Vit D3>125nmol/L min in blood. FIRST SMALL STEP for pwMS

A forum to discuss Chronic Cerebrospinal Venous Insufficiency and its relationship to Multiple Sclerosis.

Re: Paper from Berlin Neuros

Postby Squeakycat » Sat Mar 02, 2013 9:03 am

MarkW wrote:Hello Ed,
A useful paper (not bad for neuros) but already listed at the top of page 22.
Kind regards,
MarkW

So I not only put it outside this thread by accident, I failed to notice that it had already been posted!

Time to up my Vitamin D intake I think. :oops:
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Re: FIRST STEP-Vit D3 min for pwMS=125mmol/L (50ng/ml)

Postby BBE » Sat Mar 02, 2013 11:48 am

there is a mistake in the subject.
I hope it should say 125 nmol/L not mmol/L. And you can even extend it to 125nmol/L (50ng/ml) (50ug/L)
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Re: FIRST STEP-Vit D3 min for pwMS=125mmol/L (50ng/ml)

Postby NZer1 » Sat Mar 02, 2013 11:52 am

Hi Everyone.
I read an article recently that links Vit E into the role of apoptosis and Vit D is also required.
The importance of the synergy of a collection of Vits and minerals grows bigger the more I look.

Apoptosis is important in maintaining the balance of functional cells in the matrix of wellness.

If we have excess dysfunctional cells that have been intra-cellularly infected (eg by bacteria) and are living beyond their 'time' then we have weakened our system.
If the immune system is also intra-cellularly infected and dysfunctional as well then we have a compounding situation of un-wellness or dis-ease in our system as a whole.

So cherry picking one Vit or mineral is pointless imo.

:)
Nigel
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Re: FIRST STEP-Vit D3 min for pwMS=125mmol/L (50ng/ml)

Postby NZer1 » Sat Mar 02, 2013 2:26 pm

Interesting angle on Health in general taken from a Lyme Disease prospective, I have also posted good insights from Dr David Jernigan on my site
https://www.facebook.com/pages/CCSVI-in ... 1636357984
Health tip of the day: The question that dominates most Lyme Disease Forums is why don’t I feel better, even after doing everything I can think of to get well.

The dominant doctor-driven natural medicine protocols are the Zhang Protocol, The Cowden Protocol, The Klinghardt Protocol, and The Jernigan Protocol.

Each of these doctors have spent years pursuing the identification of the best remedies/natural medicines to help facilitate the restoration of health of real suffering in their clinics. Each one of these doctors had to eventually develop their own line of remedies where none existed on the open market.

Most of these doctors use hundreds if not thousands of various remedies in their clinics and like myself have usually only developed a few unique formulas. I personally have only formulated about a dozen formulas though I don’t own the company, Jernigan Nutraceuticals, yet I use over three thousand different natural remedies that we keep on hand at all times at the Hansa Center.

The reality is that no canned protocol, natural or conventional, can do everything and cover every potential health issue, especially when dealing with people who have many symptoms and been sick for many years.

A great friend of mine, and one who is an M.D., PhD. said a wonderful statement today… “Lyme disease is not a true disease, but is more a syndrome and should actually be called Lyme Syndrome, since it is truly not one cause, but is indeed a tremendous range of symptoms unique to the various weaknesses in the body, mind, and spirit of the person who succumbed to the illness.”

Most if not all of the natural protocols are designed to address the most common issues that lead to illness in Lyme disease.

None of the various protocols can address every issue, since not every issue needing to be corrected can be fixed with a pill or nutritional supplement. For example, if you dislocate your finger there isn’t a pill in the world that can correct that finger. If what you need is a myofascial Release Therapy or spinal alignment, or NeuroPhotonic Therapy to correct the biophotonic metabolism you cannot achieve these with a pill or supplement.

Any resistance or interference in your body, mind, or spirit will put a little resistance or interference throughout the entire organism. This means you can be taking the absolutely best medicine in the world and yet that medicine cannot reach or work everywhere in your body because of these interferences.

