Quiet Vitamin K

Vitamin K mostly flies under the radar. Very few health studies are conducted relative to other vitamins, but this does not mean vitamin K is any less vital. New information is now available to vault Vitamin K to mega-star status.

WHY SO LOW KEY 

Perhaps it is due to the fact that the major known function for Vitamin K was for blood coagulation, and that was pretty cut and dried. Vitamin K is supplied in the diet by many food sources, especially the greens. Doctors measure vitamin K's blood clotting ability before surgery, plus also in connection with blood thinners in treating cardiovascular disease to prevent spontaneous clotting. Plus all newborn babies have been receiving vitamin K injections to prevent internal bleeding conditions since many infants measure low in vitamin K. Most Nutritionists before this discovery thought vitamin K levels were not an issue because these was enough in diet plus the intestinal bacteria also produced some as well. Funny, since many infants are born low, shouldn't this have sounded alarms that the Mothers were vitamin K deficient during pregnancy? Since 1944, all babies have been given a vitamin K injection on the first day of life to prevent internal bleeding conditions. 

SIDEBAR: As margarine use grew popular, a new form of vitamin K emerged from the Hydrogenation of oils used to make margarine. ref This new vitamin K form, dihydrophylloquinone, is less active than the normal form of K1, phylloquinone, and could even interfere with the normal form causing a further deficiency of vitamin K actions. ref ref Look for both partially-hydrogenated on food ingredient labels and also the trans-fat content. But, remember, if a serving is under .5 grams, the trans-fat content is listed as 0. Many food manufacturers such as for some Girl Scout cookies keep the level just under .5 gram per serving. While this is a very small amount and is listed as "0" on labels, look at the label for the above trans fat forms listed, it all adds up. About trans-fat.

The body simply maintains the critical blood clotting ability mechanism at functioning amounts until vitamin K levels get extremely low. Amazing! Now with further research, vitamin K functions have expanded beyond blood clotting but the Public remains in the dark about this new work. Areas now include artery and vein integrity, bone building, cancer cell destruction, and insulin resistance. Pretty impressive!  

For many years, bone Doctors have been measuring the amount of activated (carboxylated) osteocalcin in the blood as a way to measure the body's bone building activity. Osteocalcin (OC) can be in two forms, activated (cOC) or non-activated (unOC). Only the activated form functions to bind calcium into bone. Vitamin D directs the building of osteocalcin, BUT it is vitamin K that activates it (carboxylation). Doctors never mentioned this blood test really indicated vitamin K levels. Can you see why most bone building studies testing just calcium and vitamin D would be doomed to failure with if vitamin K(2) levels were too low?

Extra INTEREST:  Osteocalcin levels are not only needed for bone building, but new research points to a direct link to blood sugar control through beta cell and insulin production and sensitivities. article ref Exercise and vitamin D increase Osteocalcin. Thus, it is of vital importance to get the right amount of vitamin K2 to maintain the balance between carboxylated and un-carboxylated osteocalcin since they both appear to have different functions and not only bone building, blood sugar levels, and lately added brain development. It is interesting to note that Medical Doctors have been measuring for the amount of carboxylated osteocalcin as a marker of bone building activity. BUT, they never told patients it was really a vitamin K2 test. The blood sugar control link is relatively young research. ref 

VITAL: Both forms of osteocalcin are vital for important body functions. Since Vitamin K2 participates in the regulation between these forms, it is critical to not over or under dose. This appears in many other vitamins as well, not enough as well as too much can both have adverse effects. Science should be searching for the appropriate window of amount needed, but so far, no recommendation. 

FORMS OF VITAMIN K

Vitamin K comes in many forms, with 3 main forms: K1, as phylloquinone from green leafy plants is the dominiate form; K2 has ten forms as different menaquinones (MK-4, Mk-7, Mk-9, etc) from grass fed organ meats, dairy, and fermented foods such as cheese and soy. MK-4 and MK-7 is also produced synthetically so get products that list natto as natural source for Mk-7, MK-4 is always synthetic, as well as K3, which is synthetic and toxic and only used in animal feed, thus not used in nutrition and only under close inspection for certain cancers, where it's toxic function is exploited. See reference below. Vitamin K2 as MK comes in at least 10 forms. For humans, MK4 is the most common form found in the body. Another form is MK7 from fermented soy as Natto now available as a supplement, but it is also available as a synthetic, so make sure natto is listed as source. Hard cheeses provide mainly MK-8 and MK-9.

