March is Multiple Sclerosis Month

March 9, 2017

Director's Letter

Carole Baggerly

Director, GrassrootsHealth

Do you have MS? Is it better now than at some time in the past? What is your vitamin D level?

Do you have a friend with MS? What are they doing about their D levels?

The information we see is quite clear--vitamin D matters a LOT!

With approximately 200 new cases per month, there are many, many in need--especially of getting their vitamin D tested, getting their levels to at least 40-60 ng/mL.

TAKE ACTION now, with your family, your friends. It's simple:

Forward this newsletter! (or go to Facebook and share our post)
Follow up and make sure they joined D*action for $49! Ask them what their D-level is, share yours.

Read, Learn, ACT!

Onwards!

Carole Baggerly

Director, GrassrootsHealth

A Public Health Promotion & Research Organization

Moving Research into Practice NOW!

A New Translational Research Protocol:

Using 1000 IU/day per kg Body Weight to Force MS Into Remission

Cicero G. Coimbra, MD, PhD

Associate Professor

Department of Neurology and Neurosurgery

Federal University of Sao Paulo, UNIFESP

President, Autoimmunity Investigation and Research Institute

About Dr. Cicero Coimbra

Dr. Coimbra received his medical degree from the Universidade Federal do Rio Grande do Sul in 1979. He did two years of internal medical residency and two years of adult neurology residency at the Hospital de Clínicas de Porto Alegre, Brazil; followed by a year of fellowship training in pediatric neurology at Jackson Memorial Hospital, Miami. Coimbra earned his PhD in clinical neurology from the Federal University of São Paulo in 1990. He has also completed post PhD training in experimental brain ischemia at the Laboratory for Brain Research, University of Lund, Sweden. He is currently Associate Professor in the Department of Neurology and Neurosurgery, Federal University of Sao Paulo, UNIFESP.

Click to watch short video

What is a physiological dose of vitamin D?

Coimbra believes that 10,000 IU/day of vitamin D is a physiological dose. This is the amount of vitamin D a young person makes if they are light skinned, wearing shorts and a t-shirt for about 20-30 minutes of mid-day sun. This daily dose is totally safe. No precautions are necessary. It is worth noting that the IOM indicated that 10,000 IU/day was considered the "NOAEL"--the 'no observed adverse effect level'.

Coimbra calls the RDA a "paltry dose, although still officially recommended".

Why does vitamin D work?

The active form of vitamin D is the main regulator of the immune system. It empowers the innate immunity against microorganisms and suppresses autoimmunity (which is dependent on an abnormal "program" of immune activities known as "Th17", and is powerfully counteracted by vitamin D). Vitamin D also induces the proliferation of regulatory immune cells called "regulatory T lymphocytes." There is a vitamin D receptor (VDR) in every cell of the immune system. Vitamin D modifies the function of approximately 10% of human genes.

What does Dr. Coimbra's protocol entail?

Coimbra has been able to suppress disease activity in about 95% of MS cases with variable (individually tailored) high daily doses of vitamin D. The doses are set according to the results of laboratory tests in order to compensate for that individual's degree of genetic vitamin D resistance. This resistance seems to underlie the predisposition to (and maintenance of) autoimmune aggression through the Th17 program of activities. As the protocol aims at regulating the immune system, it has been similarly effective in treating several other autoimmune diseases.

He and his team of 5 doctors have treated more than 4,000 patients at his clinic in San Paulo City using the protocol. He has trained over 40 physicians who have launched their own clinics in other cities of Brazil and other countries such as Argentina (2), Peru (1), Portugal (1), Spain (1), Italy (3), Croatia (1) and Canada (1). An ophthalmologist in Naples, FL has been recently trained and is preparing to start a research project using the same protocol to treat autoimmune diseases like uveitis - a major cause of blindness in the general population. Dr. Michael Holick, in his clinic in Boston, has seen 4 patients on this protocol.

