Post by D Man on Jul 10, 2016 19:15:18 GMT
Dr. Cicero Galli Coimbra is a Brazilian Neurologist, Professor and Researcher who has become popular for treating Multiple Sclerosis and auto immune disease with high doses of vitamin D3 combined with a combination of other supplements and diet recommendations. Dr. Coimbra does not claim to cure MS [some of his patients will tell you differently] but he has proven that his treatment does stop it progression.
Please do not attempt to duplicate Dr. Coimbra's protocol without a full understanding of how he applies his treatment. The reason you won't find an exact written version of this protocol is that Dr. Coimbra does detailed testing of each one of his patients and alters the protocol for each one. He then monitors his patients continuously for their safety and to make adjustments to their daily dosing. We can only share some basic guidelines and principals he uses.
Dr. Coimbra has no problem stating publicly that he sees 10,000 IUs per day as the "physiological dose" of D3 that is safe for any adult to take. He also states the current US RDA of a maximum of 800 IUs for vitamin D is a "paltry" amount of D3. The commonly prescribed daily dose of vitamin D3 on Coimbra's protocol ranges from 40,000 to 200,000 IU's. He uses a formula of 1,000 IU's per kilogram [one kilogram is 2.2 pounds] to find the upper range doses.
The Supplements
Here is a list of the most common supplements used in Dr. Coimbra's protocol. Vitamin D3, vitamin B2, magnesium glycinate, boron, chromium picolinate, Omega 3 DHA, Zinc, Methylcobalamin form of B12, Choline and more.
The Dietary Restrictions
All patients must discontinue eating or drinking dairy products or calcium enriched foods or beverages. Complete restriction is critical! This includes foods that are formed by milk, cheese, cheese spread, yogurt, curdled milk, cream of milk, caramel, milk pudding, condensed milk. Also includes products made of soy milk enriched with calcium (for reduction of the amount of calcium ingested due to the use of high doses of vitamin D in your treatment) . Think hard, this includes foods that use milk in their preparation. Mashed potato, breads, cakes, biscuits as well as butter and margarine need to be eliminated. While it's not mandatory Dr. Coimbra does advise the restriction of poultry, meat and pork meat for reduction of the quantity of heterocyclic amines in the diet. Information on these substances are easily found by doing a Google search for "heterocyclic amines". It is recommended egg-vegetarian diet with fish, using soy protein, tofu, egg white and mercury free fish. Coimbra also encourages patients to avoid excessive or routine consumption of bananas. Of course this includes discontinuing any calcium supplement.
Other Guidelines
Hydration is Critical
Drink as least 2.5 liters [85 ounces] of fluids, preferably water, daily to avoid excessive concentration of calcium in the urine. From Dr. Coimbra "Ingest high amounts of liquids (at least 2 and a half litres of liquids daily, including water, juices,, soft drinks, teas, etc.). This higher quantity of liquids assures a urine volume around 2.000 ml which allows calcium dilution eliminated in the urine, and avoids excessive concentration of urinary calcium ( as when calcium is diluted it does not get deposited in the kidney, preserving renal function).
Must Discontinue the use of all Nephrotoxic Drugs
The use of nephrotoxic drugs must be avoided as they may limit the elimination of calcium through the kidneys. Thus allowing accumulation in the bloodstream, as "the door" between the intestine and the blood current is "open" by higher circulating levels of vitamin D. Avoid taking unnecessary medications all together. Be especially careful with anti-inflammatory drugs and antibiotics. Especially those administered by intravenous or intramuscular injection. If you are prescribed any medication as absolutely necessary, read the leaflet and request information from the doctor and pharmacist about its nephrotoxicity. If it is verified that the medication is in fact nephrotoxic, discuss alternatives with the physician who has prescribed the drug. If it is irreplaceable or absolutely necessary, hydration should be intensified to reduce drug concentration as much as possible in the urine that is formed in the kidneys. Special care must be taken with antibiotics such as the aminoglycosides that are taken intra-muscular or intra-venously for treatment of respiratory or urinary infections.
Required Test Used to Monitor Patients
Vitamin D 25 Hydroxy blood test
The PTH Parathyroid test
Blood serum calcium test
24 hour urinary calcium test
Comprehensive Metabolic Panel - Which includes B12, urea/creatine, albumin, ferritin, chrome serum, serum phosphate, phosphaturia 24 hour and more.
These tests are critically important to get your doctor on board with if you plan on attempting the Coimbra Protocol on your own. Especially if you plan on increasing your daily dose of D3 above 40,000 IUs per day.
