The Coimbra Protocol
Dr. Coimbra has researched the treatment protocol with ultra-high doses of vitamin D since 2002, continuously developed it and successfully applied it to several thousand patients.
It all began with the chance discovery that higher doses of vitamin D in Parkinson's patients who were also suffering from vitiligo and psoriasis healed skin lesions. Dr. Coimbra then delved into basic research on vitamin D and took own research in front. In doing so, he discovered that there are numerous genetic mutations that can lead to vitamin D impairment in the body. People with this utilization disorder have a significant deficiency in the hormonally effective active vitamin D (calcitriol). Even if there is a sufficient amount of the pre-hormone vitamin D3 (cholecalciferol) in the blood or adipose tissue, they cannot produce a sufficient amount of the active vitamin D (calcitriol). However, since vitamin D is of fundamental importance for regulating the immune system, long-term deficiencies lead to autoimmune diseases.
Little by little, Dr. Coimbra found out how to calculate the individual necessary daily dose of vitamin D without causing serious side effects. In order to adjust patients to the optimally effective, side-effect-free daily dose, three to four blood count and urine tests are necessary at the beginning of treatment. Among other things, the level of parathyroid hormone (PTH) is measured as an indicator of the optimal effectiveness and safety of vitamin D.
To avoid damage to the kidneys, patients must follow a low-calcium diet: high doses of vitamin D and a lowering of the PTH result in excessive calcium being absorbed from the diet. In addition, a daily intake of at least 2,5 liters is necessary to ensure the excretion of calcium via the kidneys. Regular exercise is also an important part of the Coimbra protocol. This prevents the breakdown of bone substance and stimulates the formation of new brain cells. Relaxation and mental balance are emphasized in order to prevent hormonal stress reactions.
The Coimbra protocol is rounded off by a combination of various vitamins, minerals and trace elements that ensure optimal functioning of the vitamin D metabolism. However, about 90% of the effect is due to the optimal individual dose of vitamin D. According to previous estimates, the therapy should be continued for life. So far, there is long-term experience of up to 15 years. Dr. Coimbra and his team have treated over 5.000 patients to date. Worldwide, the number of patients treated with the Coimbra protocol is estimated at almost 20.000 (survey of all globally certified Doctors from 02/2017).
The Coimbra protocol starts at the root of all autoimmune reactions and is therefore effective in all known autoimmune diseases. Those in the clinic of Dr. Coimbra most commonly treated diseases are multiple sclerosis (all forms), rheumatoid arthritis, spondylarthrosis, psoriasis, vitiligo, Crohn's disease, ulcerative colitis and lupus. Dr. Coimbra also classifies fibromyalgia and CFS (Chronic Fatigue Syndrome) as diseases of the autoimmune group and also achieves full remission in over 90% of all cases.
Further information can be found here: Interview with Dr. Coimbra http://www.vitamind.net/interviews/coimbra-ms-autoimmun/
PROCEDURE OF TREATMENT WITH THE COIMBRA PROTOCOL
In order to be adjusted to the protocol, four blood and urine tests and appointments with a trained protocol doctor over a period of one year are required:
The first thing to do is to do a basic blood count to check the health of kidneys, thyroid, liver, and other factors. In addition, the base value of the parathyroid hormone, calcium and other blood components are determined, which are required to find the dose for the optimal daily dose of vitamin D. These examinations can also be carried out by a family doctor on site; the patient receives the list with the required blood values from the protocol doctor before the start of treatment if an appointment is made.
With the determined base values, the first appointment with the protocol doctor (in Germany, unfortunately, it is currently still required by law that a personal appointment must take place at the beginning of treatment, afterwards "remote treatment" by phone or Skype is possible). It determines the starting dose of vitamin D based on the patient's personal parameters and provides detailed information on nutrition, drinking, exercise, stress prevention and additional nutrients.
After six weeks at the earliest and 2-4 months at the latest, a blood count and a 24-hour urine check will be carried out again. The daily dose of vitamin D is adjusted depending on the blood and urine results. Necessary changes in diet or adjustments to dietary supplements may be discussed.
After two to three months, another check is carried out and the dose is adjusted again if necessary. Same game after six months. The final dose is then determined. At this point in time, the full effect of vitamin D, including freedom from relapses and the beginning of a decrease in recently developed symptoms, should already have occurred.