You must find a doctor with the knowledge necessary to correctly adjust the "dislocated finger," and then there may be some pills that will help it heal faster.

If a person is diligent with any given protocol, Zhang, Cowden, Klinghardt, or the Jernigan, and is still not getting better or is even feeling worse, they should seek out professional help from a doctor trained in Biological Medicine.

Interestingly, none of the doctors whose protocols are listed above actually use their own protocols in their clinics! All of these doctors tailor every treatment to the unique needs of the person they are treating.

The reality is that no doctor has all the answers, so if you are trying to be your own doctor and follow a canned protocol of any type, you will be very limited in your knowledge of what to do beyond that protocol to get the improvements you seek.

Find a doctor you trust. Do what he recommends until you feel that you don’t trust that it is enough. Find another doctor who does things differently that you can trust. Repeat until the last issue at the level of cause has been addressed and you will be well.

At the Hansa Center for Optimum Health we bring to bear an incredible array of healing modalities and techniques in functional diagnosis and treatments in order to facilitate the removal of everything that is interfering with your body’s ability to repair and regenerate what has been damaged.
From Dr David Jernigan's fb site;
https://www.facebook.com/doctordavidjernigan

Keep Smilin'
Nigel

Back ground on DrDavid Jernigan.
In the 1990's it was determined that if every medical school put out only General Practitioners for many years, there still would not be enough to supply the demand. Every young doctor wanted to be a specialist...Cardiologist, Nephrologist, Rheumatologist... So the Chiropractic profession and colleges took on the task to provide Chiropractic Physicians to be the "Portal Entry" physicians...General Practitioners. As a result today's Doctor of Chiropractic is trained identically to a medical doctor. In eight states D.C.'s can prescribe naturally derived prescription medicines, do I.V. med's, and in all states we are licensed to perform and order any lab or special test in the medical world. My personal training has lead me all over the world to learn everything I know. I have spent over 20 years adding daily to my knowledge base, and have been blessed to have trained under some of the best doctors that enabled me to start my career where they left off. I put myself in the way of knowledge...applied that knowledge until it became experiential wisdom. I prayed for even more wisdom, like Solomon. I trained in Classical Homeopathy by Robin Murphy, I earned a BS in Nutrition, got certified in Botanical Medicine through the University of Colorado, School of Pharmacy, trained in Anthroposophical Medicine in Germany, Trained with Dr. Thomas Rau, MD of Switzerland in Biological Medicine. I have spent time discussing and learning medicine and natural healing with native medicine men in West Africa, Brazil, Canada, Hawaii. I trained in Acupuncture and meridian therapies and studied Traditional Chinese Medicine and diagnostics. I have training in complex homeopathy. I studied and attended seminars from many of the top experts in the energy medicine field and attended conferences that would expand my knowledge base in fields such as Biological Dentistry, and Infectious Disease. My library is extensive, my natural curiosity to know more is boundless, and of course the priceless knowledge gained mostly by applying what I have learned in new ways to help many thousands of the world's toughest cases from all over the world. As I said, I am blessed to have found so many good teachers and to have been blessed with a good mind.
https://www.facebook.com/doctordavidjernigan
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Re: FIRST STEP-Vit D3 min for pwMS=125 nmol/L (50ng/ml)

Postby MarkW » Sun Mar 03, 2013 2:58 am

BBE wrote:there is a mistake in the subject.
I hope it should say 125 nmol/L not mmol/L. And you can even extend it to 125nmol/L (50ng/ml) (50ug/L)


Thanks for spotting my typo BBE. My error was on the site for 2 weeks before you spotted it !!!
To confirm my recommendation - minimum level for pwMS is 125 nmol/L of 25-hydroxyvitamin D in blood (units widely used in Europe) or 50ng/ml (units widely used in Americas).

