# High dose vitamin D for autoimmune diseases **URL:** \ **Category:** Complementary Therapies\ **Created:** [September 26, 2026, 3:37am UTC](https://forum.livingwithpsc.org/t/high-dose-vitamin-d-for-autoimmune-diseases/5761 "2026-09-26T03:37:11Z")\ **Posts on this page:** 6\ **Page:** 1
**Author:** ![milly](https://avatars.discourse-cdn.com/v4/letter/m/bbe5ce/32.png) [@milly](https://forum.livingwithpsc.org/u/milly)\ **Post date:** [September 26, 2026, 3:37am UTC](https://forum.livingwithpsc.org/t/high-dose-vitamin-d-for-autoimmune-diseases/5761/1 "2026-09-26T03:37:11Z")
Hi all, I would like to open a discussion on high dose vitamin D, order of magnitude of 1,000 IU / kg of body weight, so around 50,000 IU a day for an adult. High dose vitamin D has put a number of patients with autoimmune diseases into remission, ranging from multiple sclerosis to psoriasis by practitioners in Brazil, also known as the Coimbra protocol, since the early 2000s. I have corresponded with a PSC patient who has put his PSC and UC into remission with this treatment, and I myself have seen symptomatic improvements on high dose vitamin D that I did not see with vancomycin (which brought my liver numbers down, but did nothing for my symptoms). I [compiled a document](https://docs.google.com/document/d/1rK-ddmnILlDR0kRWV41oDwKr68RBvQweDoPRD-Ayj2U/edit?tab=t.0) with some resources on high doses of vitamin D, which [includes a spreadsheet](https://docs.google.com/spreadsheets/d/1cadEXfRbK41rXyo9pgIj8qw2H7kfaRiYsV5A03etqjg/edit?gid=242865563#gid=242865563) with patient stories along with published case reports of patients with autoimmune diseases who have improved greatly. It seems to me that this is similar to vancomycin for PSC. There are autoimmune patients who have clear improvements on this treatment, yet there’s no randomized controlled trials, so it’s not widely accepted. It could be helpful for PSC patients who do not have access to vancomycin, or for whom vancomycin doesn’t work. ---
**Author:** ![Eldermen02](https://avatars.discourse-cdn.com/v4/letter/e/c0e974/32.png) [@Eldermen02](https://forum.livingwithpsc.org/u/Eldermen02)\ **Post date:** [September 27, 2026, 9:48pm UTC](https://forum.livingwithpsc.org/t/high-dose-vitamin-d-for-autoimmune-diseases/5761/2 "2026-09-27T21:48:13Z")
Curious about this topic ---
**Author:** ![hamidsalehi](https://avatars.discourse-cdn.com/v4/letter/h/f1d935/32.png) [@hamidsalehi](https://forum.livingwithpsc.org/u/hamidsalehi)\ **Post date:** [September 30, 2026, 8:52am UTC](https://forum.livingwithpsc.org/t/high-dose-vitamin-d-for-autoimmune-diseases/5761/3 "2026-09-30T08:52:13Z")
Hello. As a physician, I would like to emphasize the following: This dose is extremely high and potentially dangerous, and it may result in serious vitamin D toxicity.50,000 IU/day of vitamin D is an extremely high dose if taken daily. It is about 12.5 times the usual adult upper tolerable intake of 4,000 IU/day and equals 350,000 IU/week.Main concern: vitamin D toxicity The major danger is severe hypercalcemia, which can cause: Nausea, vomiting, abdominal pain, constipation Marked thirst and frequent urination Dehydration and weakness Confusion or drowsiness Kidney stones and acute kidney injury Cardiac rhythm disturbances In severe cases, coma Best Regards Dr Salehi ---
**Author:** ![milly](https://avatars.discourse-cdn.com/v4/letter/m/bbe5ce/32.png) [@milly](https://forum.livingwithpsc.org/u/milly)\ **Post date:** [September 30, 2026, 5:33pm UTC](https://forum.livingwithpsc.org/t/high-dose-vitamin-d-for-autoimmune-diseases/5761/4 "2026-09-30T17:33:32Z")
Dr. Salehi, Thank you for bringing this up. I recently[made a presentation for work](https://docs.google.com/presentation/d/1nivtdjP--iScIn9Pq1XfQy4-DYGJR1wH49RUlKnOxhk/edit?slide=id.g409c93a5ca7_0_85#slide=id.g409c93a5ca7_0_85) and slides 62-79 address this topic. Dr. Coimbra and the protocol physicians are well aware of the risk of hypercalcemia and contraindications (see the slides). They require their patients do the following: - Be on a low-calcium diet - Drink at least 2.5 liters of water a day - Test PTH, ionized calcium, 24h urinary calcium, along with other blood tests From what I have read, it seems that as long as patients monitor their testing levels and stay on the diet, extremely few patients have gotten hypercalcemia. There is a procedure in place (I’ll try to find resources about this) about what to do if it does happen. A couple papers: - [Safety Data in Patients with Autoimmune Diseases during Treatment with High Doses of Vitamin D3 According to the “Coimbra Protocol”](https://pmc.ncbi.nlm.nih.gov/articles/PMC9033096/#sec4-nutrients-14-01575): indicates what is done when a patient begins to tend toward hypercalcemia > However, with respect to all single measurements in 319 patients in over 3.5 years, we temporarily stopped vitamin D3 only in 27 situations, when calcium excretion exceeded more than 10 mmol/24 h (normal values: 2.50–8 mmol Calcium/24 h). **In almost all cases, the dietary calcium intake was reviewed with the patient with emphasis on reducing calcium intake to less than 500 mg daily and they were encouraged to increase fluid intake. As a result, the patients were restarted on the CP four-to-eight weeks later without any further disruptions in their treatment.