The urinary calcium test is very important, Dr. Coimbra says "The concentration of calcium in the urine is considered adequate if it is less than 250 mg per litre of urine as calculated through the 24- Hour calcium urine test. If the calcium concentration is higher than 250 mg per litre of urine, the patient should interrupt the daily doses of Cholecalciferol for 3 days, which is usually the necessary time to obtain the disappearance of excessive thirst. On the fourth day the patient should restart taking a lower daily dose of vitamin D, as per medical recommendation." Dr. Coimbra considers calcium to be low in the urine when it's under 100mg total. He considers the ideal level is around 100-150mg/L.
Why Vitamin B2?
Dr. Coimbra tells us....."Vitamin B2 primarily or secondarily participates in a much wider range of critical metabolic pathways than currently recognized. An inherited disorder of the cellular uptake and trafficking of vitamin B2 metabolites may result in poor intestinal absorption, increased urinary loss, and disrupted homeostasis of vitamin B2 metabolites in the central nervous system or CNS. It may affect 10%–15% of the general population and be the most prevalent genetic risk factor for several human diseases. The implications include altered metabolism of several biomolecules and enzyme systems of well-established pathophysiologic relevance such as vitamins B6, B9 (folate), B12, D3, NO, lipids, amino acids, proteins, DNA, cytochrome P-450 and other enzyme systems, HO, and homocysteine. Oxidative stress, and both apoptotic and necrotic phenomena may be enhanced. Due to the loss of the brain privilege for vitamin B2 supply, this inherited condition may be particularly relevant for CNS diseases such as migraine, brain ischemia, traumatic brain injury, neurodegenerative disorders (especially Parkinson and Alzheimer’s diseases), epilepsy, multiple sclerosis, and for Guillain-Barré syndrome, myasthenia, and mitochondrial myopathies.
Independant Testing
Dr. Coimbra has claimed amazing results with his treatment and unfortunately very little is done in the US or the UK to prove or disprove any of his claims since our the medical industry has little interest in the subject. Researchers from the University of California, San Francisco have done some basic work on MS patients and have reported a reduction in brain lesions and disease activity in multiple sclerosis patients who had higher levels of vitamin D. This conclusion came after a 5 year study, involving 469 men and women with MS. All participants underwent yearly blood testing for vitamin D and brain magnetic resonance imaging (MRI) to evaluate disease progression. The researchers determined that with each 10 ng/ml increase in serum 25-hydroxyvitamin D, there was a corresponding 15% reduction in the risk of new brain lesions characteristic of MS. They also noted a 32% lower risk of areas of active disease as indicated by “white spots” or areas of inflammation visible on MRI images.
Please do not attempt to duplicate Dr. Coimbra's protocol without a full understanding of how he applies his treatment. The reason you won't find an exact written version of this protocol is that Dr. Coimbra does detailed testing of each one of his patients and alters the protocol for each one. He then monitors his patients continuously for their safety and to make adjustments to their daily dosing. We can only share some basic guidelines and principals he uses.
Dr. Coimbra has no problem stating publicly that he sees 10,000 IUs per day as the "physiological dose" of D3 that is safe for any adult to take. He also states the current US RDA of a maximum of 800 IUs for vitamin D is a "paltry" amount of D3. The commonly prescribed daily dose of vitamin D3 on Coimbra's protocol ranges from 40,000 to 200,000 IU's. He uses a formula of 1,000 IU's per kilogram [one kilogram is 2.2 pounds] to find the upper range doses.
The Supplements
Here is a list of the most common supplements used in Dr. Coimbra's protocol. Vitamin D3, vitamin B2, magnesium glycinate, boron, chromium picolinate, Omega 3 DHA, Zinc, Methylcobalamin form of B12, Choline and more.
The Dietary Restrictions
All patients must discontinue eating or drinking dairy products or calcium enriched foods or beverages. Complete restriction is critical! This includes foods that are formed by milk, cheese, cheese spread, yogurt, curdled milk, cream of milk, caramel, milk pudding, condensed milk. Also includes products made of soy milk enriched with calcium (for reduction of the amount of calcium ingested due to the use of high doses of vitamin D in your treatment) . Think hard, this includes foods that use milk in their preparation. Mashed potato, breads, cakes, biscuits as well as butter and margarine need to be eliminated. While it's not mandatory Dr. Coimbra does advise the restriction of poultry, meat and pork meat for reduction of the quantity of heterocyclic amines in the diet. Information on these substances are easily found by doing a Google search for "heterocyclic amines". It is recommended egg-vegetarian diet with fish, using soy protein, tofu, egg white and mercury free fish. Coimbra also encourages patients to avoid excessive or routine consumption of bananas. Of course this includes discontinuing any calcium supplement.