MarkW
Mark Walker - Oxfordshire, England. Registered Pharmacist (UK). 11 years of study around MS.
Mark's CCSVI Report 7-Mar-11:
http://www.telegraph.co.uk/health/8359854/MS-experts-in-Britain-have-to-open-their-minds.html
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Re: FIRST STEP-Vit D3 min for pwMS=125 nmol/L in blood

Postby jimmylegs » Sun Mar 03, 2013 6:19 pm

SI units (nmol/L) are used in Canada..
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Re: FIRST STEP-Vit D3 min for pwMS=125 nmol/L in blood

Postby BBE » Mon Mar 04, 2013 6:25 am

I had around 25 ug/L in November 2012 and my wife with MS had 62 ug/L. (She was taking D3 more often than me/ They measure it in these units in here). I didn't recalculate that well into nmol/L and ordered for both 10.000 IU daily with 30-60 mg Zinc and K2 45mcg as I wanted to achieve 125. I took 15.000 IU a day twice in that period. Now we both have around 80 ug/L (I didn't see the results myself yet, but doctor said so) and that means it is around 200 nmol/L. So we go back to 5000 IU daily + 30mg zinc.
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Re: FIRST STEP-Vit D3 min for pwMS=125 nmol/L in blood

Postby jimmylegs » Mon Mar 04, 2013 9:46 am

good plan, bbe. best to be very careful high dosing d3 when zinc is optimized. wise of you to have your levels tested regularly.
would be interesting to see zinc results over the same time period, if you have access to them.
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Letter to Berlin Researchers

Postby MarkW » Thu Mar 07, 2013 5:57 am

Here is my letter the corresponding author. He is part of the group in Berlin (Clinical and Experimental Research Center for Multiple Sclerosis, Charité - Universitätsmedizin Berlin) conducting a major study of the effectiveness of vitamin D supplementation in managing MS. Title:
Can we prevent or treat multiple sclerosis by individualised vitamin D supply?

Hello Herr Dr. Dörr,
I am pleased that you and your colleagues are close to recommending D3 minimum blood
level of 125nmol/L for people with Multiple Sclerosis. This is my recommendation, which
is widely read and supported on the internet:
chronic-cerebrospinal-venous-insufficiency-ccsvi-f40/topic14805-345.html
My background concerning MS has been documented by a broadsheet UK newspaper:
http://www.telegraph.co.uk/health/78823 ... elief.html
http://www.telegraph.co.uk/health/83598 ... minds.html
I attach three abstracts which lead me to conclude that 125 nmol/L should be
the minimum blood level, rather than 75-100 nmol/L you suggest. I trust that
when you study these papers you will agree that the positive effect of vitamin
D3 in people with MS may reach a plateau at 110-120 nmol/L (Abstract 1).
Also that high blood (above 100nmol/L) levels are beneficial (Abstracts 2 & 3).
As an experienced pharmaceutical analyst, taking a pragmatical point of view
and considering available data on efficacy, safety, tolerability, and the very low
cost of vitamin D3. It seems to be rational to monitor and control 25(OH)VD
levels in MS patients to at least 125 nmol/L (50 ng/ml), either by appropriate
sun exposure or, for most Europeans and North Americans, adequate vitamin
D3 supplementation. This must happen forthwith and prior to further clinical
trials as the economic costs of MS far outweigh those of vitamin D3
supplementation and monoriting. The imperative of vitamin D3
supplementation in Scotland has been noted by Prof George Ebers on
the BBC (http://www.bbc.co.uk/news/uk-scotland-16255661). I hope that
you and your colleagues will update your findings publically in the coming
weeks. Then your review may be cited as a pivitol paper for the addition
of vitamin D3 to the lives of people with Multiple Sclerosis.
In answer to your question:
We can mitigate multiple sclerosis relapses by individualised vitamin D
supply. I have developed a plan to target vitamin D supply to those at
increased risk of MS, in order to mitigate the rising incidence of MS.
However, that is a further step after the best minimum blood level of
25(OH)VD is agreed, which my goal in writing to you.
Kind Regards,
Mark
Mark Walker