** It is notable that a 24 h urine calcium as a marker is helpful for monitoring the possible side effects during CP, but finally not ideal, since the parameter could be under- or overestimated if the collection was less or more than 24 h. For further studies, the regular determination of the urine calcium–urine creatinine ratio might be a more sensitive measure to evaluate the need of protocol interruption. - [How Much Vitamin D is Too Much? A Case Report and Review of the Literature](https://pubmed.ncbi.nlm.nih.gov/33030138/) – this is a review of patients who were on high doses of vitamin D, however, there is no mention of a low-calcium diet, drinking lots of water, monitoring levels like PTH, ionized calcium or urinary calcium, or pre-existing conditions of the patients, and in all cases except one (which did not report the blood levels) there was at least one indicative blood marker that was high that likely would have been indicated much earlier in 24 urinary calcium, but again, we don’t have much prior information about the patients. In the case report that is specifically reported in this paper, the patient had hyperparathyroidism, which is a contraindication for the protocol because it indicates that calcium will not be regulated properly. > Our patient’s **baseline laboratory profile indicates secondary hyperparathyroidism** , characterized by increased serum PTH alongside a severe deficiency of vitamin D. The risks of this treatment are known and can be monitored and controlled. Thanks for opening the discussion on this, as it is something to be aware about and there are some dietary modifications and testing necessary. Given the number of autoimmune cases of patients who have had a clear benefit from this treatment for many years, it is certainly worth a consideration for PSC. There are a couple of videos in the spreadsheet of PSC patients in Brazil who seem to be doing better on high dose vitamin D in Portuguese (can be translated on Youtube), linked below: - Alda: [https://www.youtube.com/watch?v=S2N17c-7Zbg&list=PL1vtErCy8-8zbBVzaml6UqnwYDAZOdeEr](https://www.youtube.com/watch?v=S2N17c-7Zbg&list=PL1vtErCy8-8zbBVzaml6UqnwYDAZOdeEr) - Leandro: [https://www.youtube.com/watch?v=MpDMI9Rs2JM](https://www.youtube.com/watch?v=MpDMI9Rs2JM) ---
**Author:** ![hamidsalehi](https://avatars.discourse-cdn.com/v4/letter/h/f1d935/32.png) [@hamidsalehi](https://forum.livingwithpsc.org/u/hamidsalehi)\ **Post date:** [October 1, 2026, 6:44am UTC](https://forum.livingwithpsc.org/t/high-dose-vitamin-d-for-autoimmune-diseases/5761/5 "2026-10-01T06:44:08Z")
Thank you for your response. I sincerely appreciate your sharing more detailed information about this study with us. In clinical research, the level of evidence provided by a study is highly important when determining whether a particular method can move from an experimental approach to an accepted and clinically applicable treatment. The strongest evidence, generally considered to be **Level A evidence** , with high-quality and relatively consistent results, is provided by well-designed clinical trials, particularly multicenter randomized controlled trials, as well as high-quality systematic reviews and meta-analyses. These types of evidence provide greater confidence regarding the clinical application, efficacy, and safety of a treatment. Other types of studies, such as case series, can certainly serve as valuable preliminary evidence and may provide the basis for conducting subsequent studies with a higher level of evidence, particularly Level A evidence. Therefore, the level and quality of evidence should always be carefully considered when evaluating the safety and clinical applicability of study findings. In such circumstances, the expert opinions of physicians and specialists directly involved in the relevant field should also be taken into consideration. Given the rapid advances in medical science and technology, I am confident that more definitive and effective treatments for **primary sclerosing cholangitis (PSC)** will become available in the near future. With best regards, **Dr. Salehi** ---
**Author:** ![hamidsalehi](https://avatars.discourse-cdn.com/v4/letter/h/f1d935/32.png) [@hamidsalehi](https://forum.livingwithpsc.org/u/hamidsalehi)\ **Post date:** [October 1, 2026, 10:42am UTC](https://forum.livingwithpsc.org/t/high-dose-vitamin-d-for-autoimmune-diseases/5761/6 "2026-10-01T10:42:33Z")
Thank you for your response. I sincerely appreciate your sharing more detailed information about this study with us. In clinical research, the level of evidence provided by a study is highly important when determining whether a particular method can move from an experimental approach to an accepted and clinically applicable treatment. The strongest evidence, generally considered to be Level A evidence, with high-quality and relatively consistent results, is provided by well-designed clinical trials, particularly multicenter randomized controlled trials, as well as high-quality systematic reviews and meta-analyses. These types of evidence provide greater confidence regarding the clinical application, efficacy, and safety of a treatment. Other types of studies, such as case series, can certainly serve as valuable preliminary evidence and may provide the basis for conducting subsequent studies with a higher level of evidence, particularly Level A evidence. Therefore, the level and quality of evidence should always be carefully considered when evaluating the safety and clinical applicability of study findings. In such circumstances, the expert opinions of physicians and specialists directly involved in the relevant field should also be taken into consideration. Given the rapid advances in medical science and technology, I am confident that more definitive and effective treatments for primary sclerosing cholangitis (PSC) will become available in the near future. With best regards, Dr. Salehi