The average initial dose for patients in this treatment protocol is about 1000 IU/day per kg of body weight. In addition to vitamin D, he also prescribes vitamin B2; a diet excluding calcium; and extra fluids (minimum 2.5L/day). After 2-3 months, the daily dose of vitamin D is adjusted in response to changes in laboratory test results. After one year the daily dose is further adjusted to compensate for adaptive changes of vitamin D metabolism (not unusual in patients receiving high doses), until a stable level of laboratory parameters is reached for that individual patient, the point at which vitamin D has reached its maximum immunological effect. This is usually achieved at the third or fourth medical appointment, after 2 years on vitamin D therapy.

The blood work that Coimbra is most interested in is the parathyroid hormone (PTH). PTH production is inhibited by vitamin D and his research has shown that vitamin D immune benefit is maximized when circulating PTH has reached the lower limit of its normal (reference) range. Achieving that level of PTH requires variable daily doses of vitamin D because biological resistance to vitamin D is different for each person. PTH values are also used as a safety gauge, as vitamin D intoxication cannot occur if PTH is not fully suppressed. He carefully monitors blood and urinary calcium, to avoid kidney stones. A calcium restricted diet and minimal daily hydration of 2.5 L are imperative precautions to avoid those potential side-effects. He also administers high doses of vitamin B2 (riboflavin). A significant part of the world population (10-15%) are not able to absorb enough vitamin B2 from normal daily doses to enable the chemical reactions within the body that convert D3 into the working form of vitamin D for immune function - 1,25HydroxyD.

After his patients have been at the correct blood level of PTH for 2-3 months, most if not all of the symptoms are gone, depending on whether permanent disabilities were already established before the beginning of vitamin D therapy. They are considered to be in remission as they no longer have relapses, nor new lesions in their MRI images. They no longer expect to be blind or paraplegic, or to become disabled. They have their life back!

After the third or fourth appointment, Coimbra recommends his patients return in 2 years and again in 5 years for a review appointment and to make sure that no further adjustment of their vitamin D dosage is necessary. Right now most patients are still on very high doses of vitamin D (in some cases levels up to or even higher than 4,000 ng/mL are required to maintain PTH around its lowest normal level and suppressed disease activity due to their very high degree of resistance to both beneficial and toxic effects of vitamin D; in most patients the circulating levels are within the range of 250-1,000 ng/mL). He has not been practicing long enough to determine how long high circulating levels of vitamin D have to be maintained to keep MS in remission.

Do you think it was the chicken or the egg?

Does low vitamin D cause MS? Or does MS cause low vitamin D?

Coimbra feels low vitamin D associated with genetically inherited vitamin D resistance and stressful life events trigger MS and other autoimmune disorders. Vitamin D is a natural, powerful inhibitor of autoimmune reactions. He cites latitude charts of MS incidence (the farther you are from the equator - the more prevalent the disease) as the initial epidemiological data which triggered intensive research and cumulative evidence - enabling development of his protocol.

More Information

Physicians interested in knowing the Coimbra vitamin D3 for MS protocol can write to: [email protected]

Testimonials:

Vitamin D & MS

Ana Claudia was diagnosed with MS when she was 40 years old. She lives in Albuquerque, but is originally from Brazil - so when MS drugs were not working she sought out treatment with Dr. Coimbra. After 8 years on the protocol she has lost all her symptoms, she has no flare-ups or new lesions, and some lesions are shrinking. She no longer feels fatigue or heat intolerance. She takes 60,000 IU/day and gets in the sun whenever possible. She also authored a book on her experience and helps with many Facebook sites about vitamin D and MS. She is very giving of her time to help others who are trying to decide whether to start the protocol.

Read her full story here

Purchase her book here

Nayra was diagnosed with MS when she was 10 years old. It took 3 long years to get a proper diagnosis and then she was given a very painful drug, copaxone, to fight her disease. It was not an ideal situation and soon her mother reached out to people in a yahoo group and found out about Dr. Coimbra. That has changed her life. She started the protocol when she was 13, and has never looked back. She is not on MS medication, she has not had a relapse, and she is a healthy, vibrant young women.