After a year there is another check for safety. Sometimes the dose has to be adjusted again because the body has only now reached its final steady state of all active ingredients. Most patients require even higher daily doses, as the PTH level often begins to rise again.
If all values are "in the green area" and disease activity can no longer be determined, there are only control appointments every two years. Based on current knowledge, the individual vitamin D dose must be taken for life, and the necessary diet, drinking regulations and exercise must continue to be observed to avoid side effects.
At the moment, health insurances do not reimburse treatment with the Coimbra protocol. The costs are therefore to be borne privately, but are kept within a manageable range. The initial anamnesis, the following consultations with the doctor and the necessary examinations are billed as a private medical service according to GOÄ (fee schedule for doctors). Usually around € 150 to € 200 per hour.
The first appointment is relatively long and takes between 90 - 120 minutes: The basics and functionality of the treatment are discussed in detail and the necessary lifestyle adjustments are explained. In addition, an examination of the current overall health status and a thorough anamnesis of the previous course of the disease take place. The protocol doctor is currently treating on the legal basis of the WMA Helsinki Declaration 37, i.e. strictly speaking as part of a treatment study. This protects the patient and regulates exactly which key data of the treatment and the course must be logged.
The check-up appointments are much shorter and therefore cheaper. Here, the development to date is briefly discussed and recorded, and the daily dose of vitamin D is then adjusted based on the analysis of blood and urine values.
The costs for blood and urine tests have not yet been reimbursed by health insurance companies. You can expect about € 80 - 95 in each case.
The cost of vitamin D and dietary supplements are between € 70 and € 100 per month.
What can patients expect in the first few months?
Depending on the initial situation, it may take a few weeks until a sufficient vitamin D level has formed in the blood. Once this point is reached, most patients report an increase in energy and alertness, improvement in sleep and recovery ability. Many also feel a positive change in mood after just a few weeks, quote from an MS patient: "Suddenly, after years of energy-free, depressive mood in me, the sun has risen again."
Anyone who suffers from bladder dysfunction, which is often associated with MS, sometimes has to struggle with the increased amount of water they drink at the beginning of treatment. The first improvement usually occurs after a few weeks: On the one hand, the body develops a little more thirst, which makes it easier to drink consistently. On the other hand, the bladder adapts slightly to the larger amount of urine so that the incontinence does not get worse. After a few months, many patients experience a significant improvement in urge incontinence and bladder spasticity as soon as the healing process on the brain and spinal cord lesions begins.
Often, after this phase of the new energy, another two to three months pass before other changes set in. The body begins to find a new hormonal balance. During this time, skin blemishes or mood swings can occasionally occur, similar to what happens during puberty. Sometimes a change in previous symptoms begins, but it is not yet stable. It can be experienced like an "up and down": symptoms get better by the day, then worse again, old symptoms from previous attacks can flare up again in a slight form (but never as bad as it was the case in the attack). Shortly thereafter, there is usually a noticeable improvement in overall well-being and a stable healing of previous symptoms. An experienced protocol doctor from the field of pain therapy explained this process to me as a kind of "healing pain": We know from basic research that vitamin D promotes the formation of new brain and nerve cells and can repair myelin damage. However, this can temporarily lead to disturbances in the transmission of stimuli, which in addition to the flaring up of old symptoms can also cause slight pain (drawing, burning, etc.). I imagined this as "re-laying cables" and "reinsulating lines", which experience has shown can lead to an hourly failure of the power grid ...
The process of "up and down" does not occur in all patients. Above all, those who have had few restrictions so far, logically experience less "healing pain" or reactivations of symptoms. If such a phase begins, it is usually between the 3rd and 4th month and usually comes to a standstill two to three months later.
This is the moment when vitamin D reaches its full effect, the immune system is balanced and remission begins. The autoimmune disease has stopped, there will be no further progression of the disease, no more relapses, and the stable upward trend begins. Depending on the correct dose setting and the experience of the attending physician, this point in time is reached between the 6th and 8th month of treatment, in exceptional cases it can take up to a year. From now on, the damage of the last 12 - 24 months will be healed stably through the effects of vitamin D and other co-factors. The symptoms that arose during this period therefore regularly recede.