This question has arisen from contributor Pete Batcheller, who added a response to my question "Is Botox an effective treatment for Episodic Migraines?". Mr Batcheller is a very dedicated believer that high dose Vit D3 is effective in preventing Cluster Headaches (CH).
High dose Vit D3 has been researched for its anti-inflammatory functions and it is possible it may help reduce the incidence and severity of CH when used in doses of 10,000 IU a day. Bearing in mind the morbidity of CH and the low price of VitD3 supplements, it suggests it is worth trying provided the potential harmful effects of Hypervitaminosis D are avoided.
He quotes a paper "Burton et al. titled A Phase I/II Safety Trial of High Dose Oral Vitamin D3 with Calcium Supplementation in Patients with Multiple Sclerosis" where doses up to 40,000IU a day were given over 48 weeks and the serum 25(OH)D (along with Serum + Urinary Calcium and other markers were measured)
While it is very clear to me that this is not a sufficiently long period to be certain that the long term dangers of heart attacks and kidney damage due to increased serum 25(OH) are not worsened, the interesting observation from Burton's work was that though there was a significant delayed rise in Serum 25(OH)D to a maximum of 410nmol this fell again to approx 200nmol during the period when 10,000IU was taken, and by extrapolation would probably fall further if the time the 10,000IU was take had been extended
It is now generally accepted that 5,000 IU given long term is safe
So, bearing in mind the intense morbidity of CH and CH may be associated with low serum levels of 30nmol or less of 25(OH)D:-
1. Does anybody have experience of high dose (10,000IU/day) VitD3 for CH
2. What serum level of 25(OH)D would be safe to run at for extended periods? Is 200nmol safe? What papers are there to back up safe levels when adminise
Hi Dr. Blatchley,
Vitamin D insufficiency is defined as a 25(OH)D concentration of 20 to 30 ng/mL (50 to 75 nmol/L). Vitamin D deficiency is defined as a 25(OH)D level less than 20 ng/mL (50 nmol/L).
Therefore, 30 nmol/L (12 ng/mL ) is classified as severe deficiency, which necessitate VD repletion. I have experience with high doses of VD repletion (10.000 IU) once or twice weekly. These doses should not be used longer than 8 weeks, to be replaced by the maintenance daily doses of 800- 1200 IU/day.
Higher persistent doses of 25(OH)D may lead to VD intoxication and increased excretion of calcium in urine (hypercalciuria) with consequent increased risk of de novo urinary stones formation and will increase the bulk of the already formed calculi.
Thus, one should be cautious in replacing VD in those patients with strict flow-up for the serum level of VD.
Regards
Well, there is a lot of controversy whether or not vitamin D3 supplements has any role in treating/preventing various medical problems, including osteoporosis, neuropathy and headaches. So far, to the best of my knowledge, there is no scientific evidence that those supplements would have any positive impact on above mentioned conditions. On the other hand, it may have a "placebo" effect on pain syndromes, like migraine headaches. Because it is a fat soluble vitamin, you can get toxicity from overdosing. The average body vitamin D requirements are about 1000-2000 IU/day. If you do more than that you risk overdosing. You can check your vitamin D levels if you wish in 3 to 6 months after you start supplements to make sure you are not overdoing it.
Of course absence of evidence is not evidence of absence (of an effect), and placebo effect is often a default medical position when there is no evidence there might be one!
Indeed the idea that doses of >2000U a day may produce toxicity is mentioned on the basis that it is an oil soluble vitamin that could be stored, but without evidence of this.
I have no answers whether high dose Vit D3 can help CH but I have spoken extensively to endocrinologists on the matter
1. a)10000U a day is very unlikely to produce toxic levels in itself. The danger is related to the potential rise in Serum Ca levels and if this remains normal then there should be no problem with renal stones etc.
b) Vit D deficiency may rarely mask a parathyroid tumour, which can be the cause of increased Serum Ca levels when D3 levels are corrected.
I do not know whether high dose D3 (10000U/d) can produce increased Serum Ca in someone who had previously normal D3 levels, but it seems sensible to monitor it
2. The use of high dose Vit D3 should not be confused with treatment of D3 deficiency. One is using supra-physiological levels of D3 to (possibly) treat CH. The possible mode of action is unclear but may be related to an anti-inflammatory function, but this theory is certainly speculative!
Severe CH is sometimes called Suicide Headache and is debilitating. Perhaps high dose D3 may not be without risks, but with the suffering due to CH and the potential risks of other treatments, perhaps it should be explored further. It is after all a very cheap treatment...
It would be really good to hear more thoughts....
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