Other Guidelines
Hydration is Critical
Drink as least 2.5 liters [85 ounces] of fluids, preferably water, daily to avoid excessive concentration of calcium in the urine. From Dr. Coimbra "Ingest high amounts of liquids (at least 2 and a half litres of liquids daily, including water, juices,, soft drinks, teas, etc.). This higher quantity of liquids assures a urine volume around 2.000 ml which allows calcium dilution eliminated in the urine, and avoids excessive concentration of urinary calcium ( as when calcium is diluted it does not get deposited in the kidney, preserving renal function).
Must Discontinue the use of all Nephrotoxic Drugs
The use of nephrotoxic drugs must be avoided as they may limit the elimination of calcium through the kidneys. Thus allowing accumulation in the bloodstream, as "the door" between the intestine and the blood current is "open" by higher circulating levels of vitamin D. Avoid taking unnecessary medications all together. Be especially careful with anti-inflammatory drugs and antibiotics. Especially those administered by intravenous or intramuscular injection. If you are prescribed any medication as absolutely necessary, read the leaflet and request information from the doctor and pharmacist about its nephrotoxicity. If it is verified that the medication is in fact nephrotoxic, discuss alternatives with the physician who has prescribed the drug. If it is irreplaceable or absolutely necessary, hydration should be intensified to reduce drug concentration as much as possible in the urine that is formed in the kidneys. Special care must be taken with antibiotics such as the aminoglycosides that are taken intra-muscular or intra-venously for treatment of respiratory or urinary infections.
Required Test Used to Monitor Patients
Vitamin D 25 Hydroxy blood test
The PTH Parathyroid test
Blood serum calcium test
24 hour urinary calcium test
Comprehensive Metabolic Panel - Which includes B12, urea/creatine, albumin, ferritin, chrome serum, serum phosphate, phosphaturia 24 hour and more.
These tests are critically important to get your doctor on board with if you plan on attempting the Coimbra Protocol on your own. Especially if you plan on increasing your daily dose of D3 above 40,000 IUs per day.
The urinary calcium test is very important, Dr. Coimbra says "The concentration of calcium in the urine is considered adequate if it is less than 250 mg per litre of urine as calculated through the 24- Hour calcium urine test. If the calcium concentration is higher than 250 mg per litre of urine, the patient should interrupt the daily doses of Cholecalciferol for 3 days, which is usually the necessary time to obtain the disappearance of excessive thirst. On the fourth day the patient should restart taking a lower daily dose of vitamin D, as per medical recommendation." Dr. Coimbra considers calcium to be low in the urine when it's under 100mg total. He considers the ideal level is around 100-150mg/L.
Why Vitamin B2?
Dr. Coimbra tells us....."Vitamin B2 primarily or secondarily participates in a much wider range of critical metabolic pathways than currently recognized. An inherited disorder of the cellular uptake and trafficking of vitamin B2 metabolites may result in poor intestinal absorption, increased urinary loss, and disrupted homeostasis of vitamin B2 metabolites in the central nervous system or CNS. It may affect 10%–15% of the general population and be the most prevalent genetic risk factor for several human diseases. The implications include altered metabolism of several biomolecules and enzyme systems of well-established pathophysiologic relevance such as vitamins B6, B9 (folate), B12, D3, NO, lipids, amino acids, proteins, DNA, cytochrome P-450 and other enzyme systems, HO, and homocysteine. Oxidative stress, and both apoptotic and necrotic phenomena may be enhanced. Due to the loss of the brain privilege for vitamin B2 supply, this inherited condition may be particularly relevant for CNS diseases such as migraine, brain ischemia, traumatic brain injury, neurodegenerative disorders (especially Parkinson and Alzheimer’s diseases), epilepsy, multiple sclerosis, and for Guillain-Barré syndrome, myasthenia, and mitochondrial myopathies.
Independant Testing
Dr. Coimbra has claimed amazing results with his treatment and unfortunately very little is done in the US or the UK to prove or disprove any of his claims since our the medical industry has little interest in the subject. Researchers from the University of California, San Francisco have done some basic work on MS patients and have reported a reduction in brain lesions and disease activity in multiple sclerosis patients who had higher levels of vitamin D. This conclusion came after a 5 year study, involving 469 men and women with MS. All participants underwent yearly blood testing for vitamin D and brain magnetic resonance imaging (MRI) to evaluate disease progression. The researchers determined that with each 10 ng/ml increase in serum 25-hydroxyvitamin D, there was a corresponding 15% reduction in the risk of new brain lesions characteristic of MS. They also noted a 32% lower risk of areas of active disease as indicated by “white spots” or areas of inflammation visible on MRI images.
