Hey Chuffy,
Thanks for the update... Good questions and astute observations...
I'll be updating the anti-inflammatory regimen list of supplements and suggested dosing and will post it here at CH.com in the thread at the following link:
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I'll also update it at VitaminDWiki at:
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The only substantive changes will be listing the calcium supplement intake in a range between 220 and 500 mg/day with a caveat to limit or eliminate the calcium supplement temporarily while taking verapamil or if there's an up-tic in CH frequency after starting the complete regimen.
I posted the results of the survey of 110 CH'ers using the anti-inflammatory regimen at VitaminDWiki based on calls from physicians, who like you, had difficulty sorting through the 69 pages of posts in this thread and wanted a single source of the latest regimen and dosing.
Do I still take calcium supplements as part of the anti-inflammatory regimen? I sure do! The last thing I need at my age, (pushing 70), is to break a bone while I'm out in the woods with my chainsaw bucking up big logs and splitting them for fire wood...
Am I concerned that taking calcium and vitamin D3 causes arterial calcification? No.
My wife Joyce has been taking 500 mg/day calcium as part of the anti-inflammatory regimen for three years... and she kicked the heck out of 76 last Christmas...
I'm constantly trying new supplement preparations in an attempt to minimize the number of pills needed each day for this regimen.
I'm presently taking Mature Multi, (Kirkland brand from Costco), as a lower cost alternative to the calcium citrate, Centrum Silver, and other similar multivitamin preparations. One of these tablets provides 220 mg/day calcium.
Here's a photo of the clutch of supplements I'm taking:
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As to your observations... Yes, in a sense, this regimen is a balancing act... It's also been a serendipitous odyssey as we continue to improve its effectiveness in preventing CH with all beneficial side effects.
As CH'ers, we need a higher 25(OH)D serum concentration ~ 80 ng/mL, (200 nmol/L), to prevent our CH, so we're taking higher doses of vitamin D3...
We take the Omega-3 fatty acids as an adjunct anti-inflammatory agent that has the added benefits of improved vitamin D3 absorption and cardiovascular health.
In order to metabolize that much vitamin D3, we need plenty of magnesium, zinc and a dash of boron. We need these nutrients to support the enzymatic processes that metabolize vitamin D3 to 25(OH)D and 25(OH)D on to 1,25(OH)2D3, the active hormonal form.
As vitamin D3 mobilizes calcium, primarily from the gut, we need to supplement with sufficient calcium to avoid having the vitamin D3 mobilize calcium from our bones due to insufficient calcium from dietary sources...
We also need vitamin A (retinol) that combines with vitamin D3 to form the molecular bridge at the genetic level between a vitamin D receptor (VDR) and Retinoid X Receptor (RXR). This molecular bridge unlocks the genetic library that enables the genetic expression we think is responsible for preventing our CH...
The current theory of the mechanism of action... and I'm sticking with it until this hypothesis is proven otherwise... is the genetic expression made possible by vitamin D3 enables nerve cells in the trigeminal ganglion to inhibit or down regulate production of calcitonin gene-related peptide (CGRP).
The good Dr. Peter Goadsby and his fellow researchers found CGRP concentrations are elevated during active CH and migraine headaches. Other studies have found that CGRP is responsible for neurogenic inflammation and CH pain.
This theory starts gaining strength and it shouldn't come as a surprise, as it appears some of the big pharmas are presently in the process of developing a prescription medication to control CGRP production.
Now for the vitamin K2 (MK-4 & MK-7) supplement. I added it to the regimen for a number of reasons nearly a year ago... The first is it was finally listed as a vitamin D3 cofactor by the Vitamin D3 Council. The second reason was based on studies the vitamin K2 menaquinones MK-4 and MK-7 and their capacity to improve bone mineral density. In view of the increased calcium mobilized by vitamin D3, this appeared to be a prudent addition.
The third reason I've added vitamin K2 (MK-4, MK-7 or both) has been evolving over the last year as more studies have started researching the cardiovascular benefits of vitamin K2 and the synergistic benefits when combined with vitamin D3 and vitamin A (retinol).
Unfortunately, availability of open source data from the few gold standard studies on vitamin K2 effects on arterial calcification that have completed is limited... Most of the results I'd like to see are behind pay-walls.
Henry Lahore, he is VitaminDWiki and all things vitamin D3, keeps web crawlers and spiders running 7/24 building indexes of articles on vitamin D3 and all the cofactors including vitamin K2. He has a great page on vitamin D3 and vitamin K2... See:
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An excerpt from the above web page on the safety of supplementing with vitamin D3...
"According to Heaney, (I've been bouncing the anti-inflammatory regimen along with the results from the online survey of CH'ers using this regimen off Dr. Robert Heaney, MD for the last two years...), controlled metabolic studies with D3 found that dosages up to 50,000 IU per day for up to five months produced neither hypercalcemia nor hypercalciuria.
Hathcock et al could find no reported cases of vitamin D intoxication from daily intakes of 30,000 IU per day for extended periods, nor any intoxication from serum 25D levels up to 200 ng/mL. They concluded that a 10,000 IU daily intake should be the safe Tolerable Upper Intake Level (formally abbreviated UL) - five times the UL set by the U.S. government in 1997."
Hope this calms any angst... Take care,
V/R, Batch