Simply stated, colds, flu, bacterial infections, allergies, trauma and surgery could easily be responsible for the unpredictable nature of CH including cycle length.

Hope this helps answer the mail.

Take care and please keep us posted.

V/R, Batch