Vitamin K2 can be made from K1 by bacteria in the gut and by another unknown process also occurring or beginning in the intestinal tract during absorption. It is questionable how much of the bacteria driven form becomes available to the body since it quickly is eliminated out with stools. MK-4 is the only form built in body tissues from K1. One very important aspect to these different forms is how long they last in the body. K1 lasts about 8 hours; K2 as MK4, about 4 hours; and K2 as MK7 over 2 days. You will see supplements of much greater dosages (1000mcg) for synthetic Vitamin K2 as MK4 at very low prices, but since it is rapidly cleared out of the system, K2 as MK7 at 50-100 mcg might really be the more valuable option as the smaller dosages will build up over 3 days. ref   This might be the reason some vitamin Brands put out supplements containing all 3 forms of vitamin K.

Dosages of VITAMIN K

The AI for Adequate Intake in the USA is set at 90 mcg/day for females and 120 mcg/day for males. This is measured as K1 since K2 is difficult to access. K1 intake averages slightly less for elders and in Alzheimer's disease. The conversion of K1 in the body also most likely decreases with age as well. Remember K1 is converted in certain body tissues into K2 as MK-4 in the brain, pancreas, and other glands. This might become a factor in maintaining health. 

VITAMIN K other Health Functions

CANCER

The cancer connection is amazing. Certain forms of vitamin K are under consideration as cancer treatments. Here is one connection with prostate cancer. ref  (be sure to read about the other cancers in this reference with a vitamin K connection)  Vitamin K2 appears more active than Vitamin K1 for these functions. The level of body conversion of K1 into the K2 form is still in question. And finally, check out the date of this research about vitamin K2 and breast cancer cell lines. ref (It is interesting that the toxic form of vitamin K3, not used as a nutritional supplement, is used to kill cancer cells since cell death from the toxic activities of the K3 form prove valuable in this situation.)

VITAL CAUTION: This is very new. It appears total OC regulates normal prostate cell growth. The OC form ucOC limits prostate cancer cell growth while the cOC form stimulates prostate cancer cell growth. Finding a balance point is vital now. ref

The above issue points to an enigma. The body needs cOC for bone health, but too much and prostate cancer cells gain a growth advantage. Since vitamin K2 generates cOC, it may not wise to supplement in prostate cancers until more information surfaces to clarify. 

BONE

One aspect of vitamin K(2) and bone health regards the fact that in many studies even though the calcium group built more bone density, the vitamin K group usually had fewer fractures. Interesting! Ask a Nutritionist to explain this. Bone strength is not just from density alone, but also structure of bones, how bones are built, plus structure coupled with density. This is an important reference for the many vital functions of K, especially K2. This reference adds greater insight, vitamin K2 probably works to keep bones stronger, often without any significant change in bone density. Low density bones can be strong if they have better sturcture, less porosity, or holes in bone.

HEART

Vitamin K also activates another protein, Matrix GLA, in the artery wall to prohibit the bonding of calcium into the artery walls. The amount of calcium that calcifies in artery walls is directly related to the risk of Cardiovascular Disease. ref ref  Here is a newer study published 2015> ref

CAUTION: Like so many nutrients, vitamin K might have a narrow window where the most benefits are found. At least it appears to not have toxic effects so the only considerations are for over activity. Since the 3 vitamin K forms last different length of times in the body, a unique amount has to be found for each one to arrive at the optimal amount. IT IS CRITICAL for SCIENCE TO QUICKLY FIGURE OUT THESE IDEAL AMOUNTS since they are not exactly known and there is an interaction between two of the forms in the body to further complicate things. Important blog info on K2 from a Cardiologist.

BRAIN

Extending the work of vitamin K on artery health protection, this process also helps limit calcium build up participating in brain lesions, indicated in dementia. Dr Payne is leading research into brain lesions. She has found that higher amounts of both calcium and vitamin D play negative roles for increased brain lesions.

Dosage Differences

No RDI dosage for vitamin K2 has been established. Some vitamin K1 from leafy greens converts to vitamin K2 as MK-4 in the body. Vitamin K2 as MK7 from fermentated foods like cheeses and soy natto, is only given in microgram sizes (45 mcg), a very small amount as it is very active and lasts many days in the body instead of only a few hours like MK4, which is why MK-4 is given in amounts 1000 times larger. Nutritionally, supplements list 1 mg, (1000 mcg) while studies use up to 45 milligrams of MK-4. BUT, again, Vitamin K2 does not have a recommended amount from the US Government. Some Scientists suggest it should have an RDI as a separate form of vitamin K.