Posted on 'This is MS' website.
CC: Prof George Ebers

ABSTRACT ONE -----------------------------------------------------------------------------------
Ther Adv Neurol Disord. 2012 Jul;5(4):187-98.
Relationship between 25-OH-D serum level and relapse rate in multiple sclerosis patients
before and after vitamin D supplementation.
Pierrot-Deseilligny C, Rivaud-Péchoux S, Clerson P, de Paz R, Souberbielle JC.
Service de Neurologie 1, Hôpital de la Salpêtrière, Assistance Publique-Hôpitaux de
Paris, Université Pierre et Marie Curie (Paris VI), Paris, France.
Abstract
BACKGROUND:
Vitamin D could play a protective role in multiple sclerosis.
METHODS:
In an observational, uncontrolled study, vitamin D3 supplementation (3010 IU/day on
average) was given to 156 consecutive patients with relapsing-remitting multiple
sclerosis, under first-line immunomodulatory therapy and with initial 25-OH-D serum
level lower than 100 nmol/l (40 ng/ml). Relapses were determined for 29.1 ± 8.4 months
during vitamin D and 29.8 ± 10.1 months before supplementation. The 25-OH-D level
was measured before supplementation and several times during supplementation. The
incidence rate of relapses before and during supplementation was estimated using
negative binomial regression models with follow-up durations as offset terms. The
incidence rate and incidence rate ratio of relapses at various 25-OH-D levels were
also calculated using negative binomial regression models.
RESULTS:
In 76 patients, immunomodulatory therapy preceded vitamin D supplementation (by 4.2
± 2.7 years) and in 80 patients both treatments were started simultaneously. Under
supplementation, the 25-OH-D level increased from 49 ± 22 nmol/l to 110 ± 26 nmol/l
on average. Pooling data collected before and during supplementation, we found a
significant strong inverse relationship between the relapse incidence rate and the
25-OH-D level (p < 0.0001), suggesting that vitamin D did indeed influence the relapse
rate. Results of univariate, bivariate and multivariate analyses were analogous:
in the multivariate model adjusted for age, disease duration and previous use of
immunomodulatory therapy, every 10 nmol increase in 25-OH-D level was associated
with a reduction in the relapse incidence rate of 13.7%. Dividing iteratively the
population made up of pooled periods into two subgroups according to the 25-OH-D
levels, the relapse incidence rate ratio decreased as the 25-OH-D level increased
up to 110 nmol/l, but a plateau effect was observed beyond this limit.
CONCLUSION:
Further studies are warranted for accurate quantification of the vitamin D effect.
PMID: 22783368 [PubMed]
PMCID: PMC3388527
Free PMC Article http://www.ncbi.nlm.nih.gov/pmc/article ... ool=pubmed
---------------------------------------------------------------------------------------------------------
ABSTRACT TWO ------------------------------------------------------------------------------------
Neurology. 2012 Jun 13. [Epub ahead of print]
Lower serum vitamin D levels are associated with a higher relapse risk in multiple
sclerosis.
Runia TF, Hop WC, de Rijke YB, Buljevac D, Hintzen RQ.
Source
From the Department of Neurology, MS Centre ErasMS (T.F.R., D.B., R.Q.H.), Department
of Biostatistics (W.C.J.H.), and Departments of Clinical Chemistry and Internal Medicine
(Y.B.d.R.), Erasmus MC, Rotterdam, the Netherlands.
Abstract
OBJECTIVE:
There is increasing evidence that vitamin D can be protective against the development
of multiple sclerosis (MS), but it may also be beneficial for the clinical course
of the disease. Our objective was to prospectively investigate if 25-hydroxy-vitamin
D (25-OH-D) levels are associated with exacerbation risk in MS in a study with frequent
serum measurements.
METHODS:
This was a prospective longitudinal study in 73 patients with relapsing-remitting
MS. Blood samples for 25-OH-D measurements were taken every 8 weeks. Associations
between 25-OH-D levels and exacerbation rates were assessed using Poisson regression
(generalized estimating equations) with the individual serum levels as time-dependent
variable.
RESULTS:
During follow-up (mean 1.7 years), 58 patients experienced a total of 139 exacerbations.
Monthly moving averages of 25-OH-D levels were categorized into low (<50 nmol/L),
medium (50-100 nmol/L), and high (>100 nmol/L) levels. Exacerbation risk decreased
significantly with higher serum vitamin D levels: respective relative exacerbation
rates for the medium and high-level category as compared to the low-level category
were 0.7 and 0.5 (p value for trend: p = 0.007). The association between 25-OH-D
concentrations and exacerbation rate was log linear without a threshold. With each
