I have been on the Coimbra protocol for 1.5 years now and am feeling much better (see my previous post). I have had a number of people ask me for more information about the protocol and what it entails. Here is a short summary of the Coimbra protocol, as I understand it. However if you would like more detail than this, there are also You-tube videos online from Dr. Coimbra himself, plus the book "Multiple Sclerosis and (lots of) Vitamin D" by Ana Claudia Domene.
As I understand it, the Coimbra therapy uses high doses of Vitamin D to reduce a person's level of Parathyroid hormone (PTH). As they are inversely related, the more Vitamin D a person takes, the lower a person's PTH level becomes. However, one does not want the PTH to go too low either, as it is needed. The range that is ideal is between 1-2 pmol/L for people with MS. When the PTH is in this zone, MS activity appears to stop. One is also able to lower PTH by lowering one's stress, so it is essential to also lower one's stress while on the protocol. Otherwise you have to take even higher amounts of Vitamin D to compensate. That is why I believe meditation is so good for OMSers or anyone with MS, as it lowers the PTH. However, I had quit work and was meditating almost every day for 2 years while following OMS prior to starting the Coimbra therapy and my PTH was still too high. So although meditation and a low stress life helps to keep MS activity at bay, it may not be enough for everyone.
It takes about 2 years of being on the Coimbra protocol, while doing lab tests every 3-6months and having visits with the Coimbra trained doctor, in order to determine the right dose for you. The starting point is approx 1000IU per kg body weight, but different people need different amounts in order to get the PTH into the right zone of 1-2pmol/L. The difference between people's need for Vitamin D to balance the body, is termed 'Vitamin D resistance'.
Taking high levels of Vitamin D requires a number of precautions. Calcium is easily absorbed with taking high levels of Vitamin D, so one needs to limit the amount of Calcium in the blood and urine. To do this, one needs to drink 2.5-3L of water/liquid a day. One also needs to avoid high Calcium foods. I find if a food has more than 8% Ca in a serving, it's too high. This means no dairy (easy for OMSers), no Calcium fortified foods (which includes many non-dairy drink beverages, protein bars, etc), limit tofu to one serving once in a while, limit kale, swiss chard and spinach to only one or two leaves per serving and eating only about 1T nuts/ seeds per day. Peanut butter seems to be OK though in higher amounts, as it has 0% Calcium. Sesame seeds and almonds have the most Calcium out of any seed/nut, so eat them in very small quantities. I generally avoid nuts/seeds on a daily basis unless they are in a special recipe or when eating out. Because of my need for protein and fewer nuts available (due to Calcium), my Coimbra trained Natropath recommended me to add chicken and turkey back into my diet as well as lean beef once a week for iron. I still follow a very low saturated fat diet though.
The vitamin D is prescribed through the Natropath and compounded at a pharmacy, so it is extra concentrated. Each drop contains 10,000IU, so I only have to take 10 drops a day for my 100,000IU per day dose. The vitamin D is in liquid form and I keep it in the fridge. It lasts about 3-4 months and I get it mailed to me as the local pharmacy does not do compounding.
There are also other supplements one needs to take while on the protocol. I take a pill that has a bunch of supplements already mixed together from the Natropath 4x per day. Plus I take a few more recommended by the Natropath separately (optional). All of the supplements help to support people with MS.
As this therapy is not recognized by the medical community in Canada, I need to pay for it all myself and I need to see the only trained doctor in Canada, who is a Natropath in Vancouver for my treatment. I get my lab tests done locally from a different Natropath and then send my Coimbra trained Natropath the results right before my Skype appointment. A round of lab tests cost about $300. The Natropath appt costs about $100. Supplements through the Natropath cost about $500/year, plus the vitamin D costs about $400 (includes postage) per year. So after the first 2 years, it should only cost $1300/year assuming a once per year check up. Plus once needs to get a bone scan done at the beginning of treatment, at the one year mark and then every 5 years thereafter. I requested the bone scan through my general practitioner and done at the hospital, but I had to pay for it. It cost $170. Overall though, quite an inexpensive treatment I think.
Dr. Coimbra has found that after his centre treated more than 5000 people with this therapy over about 5 years, there was a 95% success rate with halting MS activity. This means no more relapses for people that have the relapsing remitting form of MS. This means no more progression for people that have the progressive form of MS. The 5% that it did not work for did not get worse with treatment, it's just that they did not improve. Their rate of relapse and/or progression stayed the same as before. There were only a few people with negative consequences, which were kidney stones, as a result of either eating too much Calcium or not drinking enough water. Getting kidney stones is a pretty low risk, especially if you are being careful with what you eat and drink. Also regular checkups and being monitored by a doctor trained in the Coimbra therapy is essential. (see previous posts for the weblink of doctors trained in the Coimbra approach).
Dr Coimbra stated in his videos that if the patient had a symptom for over one year prior to starting the treatment, then the symptom might go away with treatment. But if the symptom had been present for more than one year, expect it to stay. I found this to be true, as my symptoms of numbness and some drop foot/coordination remain. However, I was pleasantly surprised to find that I have more energy since starting the treatment. I no longer need to lay down for an afternoon nap. I may not feel up to climbing a mountain like before I had MS, but I am active, hiking, biking, doing yoga etc. And best of all, I don't have to give up my afternoons anymore. I feel like I have regained a third of my life back! Plus I feel more confident now, knowing that my MS is very unlikely to progress.
