Littlee,
We've not seen any problems between vitamin D3 and verapamil. There's a possible issue with calcium supplements lowering verapamil effectiveness, but not vitamin D3. Accordingly, I see no need for a trade off in taking only vitamin D3 or verapamil.
I've gone over all your posts and didn't see where you've started the 3-month course of vitamin B 50. If you did start it, great... If you didn't, starting the 3-month course of vitamin B 50 might just do the trick. You can read about the benefits of Vitamin B at Dr. Stasha Gominak's website.
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Vitamin D3 absorption is only part of the equation when trying to elevate 25(OH)D serum concentrations. There's also a process of "put and take" in play as well.
You can have a normal level of vitamin D3 absorption, (absorbing sufficient amounts of vitamin D3 into the bloodstream from the GI tract), however, there are consumers of vitamin D3 like the immune system which is capable of consuming serum vitamin D3 and 25(OH)D at high rates, (taking vitamin D3 and 25(OH)D out of the serum concentration). Accordingly, if the immune system is responding to an infection or allergic reaction and this consumes serum vitamin D3 and 25(OH)D at high rates, the resulting 25(OH)D serum concentration will be lower.
The other part of this equation deals with the enzymes that hyroxylate vitamin D3 (adds an [OH
-] group to the 25th position on the vitamin D3 molecule) to make 25-Hydroxy Vitamin D3, a.k.a., 25(OH)D.
There is also a similar enzymatic reaction that adds a second hydroxyl group to 25-Hydroxy Vitamin D3 at the 1st position on the parent vitamin D3 molecule making 1,25-Hydroxy Vitamin D3, a.k.a., 1,25(OH)2D3, the genetically active vitamin D3 metabolite we think is responsible for preventing CH.
In the endocrine path of vitamin D3 metabolism, vitamin D3 is hydroxylated in the liver to 25(OH)D. Then, if the serum calcium concentration is low, the parathyroid glands sense the low calcium concentration and release PTH which signals the kidneys to hydroxylate 25(OH)D to 1,25(OH)2D3 and push it into blood serum. This serum 1,25(OH)2D3 pulls calcium from the gut and pushes it into the bloodstream increasing the calcium concentration. This is part of what is called calcium homeostasis, the process of controlling serum calcium concentrations in a very narrow range.
The autocrine path of vitamin D3 hydroxylation is different as most of it takes place in the periphery at the cellular level. In this case, both serum vitamin D3 and 25(OH)D enter cells in the periphery (including neurons in the hypothalamus and trigeminal ganglia), where the two enzymes, 25-Hydroxylase and 1,25-Hydroxylase convert vitamin D3 and 25(OH)D to the genetically active metabolite 1,25(OH)2D3.
Biochemical reactions like this are dependent on the concentrations of the reactants, in this case vitamin D3, 25(OH)D and the two enzymes, 25-Hydroxylase and 1,25-Hydroxylase. We control the amount of serum vitamin D3 and to a lesser extent serum 25(OH)D consentrations with the vitamin D3 oral dose. The enzymes are another story. Their serum and cellular concentrations are controlled by the vitamin D3 cofactors, magnesium, zinc and boron.
Were I in your shoes, I would switch to another type of vitamin D3. (I take Nature's Bounty 5000 IU vitamin D3 liquid softgel capsules and they have worked just fine for over 5 years). I would increase the magnesium dose to 800 mg/day, 400 mg in the morning with breakfast and another 400 mg magnesium with the evening meal. Splitting the magnesium dose like this will help avoid osmotic diarrhea. I'd also increase my zinc intake to 25 mg/day.
As we're likely dealing with inflammation, I would also double the Omega-3 fish oil dose, and add, 500 to 1000 mg/day curcumin. In another recent post about curcumin, we discussed picking a brand/formulation of curcumin that includes piperine/Bioperine a.k.a., black pepper as it increases curcumin absorption. I would also add a 1000 mg tablet of vitamin C every two hours for a total of six a day and drink plenty of water a day like 2 liters/day. As far as boron is concerned, I keep a jar of almonds next to my laptop for snacks. A handful of almonds a day will more than meet boron requirements.
If the above course of action failed to halt my CH attacks and I needed a break, I would see my PCP for a prednisone taper. Prednisone is a potent steroidal anti-inflammatory agent. If it stopped my CH (as it should), that would tell me I'm likely dealing with a major source of inflammation. I would then ask my PCP for a complete workup with all the labs in an attempt to identify the source of that inflammation.
Regarding causality... Has your cycle been lengthened by taking the anti-inflammatory regimen, or was it extending all on its own? Many of us went from relatively predictable annual episodic CH cycles to chronic CH long before I started posting about vitamin D3 and the anti-inflammatory regimen in December of 2010.
Finally, there's the question of staying on the anti-inflammatory regimen after your cycle ends or stopping it in favor of restarting prior to the next episodic CH cycle. There are many episodic CHers here at CH.com who stay on this regimen year-round reporting they sail through their usual episodic cycles pain free with no attacks.
The health benefits of this regimen are too great to ignore. Take a look at the following vitaminDwiki link for a long and growing list of medical conditions and diseases that are either prevented or successfully treated with vitamin D3.
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At 50 cents a day, $183/year, a year's supply of this regimen costs less than a two-pack of imitrex injectors. It provides a very long list of health benefits with no adverse side effects. In short, it's the most cost effective health insurance we can buy.
Take care and please keep us posted.
V/R, Batch