doubling of the serum 25-OH-D concentration the exacerbation rate decreased by 27%
(95% confidence interval 8%-42%, p = 0.008).
CONCLUSIONS:
Our finding that higher vitamin D levels are associated with decreased exacerbation
risk in relapsing-remitting MS suggests a beneficial effect of vitamin D on disease
course in MS. However, the possibility of reverse causality cannot be ruled out completely.
Randomized intervention studies are therefore needed to investigate the effect of
vitamin D supplementation in MS.
PMID: 22700811
-----------------------------------------------------------------------------------------------
ABSTRACT THREE ------------------------------------------------------------------------
Ann Neurol. 2012 Aug;72(2):234-40. doi: 10.1002/ana.23591.
Vitamin D status predicts new brain magnetic resonance imaging activity in multiple
sclerosis.
Mowry EM, Waubant E, McCulloch CE, Okuda DT, Evangelista AA, Lincoln RR, Gourraud
PA, Brenneman D, Owen MC, Qualley P, Bucci M, Hauser SL, Pelletier D.
Source
Multiple Sclerosis Center, Department of Neurology, University of California at San
Francisco, San Francisco, CA. emowry1@jhmi.edu.
Abstract
OBJECTIVE:
We sought to determine whether vitamin D status is associated with developing new
T2 lesions or contrast-enhancing lesions on brain magnetic resonance imaging (MRI)
in relapsing multiple sclerosis (MS).
METHODS:
EPIC is a 5-year longitudinal MS cohort study at the University of California at San
Francisco. Participants had clinical evaluations, brain MRI, and blood draws annually.
From the overall cohort, we evaluated patients with clinically isolated syndrome
or relapsing-remitting MS at baseline. In univariate and multivariate (adjusted for
age, sex, ethnicity, smoking, and MS treatments) repeated measures analyses, annual
25-hydroxyvitamin D levels were evaluated for their association with subsequent new
T2-weighted and gadolinium-enhancing T1-weighted lesions on brain MRI, clinical relapses,
and disability (Expanded Disability Status Scale [EDSS]).
RESULTS:
A total of 2,362 3T brain MRI scans were acquired from 469 subjects. In multivariate
analyses, each 10ng/ml higher 25-hydroxyvitamin D level was associated with a 15%
lower risk of a new T2 lesion (incidence rate ratio [IRR], 0.85; 95% confidence interval
[CI], 0.76-0.95; p = 0.004) and a 32% lower risk of a gadolinium-enhancing lesion
(IRR, 0.68; 95% CI, 0.53-0.87; p = 0.002). Each 10ng/ml higher vitamin D level was
associated with lower subsequent disability (-0.047; 95% CI, -0.091 to -0.003; p
= 0.037). Higher vitamin D levels were associated with lower, but not statistically
significant, relapse risk. Except for the EDSS model, all associations were stronger
when the within-person change in vitamin D level was the predictor.
INTERPRETATION:
Vitamin D levels are inversely associated with MS activity on brain MRI. These results
provide further support for a randomized trial of vitamin D supplementation. ANN
NEUROL 2012;72:234-240.
Copyright © 2012 American Neurological Association.
PMID: 22926855
----------------------------------------------------------------------------------------------
http://www.epmajournal.com/content/4/1/4#B128
Conclusions
In this review article, which follows the recommendations of the “EPMA White Paper”
[128], we summarise and discuss available data on the role of VD for the development
and disease course of MS. Many lines of evidence, in particular epidemiologic data,
preclinical investigations, animal studies, and association studies on VD status
and disease activity, suggest that higher serum concentrations of VD are beneficial
in terms of the risk to develop MS as well as the further course of the disease in
already-established MS. Moreover, VD supplementation is safe, cheap, and convenient
to perform. Therefore, it is intriguing to hypothesise that boosting the VD serum
levels would be an option to both prevent and treat MS. Despite the inherent methodological
drawbacks of epidemiologic studies, existing data on the preventive capacity of higher
VD levels are quite compelling. Final proof of this hypothesis would be reached by
large-scale prospective epidemiological studies which will probably not be available
in the near future, for obvious reasons. With respect to the therapeutic efficacy,
an association between higher VD serum concentrations and a favourable disease course
has been conclusively shown. Unfortunately, the so-far performed interventional trials,
though not negotiating this hypothesis, also do not unambiguously support the idea
that raising patients' VD levels would be favourably in terms of disease outcome.
Hopefully, ongoing (Table 2) and future trials will shed more light on this aspect.

