Dr Coimbra has been researching the treatment protocol with ultra-high doses of vitamin D since 2002, constantly developing it further and successfully applying it to several thousand patients.

It all started with the chance discovery that skin lesions healed when higher doses of vitamin D were administered to Parkinson's patients who also had  vitiligo and psoriasis. Dr. Coimbra then delved into basic research on vitamin D and conducted his own research. He discovered that there are numerous genetic mutations that can lead to vitamin D utilisation disorders in the body. People with this utilisation disorder have a significant deficiency of hormonally active vitamin D (calcitriol). Even if there is a sufficient amount of the prehormone vitamin D3 (cholecalciferol) in the blood or fat tissue, they cannot produce a sufficient amount of the active vitamin D (calcitriol). However, since vitamin D is fundamental for the regulation of the immune system, among other things, a long-lasting deficiency leads to autoimmune diseases.
Gradually, Dr. Coimbra found out how to calculate the individually necessary daily dose of vitamin D without causing serious side effects. To adjust patients to the optimally effective daily dose without side effects, three to four blood count and urine checks are necessary at the beginning of the treatment. Among other things, the level of parathormone (PTH) is measured as an indicator for 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 PTH lead to an excessive intake of calcium from food. In addition, a daily drinking quantity of at least 2.5 litres 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 emphasised 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 current estimates, the therapy should be continued for life. Long-term experience of up to 15 years is available so far. Dr. Coimbra and his team have treated more than 5,000 patients so far. The number of patients treated with the Coimbra Protocol worldwide is estimated at almost 20,000 (survey of all certified doctors worldwide from 02/2017).

The Coimbra Protocol addresses the root cause of all autoimmune reactions and is therefore effective for all known autoimmune diseases. The most common diseases treated in Dr Coimbra's clinic are multiple sclerosis (all courses), rheumatoid arthritis, spondyloarthritis, psoriasis, vitiligo, Crohn's disease, ulcerative colitis and lupus. Dr. Coimbra also classifies fibromyalgia and CFS (chronic fatigue syndrome) as autoimmune diseases and achieves full remission in over 90% of all cases.

You can find more information here: Interview with Dr. Coimbra http://www.vitamind.net/interviews/coimbra-ms-autoimmun/

PROCEDURE OF THE TREATMENT WITH THE COIMBRA PROTOCOL

To be put on the protocol you need four blood and urine checks and appointments with a trained protocol doctor over a period of one year:

First, a baseline blood count is taken to check the health of the kidneys, thyroid, liver and other factors. In addition, baseline levels of parathyroid hormone, calcium and other blood components needed to determine the optimal daily dose of vitamin D are determined. These examinations can also be carried out by a family doctor on site; the list with the required blood values is given to a patient by the protocol doctor before the start of treatment when an appointment is made.

With the basic values determined, the patient goes to the first appointment with the protocol doctor (in Germany, unfortunately, it is currently still legally required that a personal appointment must take place at the beginning of treatment, after which "remote treatment" by telephone or Skype is also possible). He determines the initial dose of vitamin D based on the patient's personal parameters and provides detailed information about nutrition, drinking, sport, 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 drinking check are carried out again. The daily dose of vitamin D is adjusted depending on the blood and urine results. Any necessary changes in diet or adjustments to dietary supplements may be discussed.

After two to three months, a new check-up is carried out and, if necessary, the dose is adjusted again. The same thing happens after six months. Then the final dose is determined. By this time, the full effect of the vitamin D should have been achieved, including freedom from relapses and the beginning of a reduction in recently developed symptoms.

After one year, another check is made to make sure. Sometimes the dose has to be adjusted again because the body has only now reached its final equilibrium of all active substances. Most patients need higher daily doses because the PTH level often starts to rise again.

When all values are "in the green zone" and no more disease activity can be detected, only control appointments take place at intervals of two years.According to current knowledge, the individual vitamin D dose must be taken for the rest of one's life, and the necessary diet, drinking instructions and exercise must also be continued in order to avoid side effects.

APPROXIMATE COSTS

At present, health insurance companies do not reimburse treatment with the Coimbra Protocol. The costs must therefore be borne privately, but are kept within manageable limits. The initial anamnesis, the following consultations with the doctor and the necessary examinations are billed as private medical services according to GOÄ (Gebührenordnung für Ärzte). As a rule, about € 150,- to € 200,- per hour are charged.

The initial appointment is relatively long and lasts between 90 - 120 minutes: It is discussed in detail about the basics and how the treatment works and the necessary lifestyle adjustments are explained. There is also an examination of the current overall health and a thorough history of the disease process to date. The protocol doctor currently treats on the legal basis of the WMA Helsinki Declaration 37, i.e. strictly within the framework of a treatment study. This protects the patient and regulates exactly which key data of the treatment and the course must be recorded.

The control appointments are much shorter and thus less expensive. Here, the previous development is briefly discussed and recorded, and then the daily vitamin D dose is adjusted on the basis of the analysis of blood and urine values.

The costs for blood and urine tests are not yet reimbursed by the health insurance companies. Here you have to calculate with about € 80 - 95 each.

The costs for vitamin D and food supplements range from € 70 - 100 per month.

What can patients expect in the first few months?

Depending on the initial situation, it takes a few weeks for a sufficient vitamin D level to build up in the blood. Once this point is reached, most patients report an increase in energy and alertness, improved sleep and recovery. Many also experience a positive change in mood after just a few weeks, quoting an MS patient: "Suddenly, after years of a low-energy, depressed mood, the sun has come out in me again."

Those who suffer from bladder dysfunction, which often goes hand in hand with MS, sometimes struggle with the increased drinking quantity at the beginning of treatment. There is usually an initial improvement here 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 to the larger amount of urine to some extent, so that the incontinence no longer gets worse. Several patients experience a significant improvement in urge incontinence and bladder spasticity after a few months, as soon as the healing process of brain and spinal cord lesions begins.

Often, after this phase of new energy, another two to three months pass before other changes begin. The body begins to find a new hormonal balance. During this time skin blemishes or mood swings may occasionally occur, similar to what happens during puberty. Sometimes a change in previous symptoms already begins, but it is not yet stable. It can be experienced like an "up and down": Symptoms get better for days, then worse again, old symptoms from previous relapses may flare up again in a mild form (but never as bad as they were during the relapse).  Shortly thereafter, there is usually a clearly 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 impulses, which can cause mild pain (pulling, burning, etc.) in addition to a flare-up of old symptoms. I have thought of this as "re-routing cables" and "re-insulating wires", which, after all, experience has shown can cause the power grid to go down for hours... 

The process of "up and down" does not occur in all patients. Especially those who have had few restrictions logically also experience less "healing pain" or symptom reactivation. Should such a phase begin, it is usually between the 3rd - 4th month and comes to a halt usually 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, no further disease progression will occur, no new relapses will occur, and the stable upward trend begins. This point in time is reached approximately between the 6th - 8th month of treatment, depending on the correct dose finding and experience of the accompanying doctor, in exceptional cases it can take up to a year. From now on, the damage of the last 12 - 24 months is stably healed by the effect of vitamin D and the other co-factors. Therefore, the symptoms that developed during this time regularly disappear.