WRAP UP

Since Vitamin K participates in many vital health areas, blood coagulation, bone growth, blood sugar control, cardiovascular artery health, brain legions, as well as in some cancer protection, it is critical to know how much to take and which forms. The cancer fighting effect of vitamin K2, mitochondrial membrane disruption, may be inhibited by higher amounts of vitamin E as alpha tocopherol. The bone and blood sugar mechanisms are related to the ratio of carboxylated osteocalcin to uncarboxylated osteocalcin. Vitamin K regulates carboxylation. See the potential dilemma? Luckily, this blood sugar control problem of vitamin K has only been observed in animal studies and not in human studies so far.

Part of the reason both K1 and K2 should be measured and the greatest beneficial levels discovered is due to how each is circulated in the body. This may also be why K2 forms are better for certain sideline functions of vitamin K beyond blood coagulation. Vitamin K1 as phylloquinone is mostly found in the liver and blood stream bound to TRL, Tryglceride-rich Lipoproteins. The MK forms of vitamin K2 not only bind with TRL but also with LDL and HDL which give them greater exposure to arteries and other body tissues like bones, brain, and numerous glands.

CAUTION:    

Update on Wednesday, November 19, 2014 at 10:16AM by Team RightWay

Follow Up to Quiet Vitamin K

From Medscape at Large comes a Doctor's views on Vitamin K2. Concise, simple, and to the point. This deserves to be shared:

"Hello and welcome. I am Dr George Lundberg, and this is At Large at Medscape.

I do not know anything about nutrition as it relates to chronic illness, including obesity. I used to think that was because, probably like you, I was taught so little about nutrition in medical school. I have spent a medical lifetime reading articles about nutrition, before and after publication. But I am still woefully ignorant of "nutritional truth."

Take vitamin D. The minimum daily requirement prevents rickets. But then, just a few years ago, it became popular to check vitamin D blood levels. And many people were found to have "low" vitamin D levels. Then many diseases were found to be associated with "vitamin D deficiency," except it turns out that many labs were not doing the tests in equivalent ways.

After a whole lot of fuss and study, the Agency for Healthcare Research and Quality (AHRQ) issued a report this year that finds no consistent correlation between vitamin D and health outcomes such as cardiovascular disease, all-cause mortality, several types of cancer, or bone health.^[1] Amazing.

Which Brings Us to Vitamin K

What do you know about vitamin K? It has something to do with blood coagulation, right? Yes, but that is vitamin K₁. I am asking about vitamin K₂. I bet you have not thought much about that vitamin.

Here are nine things every physician should know about vitamin K₂:

1. It exists.

2. It is essential for life and health.

3. There is currently no reliable blood test to measure it.

4. Your body makes a certain amount via menaquinone-4 (M-4) in your gut from vitamin K₁.

5. That may not be enough.

6. Your body probably needs more vitamin K₂ for disease prevention than it manufactures, so nutritional sources are important.

7. Foods rich in vitamin K₂ (often in the form of M-4 or M-7) include: natto (fermented soybeans); green, leafy vegetables; organ meats such as goose liver; grass-fed beef; dairy; eggs; and fish.

8. Or you can take nutritional supplements to achieve healthy levels of vitamin K₂.

9. Deficiencies of vitamin K₂ are now being reported in serious journals to be associated with—get this—all-cause mortality, cardiovascular disease, osteoporosis, diabetes, many forms of cancer, dementia, and chronic inflammation. ref

Sound familiar?

Is vitamin K₂ the ubiquitous disease-associated vitamin D-like deficiency, sans blood testing, all over again? A fad disease about to pop up, flourish, and disappear? Or is this a real, late-to-the-table, fundamental new understanding of possible causes of many common diseases, disability, and death? And if vitamin K₂ is taken correctly, will it result in prevention and treatment of same? Look it up; check it out.

I do not know how this is going to work out, but I have a hunch that vitamin K₂ will turn out to be a really big deal rather than only "the new vitamin D," with much fuss and little substance.

Most of this research is being done in Japan and Europe, especially The Netherlands, well away from the US Department of Agriculture and lobbyists for the American food industry and its captured government and academic partners.

I owe my current interest in this topic to a product of the Internet as the world's greatest library—a well-educated, nonscientist who got really interested in this topic and will not let up. Thank you, Micki Jacobs of Cincinnati.

That's my opinion. I am Dr George Lundberg, at large at Medscape." - end of copy

NOTE: Since some of the Vitamin D and K activities are linked, both vitamins have to be measured for any research to be valid, especially for bone studies. It is rather ironic that Doctors have for so long measured Carboxylated Osteocalcin vs Uc levels as an indicator for the amount of bone building but never said the test really was measuring vitamin K activity. Then add sun avoidance to limit vitamin D production plus margarine trans-fats interfering  with vitamin K effectiveness, and this may be a perfect storm to explain some modern day disease patterns.