Hey Steady,

Make sure your doctor has a copy of the anti-inflammatory regimen CH preventative treatment protocol.

There's nothing wrong with a 25(OH)D serum concentration of 311 nmol/L as long as you remain CH pain free, your serum calcium remains within its normal reference range and your PTH is in the lower third of its normal reference range.

I'm chronic so take an average maintenance dose of vitamin D3 between 15,000 IU/day and 25,000 IU/day...  I also maintain an average 25(OH)D serum concentration of 140 ng/mL (350 nmol/L).  My PCP is comfortable with that as long as my serum calcium remains within its normal reference range...  and it has for the last three years, and my PTH stays within the lower third of its normal reference range. 

To put this topic in perspective, MS sufferers  in Brazil on Dr. Coimbra's treatment protocol take ten times the amount of vitamin D3 that we do for CH...  They also have a responding 25(OH)D serum concentration ten times higher...  In many cases over 500 ng/mL (over 1250 nmol/mL) and their serum calcium remains within its normal reference range with no evidence of vitamin D3 intoxication/toxicity. 

In many cases, the diagnostic lab assay method used to determine 25(OH)D can't measure concentrations that high so as far as Dr. Coimbra is concerned, 25(OH)D is no longer a valid bio-marker...  Instead, he uses PTH as the primary bio-marker in his treatment protocol. 

Even though the Coimbra protocol and the anti-inflammatory treatment protocol are similar with respect to the vitamin D3 cofactors, there are also two main differences...  At vitamin D3 doses of 1000 IU per Kg of body weight a day, (50,000 IU/day up to 100,000 IU/day vitamin D3 and higher), MS patients on this protocol must avoid calcium supplements, calcium rich food types (read dairy products) and drink 2.5 liters of water a day to flush any excess calcium from the kidneys.

If you're taking the Kirkland brand Mature Multi, you're getting 200 mg/day of calcium.  This is a good idea and an ideal dose of calcium to help ensure you maintain a healthy bone mineral density.  It's also important to take the 400 mg/day magnesium.  That give us a 2 to 1 magnesium to calcium supplement intake ratio.

Hope this helps...

Take care,

V/R, Batch

Steady,

What I would try at this point is a week to 10-day course of Benadryl (Diphenhydramine HCL) at 25 mg before bed.  It that doesn't reduce the frequency of your CH, I would bump the dose to 50 mg before bed.  This has worked very effectively for me and many other CHers during high pollen count seasons.

It turns out that most of us are battling allergic reactions most of the time.  These can be sub-clinical, i.e., no outward or obvious symptoms...  but the allergic reactions are still there causing mast cells to release a flood of histamine...  The histamine in turn, triggers neurons within the trigeminal ganglia to release calcitonin gene-related peptide (CGRP), a nasty protein that triggers neurogenic inflammation and the pain we know as CH...

It gets worse...  The CGRP triggers mast cells to release more histamine so we end up with a circular chemical chain reaction that continues for up to two hours until one or more of the reactants run out and the CH ends... for now...  After working with a number of CHers taking Benadryl (Diphenhydramine HCL) to stop their CH over the last two years, I'm convinced the histamine-CGRP circular chain reaction is the primary reason why CHers are refractory to CH preventatives.

Diphenhydramine is a first-generation antihistamine that crosses the blood brain barrier to block H1 histamine receptors on neurons throughout the brain and in our case as CHers, neurons within the trigeminal ganglia...  Blocking the H1 histamine receptors with a first-gen antihistamine stops/prevents the circular chain reaction and that enables vitamin D3 to do its thing with genetic expression to prevent our CH.

Hope this helps...

Take care and please keep us posted.

V/R, Batch