Hey Constantine,
I can see you're faced with an interesting (and painful) dilemma... Tennis Elbow?
From personal experience, and data from several other chronic CHers, stopping the anti-inflammatory regimen within the first one to two months will result in a return of full blown CH in as little as 3 to 10 days. Episodic CHers still in cycle will experience this same return of their CH.
It all depends on your present serum concentration of 25(OH)D and the therapeutic concentration needed to prevent your CH. In other words, if your 25(OH)D serum concentration is 70 ng/mL and your minimum therapeutic serum concentration is 65 ng/mL... it's just a matter of a few days before your 25(OH)D serum concentration drops below 65 ng/mL and your CH returns. If you've just started the anti-inflammatory regimen, your CH will return within 24 to 36 hours.
PRP can be effective in treating sports injuries like Tennis Elbow... but it could take several months... See: Treatment of Chronic Elbow Tendinosis With Buffered Platelet-Rich Plasma
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"At 6 months, the patients treated with platelet-rich plasma noted 81% improvement in their visual analog pain scores (P = .0001). At final follow-up (mean, 25.6 months; range, 12-38 months), the platelet-rich plasma patients reported 93% reduction in pain compared with before the treatment (P < .0001)."
Stopping NSAIDs in your case prior to PRP injections is likely done to prevent any bias in the results and not to ensure there's ample inflammation prior to the injections. In other words, I see no reason why you should stop taking the anti-inflammatory regimen.
What is interesting here is the anti-inflammatory regimen can be even more effective than NSAIDs in reducing joint pain if the vitamin D3 dose is high enough.
It really doesn't matter if your elbow and shoulder pain is the result of a sports injury, the anti-inflammatory regimen can be very effective in reducing pain levels. See the following link for more details:
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In the final analysis, as neither condition is life threatening and the real issue is quality of life.. you are your best advocate in deciding the best course of action. You know the pain associated with your elbow and shoulder just as you know the pain of CH. Accordingly, the choice of treatments is really up to you. Moreover, I see no reason why you should be faced with an either or situation as both PRP and the anti-inflammatory regimen are compatible.
The common denominator in both conditions is inflammation. Accordingly, in my mind, the anti-inflammatory regimen with vitamin D3 is an obvious choice in treating both conditions.
There are a number of things to try that can stop the shadows... The first is a 7 to 10 day course of Benadryl (Diphenhydramine HCL). I've found that Children's Liquid Benadryl allergy medicine can be very effective in kick starting the anti-inflammatory regimen and in quelling shadows. 12.5 mg in the morning and another 12.5 mg in the evening can be very effective with only minimal drowsiness...
Increasing the vitamin D3 dose is the second thing to try. Doubling the Omega-3 fish oil dose is also helpful with shadows. Adding vitamin C at 1000 mg every two hours has helped several CHers with shadows.
Regarding the joint pain, increasing the boron dose to 3 or 6 mg/day can help. Increasing the magnesium dose and adding CoQ10 can also help.
From personal experience, I've found taking additional zinc, vitamin K2, Glucosamine, Chondroitin, MSM [Methylsulfonylmethane (MSM) a.k.a., DMSO] and Turmeric to be effective in reducing joint pain
Hope this helps...
Take care and please keep us posted.
V/R, Batch
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