Hey RickJim,

Thank you for the update and good question...  But first, do you go by Rick, Jim or both?  I've a dear friend and squadron mate who grew up in the South and he went by Jimmy John.

Good job keeping your 25(OH)D elevated.  I've kept mine at a average of 140 ±50 ng/mL over the past three years...  I also go in for an annual physical to have my calcium and PTH labs along with everything else... 

My PCP just looks at my labs, smiles then says...  "Your 25(OH)D is elevated... as usual... but as long as your calcium stays within its normal reference range and your PTH stays in the lower third if its normal reference range... I guess you know what you're doing controlling your CH this way...  I gave him a copy of the anti-inflammatory regimen treatment protocol when I went in for my first visit with him...

That you're still getting hit with CH tells me you're likely missing one or more of the supplements... or you're not taking enough Benadryl (Diphenhydramine HCL).

There's medical evidence behind each of the supplements in this regimen.  For starters, if you were vitamin D3 deficient prior to starting this regimen, you were also likely deficient in one or more of the seven B vitamins...  That's why this regimen includes a 3-month course of vitamin B 100 complex... 

The rationale for the B complex comes from Dr. Stasha Gominak, MD, a neurologist who has been suggesting a very similar vitamin D3 regimen to her patients with sleep, chronic pain and headache disorders for longer than I've been posting about it.  The B vitamins, among other things, help develop friendly colonies of bacteria in the GI tract called the microbiome...  and that does several things for us like maintaining a healthy immune system.

Calcium is important because in keeping our vitamin D3 status rev'd up to prevent CH also pulls calcium from the gut to help build bone mineral density (BMD).  If there's insufficient calcium in the gut... vitamin D3 pulls it from our bones to maintain serum calcium in a very narrow range. 

Calcium kinetics happens all the time with a lot of "put and take" going on with respect to serum calcium going in and out of BMD.  What we want is sufficient calcium in the gut to make sure more calcium is put into BMD than taken out... 

Accordingly this regimen calls for a minimum of 200 to 500 mg/day...  Some vitamin D3 experts call for 1500 mg/day calcium.  If you're eating good whole foods with lots of green veggies and cheese, you're likely getting sufficient calcium so the 200 mg in the 50+ Mature Multi I take is just a small insurance policy.  I'm out in the woods around our home with a chainsaw bucking up fire wood several times a year and I don't need brittle bones at 73...

The rest of the listed supplements in this regimen are considered vitamin D3 cofactors as they aid in the pharmacokinetics (what the body does to vitamin D3) and pharmacodynamics (what vitamin D3 does for us) as among its many healthy functions, is the prevention of CH. 

Of these supplements, magnesium is the most important as it supports the enzymatic reactions that hydroxylate (metabolize) vitamin D3 to 25(OH)D and on to 1,25(OH)2D3, the genetically active metabolite we need to prevent CH.  Magnesium is consumed in this process so it must be replaced daily. 

The other reason we need a daily intake of magnesium while taking vitamin D3 at doses > 5000 IU/day is muscles use calcium to contract and magnesium to relax. Without a daily intake of magnesium we end up with a magnesium calcium imbalance.  This results in muscle cramps... That's a minor problem... until it happens to your heart muscle...  That will get your attention...

The other supplements like vitamin C, Turmeric (Curcumin), CoQ10 and the probiotics come into play as additional anti-inflammatory agents, antiviral, antibacterial and antioxidants.  Among them, vitamin C is so important, everyone should be taking at least 2000 mg/day or more... 

The rational for taking vitamin C supplements is simple.  Somewhere along mammalian evolutionary history, the great apes, simians (monkeys), some bats, guinea pigs and man lost the gene that expresses the enzyme needed to synthesize vitamin C from simple sugars...  All the rest of the mammals in the animal kingdom synthesize all the vitamin C needed. 

It's very interesting to note that man, the great apes, simians, some bats and guinea pigs all suffer from some form of cardiovascular disease...  Not so with the rest of the animals...  Hmmm...

CoQ10 is another heart healthy supplement that has also been found to help prevent migraine headaches.

As CHers, with a 25(OH)D serum concentration in the therapeutic range... if the CH beast is still jumping ugly... we may be fighting a low grade infection... in which case, vitamin C helps knock down most infections and the inflammation associated with infections.  The curcuminoids also help as a natural anti-inflammatory agent.

The Benadryl (Diphenhydramine HCL) is a first-generation antihistamine that crosses the blood brain barrier to block histamine H1 receptors if we're suffering from an allergy...  Our immune systems are fighting off allergens 7X24 365 days a year so allergies pose a very real problem for CHers. 

Allergies can release a flood of histamine that triggers the release of calcitonin gene-related peptides (CGRP) in our trigeminal gangila.  CGRP is responsible for neruogenic inflammation and the pain we know as CH... 

If we've taken all the supplements in this regimen, it's the genetically active vitamin D3 metabolite 1,25(OH)2D3 that down-regulates/suppresses the expression of CGRP and that's the basic mechanism of action that prevents our CH.  This function can be overridden by an allergic reaction... hence, the need for a week to 10 day course of a first-generation antihistamine.

When I suspect an allergic reaction, I start taking Benadryl (Diphenhydramine HCL.  It has a Tmax of 2.6 hours after an oral dose and a median half-life of 4.6 hours.  Accordingly, I take 25 mg every 4 hours throughout the day and 50 mg at bedtime for a week to 10 days or as needed.  I've also found that taking 12.5 mg of Children's Benadryl liquid allergy medicine every four hours is just as effective with a little less drowsiness.  Try not to drive if taking either type...  If you do need to drive during the day, take a 25 mg dose when you get home for the day and 50 mg at bedtime.

I think I've address your questions, but in case I missed something, you can download a pdf copy of the latest version of the anti-inflammatory regimen CH preventative treatment protocol at the following link.  Henry Lahore, the brains and brawn behind the VitaminDWiki website posted it for me in January of this year...  As of this morning, readers at this website have downloading 4178 copies...

Multimedia File Viewing and Clickable Links are available for Registered Members only!!  You need to or

Take care and please keep us posted.

V/R, Batch

Hola Rick,

It appears you've got the situation well in hand.  I would suggest you bump the vitamin C to 1000 mg every 4 hours during the day and at bed time.

Rationale... Vitamin C is an excellent antiviral agent that helps our immune systems to knock down viral infections...  It has a half-life of ~30 minutes so you could push this dose to 1000 mg every two hours if need be...   I realize that may sound like a lot of vitamin C...  but Dr. Linus Pauling took 18 grams of vitamin C a day and he and lived to 93..

Adios and please keep us posted.

V/R, Batch