But, how are we going to deal with this issue in the meantime? From a pragmatical
point of view and considering available data on efficacy, safety, tolerability, and
last but not least costs, it seems to be reasonable to regularly control 25(OH)VD
levels in MS patients, especially during winter months. In patients with inadequate
VD, levels should be raised to at least 30–40 ng/ml (75–100 mmol/l), either by appropriate
sun exposure and/or adequate VD supplementation. As a rule of thumb, supplementary
1 μg (40 IU) cholecalciferol will increase 25(OH)VD levels by 1 ng/ml (2.5 nmol/l).
===================================================
Mark Walker - Oxfordshire, England. Registered Pharmacist (UK). 11 years of study around MS.
Mark's CCSVI Report 7-Mar-11:
http://www.telegraph.co.uk/health/8359854/MS-experts-in-Britain-have-to-open-their-minds.html
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Re: FIRST STEP-Vit D3 min for pwMS=125 nmol/L in blood

Postby jimmylegs » Thu Mar 07, 2013 6:40 am

2010 post containing some related arguments and abstracts supporting the notion that levels below 100 nmol/L are equivalent to hypovitaminosis D, and that the lower limit of the normal range, never mind optimal, would be better set at 100 nmol/L as opposed to 75.

natural-approach-f27/topic18559-705.html#p13575
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Re: FIRST STEP-Vit D3 min for pwMS=125 nmol/L in blood

Postby MarkW » Thu Mar 07, 2013 6:43 am

BBE wrote:I had around 25 ug/L in November 2012 and my wife with MS had 62 ug/L. (She was taking D3 more often than me/ They measure it in these units in here). I didn't recalculate that well into nmol/L and ordered for both 10.000 IU daily with 30-60 mg Zinc and K2 45mcg as I wanted to achieve 125. I took 15.000 IU a day twice in that period. Now we both have around 80 ug/L (I didn't see the results myself yet, but doctor said so) and that means it is around 200 nmol/L. So we go back to 5000 IU daily + 30mg zinc.

Hello BBE,
125 nmol/L is a minimum level for pwMS. I target 150nmol/L and say that 200nmol/L is a high value but unlikely to be harmful. I suggest that you stay with 10,000 iu/day and measure again in May. You say you are cutting Zinc to 30mg/day and that could have an impact, let's see what it is.
A rule of thumb, says supplementing 1 μg (40 IU) cholecalciferol will increase 25(OH)D3 levels by 1 ng/ml (2.5 nmol/l).
This is for an average human, so may not apply to you. However if we use your data and make big assumptions:
10,000 iu/day extra produces 80 ng/ml, maybe 9000 iu/day is the correct dose for you.
If you have 1000iu liquid filled capsules and can have your D3 blood levels measured at no cost to you (two ifs). Then cut your D3 dose by 1000iu/day, every two weeks and check your D3 level until you arrive at 60 ug/L. Also remember that our bodies have control mechanisms, so the variation between patients may be significant.
Please post your results
Best wishes,
MarkW
PS I should have used the same units every time, hope you can follow.
Mark Walker - Oxfordshire, England. Registered Pharmacist (UK). 11 years of study around MS.
Mark's CCSVI Report 7-Mar-11:
http://www.telegraph.co.uk/health/8359854/MS-experts-in-Britain-have-to-open-their-minds.html
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Re: FIRST STEP-Vit D3 min for pwMS=125 nmol/L in blood