I hope that you have found this information to be helpful. If you have any direct questions for me, please send me a private message through this website. Thank you.
As I understand it, the Coimbra therapy uses high doses of Vitamin D to reduce a person's level of Parathyroid hormone (PTH). As they are inversely related, the more Vitamin D a person takes, the lower a person's PTH level becomes. However, one does not want the PTH to go too low either, as it is needed. The range that is ideal is between 1-2 pmol/L for people with MS. When the PTH is in this zone, MS activity appears to stop. One is also able to lower PTH by lowering one's stress, so it is essential to also lower one's stress while on the protocol. Otherwise you have to take even higher amounts of Vitamin D to compensate. That is why I believe meditation is so good for OMSers or anyone with MS, as it lowers the PTH. However, I had quit work and was meditating almost every day for 2 years while following OMS prior to starting the Coimbra therapy and my PTH was still too high. So although meditation and a low stress life helps to keep MS activity at bay, it may not be enough for everyone.
It takes about 2 years of being on the Coimbra protocol, while doing lab tests every 3-6months and having visits with the Coimbra trained doctor, in order to determine the right dose for you. The starting point is approx 1000IU per kg body weight, but different people need different amounts in order to get the PTH into the right zone of 1-2pmol/L. The difference between people's need for Vitamin D to balance the body, is termed 'Vitamin D resistance'.
Taking high levels of Vitamin D requires a number of precautions. Calcium is easily absorbed with taking high levels of Vitamin D, so one needs to limit the amount of Calcium in the blood and urine. To do this, one needs to drink 2.5-3L of water/liquid a day. One also needs to avoid high Calcium foods. I find if a food has more than 8% Ca in a serving, it's too high. This means no dairy (easy for OMSers), no Calcium fortified foods (which includes many non-dairy drink beverages, protein bars, etc), limit tofu to one serving once in a while, limit kale, swiss chard and spinach to only one or two leaves per serving and eating only about 1T nuts/ seeds per day. Peanut butter seems to be OK though in higher amounts, as it has 0% Calcium. Sesame seeds and almonds have the most Calcium out of any seed/nut, so eat them in very small quantities. I generally avoid nuts/seeds on a daily basis unless they are in a special recipe or when eating out. Because of my need for protein and fewer nuts available (due to Calcium), my Coimbra trained Natropath recommended me to add chicken and turkey back into my diet as well as lean beef once a week for iron. I still follow a very low saturated fat diet though.
The vitamin D is prescribed through the Natropath and compounded at a pharmacy, so it is extra concentrated. Each drop contains 10,000IU, so I only have to take 10 drops a day for my 100,000IU per day dose. The vitamin D is in liquid form and I keep it in the fridge. It lasts about 3-4 months and I get it mailed to me as the local pharmacy does not do compounding.
There are also other supplements one needs to take while on the protocol. I take a pill that has a bunch of supplements already mixed together from the Natropath 4x per day. Plus I take a few more recommended by the Natropath separately (optional). All of the supplements help to support people with MS.
As this therapy is not recognized by the medical community in Canada, I need to pay for it all myself and I need to see the only trained doctor in Canada, who is a Natropath in Vancouver for my treatment. I get my lab tests done locally from a different Natropath and then send my Coimbra trained Natropath the results right before my Skype appointment. A round of lab tests cost about $300. The Natropath appt costs about $100. Supplements through the Natropath cost about $500/year, plus the vitamin D costs about $400 (includes postage) per year. So after the first 2 years, it should only cost $1300/year assuming a once per year check up. Plus once needs to get a bone scan done at the beginning of treatment, at the one year mark and then every 5 years thereafter. I requested the bone scan through my general practitioner and done at the hospital, but I had to pay for it. It cost $170. Overall though, quite an inexpensive treatment I think.
Dr. Coimbra has found that after his centre treated more than 5000 people with this therapy over about 5 years, there was a 95% success rate with halting MS activity. This means no more relapses for people that have the relapsing remitting form of MS. This means no more progression for people that have the progressive form of MS. The 5% that it did not work for did not get worse with treatment, it's just that they did not improve. Their rate of relapse and/or progression stayed the same as before. There were only a few people with negative consequences, which were kidney stones, as a result of either eating too much Calcium or not drinking enough water. Getting kidney stones is a pretty low risk, especially if you are being careful with what you eat and drink. Also regular checkups and being monitored by a doctor trained in the Coimbra therapy is essential. (see previous posts for the weblink of doctors trained in the Coimbra approach).
Dr Coimbra stated in his videos that if the patient had a symptom for over one year prior to starting the treatment, then the symptom might go away with treatment. But if the symptom had been present for more than one year, expect it to stay. I found this to be true, as my symptoms of numbness and some drop foot/coordination remain. However, I was pleasantly surprised to find that I have more energy since starting the treatment. I no longer need to lay down for an afternoon nap. I may not feel up to climbing a mountain like before I had MS, but I am active, hiking, biking, doing yoga etc. And best of all, I don't have to give up my afternoons anymore. I feel like I have regained a third of my life back! Plus I feel more confident now, knowing that my MS is very unlikely to progress.
I hope that you have found this information to be helpful. If you have any direct questions for me, please send me a private message through this website. Thank you.
