Hey Jackie,

Thanks for the update and sorry you're not responding to the anti-inflammatory regimen.  Have you had a recent lab test of your serum 25(OH)D?

The most likely problem you're facing is either your vitamin D3 maintenance dose is too low or you've an allergic reaction.  These can be sub-clinical, i.e., no outward or obvious symptoms, but it can still be present causing the release of histamine that makes nearly all types of CH intervention/prevention ineffective. 

You've already taken the best course of action by starting a week to 10 day course of Benadryl (Diphenhydramine HCL) at 25 mg every four hours throughout the day.

The alternative is Children's Liquid Benadryl Allergy medicine at 12.5 mg (5 mL in the measuring cap) four times a day.  Try to hold it in your mouth and under your tongue for a few minutes.  This sublingual method bypasses the GI tract allowing the Benadryl to enter directly into the bloodstream through the mucus membranes under the tongue.

Benadryl will make you drowsy but the liquid form a little less so.  In either case avoid driving due to the drowsiness.  If you need to drive or be sharp as a tack during the day, wait until you're home for the day then take 50 mg of the tablets as you walk in the house and another 50 mg prior to bed time.

The other possibility is you're experiencing a low grade infection. These can be sub-clinical as well and include things like an infected tooth or gum infection, sinusitis and the list goes on.  Infections cause inflammation and when that happens, our immune systems take first priority on available serum vitamin D3 and 25(OH)D leaving too little to prevent CH. In this case, start taking vitamin C at 2000 mg when you get up in the morning and 1000 mg every two hours throughout the day with another 2000 mg at bed time.  For reference, I take 8 to 10 grams (8,000 to 10,000 mg) of vitamin C a day come rain or shine and even more up to 18 grams/day if I suspect a cold or infection...

I would start the vitamin C along with the Benadryl to cover all the bases.  The rationale for the vitamin C is it's a potent antiviral, antibacterial, antifungal and anitoxident.  We need a minimum of 4 grams a day anyway as our bodies are unable to synthesize it and dietary vitamin C is not sufficient in most cases.

The next step is diet.  Avoid all sugars including fruit juices and soda pop, avoid all carbohydrates and avoid all grain and wheat products including grain, canola and corn oils.  Good oils include organic butter, olive oil, avocado oil and my favorite, extra virgin coconut oil.  You can eat organic free range meats, poultry and eggs as will as a serving or two a week of wild caught fish like Sockeye Salmon, cod, halibut and fresh shellfish.  Avoid farmed fish and shrimp as most are fed high levels of antibiotics and grain products tainted with glyphosate (Roundup).

You can eat all the green and yellow organic NON GMO veggies you want but limit fruit to an apple or orange a day for the first month.

Although this may sound like a spartan diet, you can still gain weight so a little more exercise will also help.  A 10 minute brisk walk a day and some morning exercises like 10 pushups and 10 situps every morning...  Add an additional pushup and situp each day...

In addition to this diet, I'd also suggest starting a probiotic and continue taking it until the bottle is empty.  The rational here is we have friendly colonies of bacteria and biota living in our GI tract called the microbiome.  Too much sugars and starches cause an imbalance in the bacterial makeup with too many less friendly colonies of bacteria.  The probiotic helps restore a proper balance.

Finally... back to the vitamin D3...  Your present 25(OH)D serum concentration may not be sufficient to prevent your CH.  For reference, I'm a chronic CHer and have maintained a serum 25(OH)D concentration of 139 ± 50 ng/mL for the last three years in order to remain CH pain free.  This requires a vitamin D3 dose of 20,000 to 25,000 IU/day.  My PCP is OK with my 25(OH)D concentration being this high as long as my serum calcium remains within its normal reference range, i.e., no hypercalcemia which means no vitamin D3 intoxication/toxicity.

You've a couple options on increasing your vitamin D3 intake.  The first is to take 50,000 IU/day loading doses for a week or until you've experienced a significant drop in the frequency of your CH for at least 3 days which ever comes first, then drop back to a new vitamin D3 maintenance dose of 15,000 to 20,000 IU/day.

If there's no change in your CH patterns after a week at 50,000 IU/day vitamin D3, lower the loading dose to 40,000 IU/day and stay at that dose until you experience a significant reduction in the frequency of your CH... By significant, I'm saying a reduction in frequency from 4 to 5 CH/day down to 3 or 4 CH/week...  Better yet, a CH pain free response.

The second option takes a little longer as it involves titrating your vitamin D3 maintenance dose up by 5,000 IU every week until you experience a significant drop in the frequency of your CH...

No matter which method you choose, be sure to see your PCP after two weeks at a stable vitamin D3 dose for lab tests of your serum 25(OH)D, calcium and PTH.  As long as your serum calcium remains within its normal reference range and your PTH is in the lower third of its normal reference range, whatever vitamin D3 dose you're taking is good to go... and your serum 25(OH)D doesn't really matter...

If you haven't already pulled down the latest posted version of the anti-inflammatory regimen from the vitaminDwiki.com website, the following link will do this.

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Take care and please keep us posted.

V/R, Batch