Postby jimmylegs » Thu Mar 07, 2013 8:11 am

just watch that the serum magnesium stays up above 0.90-0.95 mmol/L when vit D3 levels are up in the 200 neighbourhood...
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Re: FIRST STEP-Vit D3 min for pwMS=125 nmol/L in blood

Postby Squeakycat » Thu Mar 07, 2013 8:36 am

jimmylegs wrote:just watch that the serum magnesium stays up above 0.90-0.95 mmol/L when vit D3 levels are up in the 200 neighbourhood...

At that level, you also need to watch calcium and phosphorus levels, that the product of them (in mg/dL) is less than <70, and that AlkPhos and creatinine are within normal limits.

While most people can get away with these levels without hypercalcemia, not everyone can.
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Re: FIRST STEP-Vit D3 min for pwMS=125 nmol/L in blood

Postby jimmylegs » Thu Mar 07, 2013 10:05 am

naturally. watching for markers of hypercalcemia are of course a given.

scavenged this list of tests to watch when hypercalcemia is suspected:

Full blood count and ESR
Electrolytes, including calcium and phosphate levels ( elevated phosphate levels are common with hyperparathyroidism)
Renal function tests
Liver function tests, including albumin level
PTH level - If increased this would suggest parathyroid tumor, parathyroid hyperplasia or ectopic PTH secretion.
Alkaline phosphatase level - Elevated calcium and elevated alkaline phosphatase without elevated PTH suggests bone metastases, Paget's disease and other bone tumor. Elevated calcium without elevated alkaline phosphatase suggests multiple myeloma and elevated protein due to other causes.
Thyroid function tests looking for hyperthyroidism which may cause elevated calcium due to high bone turnover states
Serum protein electrophoresis will help detect multiple myeloma
Vitamin D and Vitamin A levels, if suspect Vitamin D or A toxicity as may cause elevated calcium levels

re electrolytes and high vit d3, i have the most personal xp with magnesium (even though it is not mentioned explicitly in the list above), hence the targets provided.
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Neuros from Norway say 75-125 nmol/L

Postby MarkW » Thu Mar 07, 2013 1:28 pm

Eventually the experts will catch up with ThisIsMS...............MarkW

Expert Rev Neurother. 2012 Sep;12(9):1101-12. doi: 10.1586/ern.12.99.
Vitamin D in multiple sclerosis: implications for assessment and treatment.
Holmøy T, Kampman MT, Smolders J.
Source
Department of Neurology, Akershus University Hospital, Lørenskog, Norway. trygve.holmoy@medisin.uio.no
Abstract
Epidemiological and experimental evidence suggest that a poor vitamin D status is associated with an increased risk of developing multiple sclerosis (MS), and also an unfavorable disease course. Vitamin D may exert relevant effects both on the immune system and on resident cells within the CNS. The data from clinical trials is, however, restricted, and does not allow any conclusion on the effect of high-dose vitamin D supplementation on disease course. The results from sufficiently powered studies will not be available for at least 2 years. MS patients are, however, prone to develop osteoporosis and have increased risk of fractures. Therefore, the authors advise that the serum concentration of 25-hydroxyvitamin D is monitored in order to prevent bone deficit, and that a serum level of 75-125 nmol/l is targeted. This level is sufficient for maintenance of bone health, is not known to be associated with adverse events, and is in the range that has been associated with low risk of developing MS and low disease activity.
PMID: 23039389
Mark Walker - Oxfordshire, England. Registered Pharmacist (UK). 11 years of study around MS.
Mark's CCSVI Report 7-Mar-11:
http://www.telegraph.co.uk/health/8359854/MS-experts-in-Britain-have-to-open-their-minds.html
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