The Coimbra Protocol describes a medically supervised orthomolecular therapy that uses ultra-high-dose vitamin D against autoimmune diseases.
In doing so, “it is not disease XY that is treated; rather, the immune system is brought back into its natural balance by compensating for a genetically determined impairment in vitamin D utilisation,” as Dr Coimbra puts it.
In our experience, every autoimmune process responds to some degree to ultra-high-dose vitamin D therapy. Certain nutritional supplements, stress prevention and dietary adjustments support its success.
The Brazilian doctor Dr Cicero G. Coimbra developed this ultra-high-dose therapy from 2002 onwards in his practice, together with patients, and focused his university research on it.
He discovered by chance that under higher doses of vitamin D, autoimmune diseases of the skin came to a halt. Even higher doses were able to help his patients with various other autoimmune diseases. In this way, by 2009 he had developed an effective and, at the same time, side-effect-free ultra-high-dose therapy, which has become established as the “Coimbra Protocol”.
Vitamin D is not actually a vitamin but a hormone precursor that regulates the immune system. It also controls the absorption of calcium and promotes its incorporation into bones and teeth. Vitamin D influences physical performance, the hormone balance and mental wellbeing. It plays an essential role in the treatment of cancer and cardiovascular diseases, and during pregnancy.
Before vitamin D can regulate the immune system, it must pass through several steps. The biologically inactive form of vitamin D is cholecalciferol, as it is formed in our skin through UV-B sunlight and measured in the blood. It is converted enzymatically, mainly in the liver and kidneys, into calcitriol, the biologically active form. Calcitriol must enter the cell via the vitamin D receptor. Only there does it act to regulate gene expression and the immune system.
Dr Coimbra speaks of an “individual vitamin D resistance” in autoimmune diseases, which can be explained by changes in individual sections of the DNA. These so-called single nucleotide polymorphisms disrupt the formation, conversion or utilisation of vitamin D. As a result, the immune system is not adequately supplied with activated vitamin D, which it urgently needs in order to regulate itself. On the one hand, this can lead to a weakened defence; on the other hand, to excessive inflammation that favours autoimmune processes.
Dr Coimbra found that individually varying daily doses of vitamin D can overcome this utilisation impairment. As soon as enough active vitamin D (calcitriol) reaches the cell, the immune system stabilises. It stops the autoimmune reaction and strengthens the natural defence against pathogens.
At first, appointments with the trained protocol doctor take place at intervals of three, and later six, months. From the third year onwards, an annual check-up is sufficient, each time with current blood and urine values.
These appointments ensure the patient’s safety and serve to find the correct individual vitamin D dose that is needed for the optimal effect and the fastest possible halting of the disease. Should unusual changes occur in the metabolism, the doctor can detect and correct this early, before symptoms appear.
The greater part of the Coimbra Protocol’s effect goes back to compensating for the genetically determined impairment in vitamin D utilisation. The body needs certain nutrients in order to convert vitamin D enzymatically into its hormonally active form. These are the orthomolecular cofactors, in particular magnesium and vitamin B2. Further supplements such as omega-3 fatty acids, chromium, zinc, selenium and choline help to reduce inflammatory processes, normalise immune function and optimise cellular metabolism.
Another, non-material cofactor is good stress management, since an excessive stress response of the brain and hormone system also disrupts the regulation of the immune system.
Vitamin D increases the absorption of calcium from food. To ensure that not too much calcium enters the blood, the following measures are necessary:
The low-calcium diet and regular drinking are a double safeguard against hypercalcaemia, which can otherwise occur with high vitamin D doses when an excess of calcium builds up in the blood and urine. Hypercalcaemia can damage the kidneys in the long term.
Under ultra-high-dose vitamin D therapy, bone metabolism increases. Exercise is important so that osteoporosis does not develop. With sufficient exercise, bone density improves.
Stress can trigger a flare-up of the autoimmune disease, because it can lead to an over-activation of the immune system with elevated inflammatory markers in the blood and brain.
As soon as the individual vitamin D dosage is reached, the optimal regulation of the immune system begins: autoimmune diseases go into remission. No new flare-ups or symptoms occur, and no increased inflammatory activity can be detected any longer in imaging procedures or in the blood.
In the long term, there is also the chance that more recent tissue damage may heal: vitamin D stimulates the formation of new skin, brain and nerve cells. Younger patients with a short duration of illness usually experience a complete regression of symptoms and can from then on lead a normal, healthy life.
When applied correctly and under medical supervision, no side effects are to be expected. Because the hormone metabolism is being corrected, mild symptoms and hormonal fluctuations can occur in the initial phase, such as changes in the female cycle.
If applied incorrectly, however, ultra-high-dose vitamin D therapy can lead to serious side effects such as hypercalcaemia, osteoporosis or kidney damage. We therefore strongly advise against carrying out the treatment without the support of a certified Coimbra Protocol doctor.
If a low-calcium diet with a sufficient amount of fluid, exercise and stress management are observed, the treatment is safe and free of side effects.
Before beginning the treatment, we recommend an initial Coimbra Protocol consultation, which is conducted by long-standing patients. They explain the most important components of the Coimbra Protocol and how to implement them in everyday life. They also help with choosing a suitable doctor. In this way, patients arrive well informed at their doctor’s appointment, save time and costs, and can make a focused start there.
The orthomolecular therapy of autoimmune diseases with individually ultra-high-dosed vitamin D is not yet scientifically recognised. The treating doctor must comply with the statutory requirements of the World Medical Association (WMA) for experimental therapies (§ 37 of the WMA Declaration of Helsinki) and provide thorough information about the basis of the therapy, the expected results and possible risks. Patients are usually asked to sign a treatment agreement of their own wish and at their own risk.
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