Read her full story here

Dr. Barbara van Amerongen lives in a completely different part of the world, in The Netherlands. She has a PhD and is a dentist. She first was diagnosed with MS in 1990, although looking back the symptoms started in 1975. She had to close her dental practice due to the fatigue from MS, but being a scientist started researching her condition. She soon found the connection between vitamin D and MS - but her neurologist was not on board. She started small, 800 IU/day, and gradually increased to 6000 IU/day. She wrote a paper on her experience and also hosts a web site on vitamin D and MS.

Read her full story here

Scientists Weigh In

Dr. Cedric Garland is an epidemiologist and vitamin D researcher at the University of California, San Diego School of Medicine. He is also the principal investigator for D*action. When asked to if there is an association between vitamin D and MS - he would say, "YES!" You can read his full editorial here, as well as 5 papers on the correlation between latitude and MS.

Read full editorial

Dr. Reinhold Vieth is a retired professor and vitamin D researcher at the University of Toronto. He wrote an editorial on whether there is enough scientific evidence to connect vitamin D deficiency to MS. He cites different types of studies and how they all work together to affect change in public policy.

Read full editorial

Preliminary Results from SOLAR Trial

The "SOLAR" trial - stands for Supplementation of VigantOL® oil versus placebo as Add-on in patients with relapsing-remitting multiple sclerosis receiving Rebif® treatment. It was funded by Merck KGaA who makes both Rebif, an interferon drug used to treat MS, and Vigantol, vitamin D3 drops. The lead investigator is Raymond Hupperts, MD, Orbis Medical Center, Sittard, the Netherlands.

While the results paper has not yet been published, Dr. Smolders presented his findings at the Congress of the European Committee for Treatment and Research in Multiple Sclerosis (ECTRIMS) 2016. You can read our summary of the trial here, but some changes seemed to have occurred.

The trial only lasted 48 weeks, instead of 96, and had 229 treated participants, as opposed to the projected enrollment of 348. Two positive outcomes of the study were 1) no adverse effects with 14,000 IU vitamin D/day and 2) a 32% reduction in the number of new lesions from the vitamin D group (p=.005). Nonetheless the summary from all involved was that more RCTs are needed and, based on similar results found in other trials with lower doses of vitamin D supplementation, that 14,000 IU/day may be a larger dose than necessary to affect change.

Article on result presentation at ECTRIMS

ECTRIMS summary of conference

Editor's Letter

Susan Siljander

Marketing Director, GrassrootsHealth

As I was reviewing information for this newsletter I came across a blog at a big, national MS advocacy web site. The question posted was - "Do you know your vitamin D levels???" There were many, many posts. A few people understood the importance of vitamin D and MS. No one knew, or was on, the Coimbra protocol. The people who took "a lot" were taking 5,000 IU/day. Many people reported their neurologist testing their vitamin D levels (yeah!) and telling them they were "fine".

I am always wary of that. What is fine? Most probably it means > 20 ng/ml and if my blood level were that low, I would not consider that fine. That would be far from fine.
So, we have launched D*action for MS. It is the same D*action you are familiar with - a home blood test where you get the EXACT value in your blood along with information that encourages you to be in the recommended range of 40-60 ng/ml. But, as people with MS join, they will enter their health data - pain levels, the severity of their MS, falls, etc.. If they test every 6 months - this will give us lots of data to help guide their actions with what works for them, for the larger population.

Let's use MS Month to get more people with MS to join D*action. We have a lot of information NOW - and these people can get up-to-date, personal information about vitamin D and MS!

Sign them up!

Susan Siljander

Marketing Director, GrassrootsHealth

A Public Health Promotion & Research Organization

Moving Research Into Practice NOW!

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Only Under Doctor Supervision

This newsletter is in no way intended to encourage or push patients to begin high dose Vitamin D therapy without the opinion and consent of a medical doctor. Health risks can be serious and may involve toxicity, other drug interactions, or organ damage.

Doses over 10,000 IU/day, if not managed properly may cause irreversible damage of renal function or cause other medical complications.

It is important to understand that doses of vitamin D are specifically calculated by Dr. Coimbra based on individual patient parameters during the medical examination. Therefore, it is necessary to seek treatment with high dose vitamin D from an experienced medical doctor.