Vitamin K and vitamin K2

Vitamin K is a collective term for a number of essential fat-soluble nutrients that share the same the same nuclear structure. The more common analogues include:

  • Vitamin K1 (phylloquinone) found in green leafy vegetables, algae
  • Vitamin K2 – MK-4 found in some vegetables some dark meats, eggs, and cheeses
  • Vitamin K2 – MK-7 found in Natto and some fermented cheeses
  • Vitamin K2 – MK-10–MK-13 (menaquinones) produced by healthy gut bacteria

Biological roles in the body; All vitamin K analogues play a large role in blood clotting, as they are required for the production and activity of coagulation and anticoagulation factors. Thus they help blood form clots when needed (following a cut or surgery) but an efficient coagulation system will also help to avoid blood clots (thrombosis) when they are not needed. Vitamin K2 is a cofactor of gamma-carboxylase, which is essential for activation of osteocalcin, a bone matrix protein, which is made in osteoblasts to form bone. Numerous studies have reported that people with hip fractures have a lower level of Vitamin K2 than the general population. People in Japan who eat the fermented soya dish (Natto) have significantly higher vitamin K2 levels and a lower fracture rate. Laboratory study showed that extra vitamin K2 supplementation prevented bone loss in animals rendered post-menopausal. Quite remarkably, Vitamin K2 has the opposite effect on arterial calcification. An adequate intake of vitamin K2 is associated with a lower risk of vascular damage because it activates matrix GLA protein (MGP), which inhibits the deposits of calcium plaques on the walls of coronary and systemic arteries. This factor is particularly relevant amoung individuals taking calcium and vitamin D supplements as a meta-analysis, published in the BMJ, concluded these supplements have little effect on their own and more worryingly they may raise the risk of heart disease by accelerating deposits of calcium in blood-vessel walls and soft tissues. So, taking Vitamin K2 together with calcium and vitamin D is likely protect people from arterial calcification and stiffening and promote calcium formation in the bone.

Vitamin K deficiency: A vitamin K deficiency in adults can lead to heart disease, weakened bones, tooth decay and cancer. A warning sign of a vitamin K deficiency is bleeding and bruising easily. This bleeding can begin as an oozing from the gums or nose or intracranial haemorrhage. The most common causes of vitamin K deficiency are insufficient dietary intake, inadequate absorption, and decreased storage of the vitamin due to liver disease. The risk of developing vitamin K deficiency bleeding is 80 times greater in infants who do not receive a prophylactic vitamin K injection after birth. As mentioned above inadequate Vitamin K is linked an increased risk of osteoporosis and fractures.

Recommended daily amounts: The RDA for adults aged 20 and older, the average daily vitamin K intake from foods is between100-150 μg for women and 120-180 μg for men. The reference range of vitamin K is 0.2-3.2 ng/mL, but impaired blood clotting has been reported with levels below 0.5 ng/mL.

Toxicity: Excessive intake of vitamin K has not been reported to cause toxicity syndromes as the body is limited in the amount of vitamin K it can store and this lack of accumulation contributes to the safety of natural vitamin K. Even taking supplements of K and K2, in sensible amounts have no reported toxicity. Vitamin k containing foods are safe for people taking warfarin but supplements are best avoided.

Sources of dietary  vitamin K and vitamin K2

Leafy dark green vegetables are one of the richest dietary sources of vitamin K. Cooking does not significantly damage vitamin C and by condensing foods can increase levels per gram. Fortunately these foods are also rich in fibre, other vitamins, polyphenols and essential minerals. Vitamin K2 is found in fermented products and some cheeses with some also coming from healthy gut bacteria – another reason to maintain an optimum gut flora.

Dietary Vitamin K:

  • Screen Shot 2017-10-10 at 10.11.30Kale and mustard greens (½ cup) – 400 μg.
  • Spinach, Swiss chard other dark greens (½ cup) – 300 μg.
  • Rocket, beetroot leaves and other leaves (½ cup) – 250 μg.
  • Cooked broccoli or Brussel sprouts (½ cup) – 200 μg.
  • Liver paste 50g – 150 μg.
  • Liver (100g) – 100 μg.
  • Cooked cabbage (½ cup) – 80 μg.
  • Chicken legs and wings (brown meat 100g) – 60 μg.
  • Green beans (¼ cup) – 30 μg.
  • Prunes (¼ cup) – 30 μg.
  • Eggs (100g) – 30 μg
  • Blueberries or blackberries (¼ cup) – 25 μg.
  • Canola and soybean oil (one tablespoon) – 25 μg.
  • Avocados (1 medium) – 20 μg.
  • Peas (½ cup) – 20 μg.
  • Kiwis, grapes, pomegranates, currants, avocados (1 cup) – 15 μg.
  • Bread 100g portion – 1 to 15 μg.
  • Breakfast cereals one bowl – 5 μg.
  • Olive, peanut, safflower, sunflower and sesame oils (one tablespoon) – 4 μg.

Dietary vitamin K2: 

  • screen-shot-2017-03-06-at-16-07-06Fermented soya, natto (100g) – 1000 μg
  • Liver paste from grass fed animals 50g – 150 μg.
  • Liver from gras fed animals (100g) – 100 μg
  • Fermented hard cheeses particularly Goudam (100g) – 50μg,
  • Other hard cheeses Edam Cheddar – 30 μg
  • Egg yolk (one free range egg) – 30 μg
  • Blue cheeses stilton, rockfort (100g) – 20 μg
  • Soya beans (½ cup) – 15 μg
  • Curd (100g) – 15 μg
  • Meat from grass fed animals (100g) 4.5 μg
  • Butter from grass fed animals (25g) 4 μg

Fermented products. These contain vitamin k2 in small amounts but promote gut health indirectly increasing K2 production by healthy probiotic bacteria. Food sources include:

  • probiotic supplementsSaurekraut
  • Miso soup
  • Serrano ham
  • Tempura
  • Kefir
  • Kombucha
  • Kimchi

In summary

So far, the research shows that adequate levels of vitamin K particularly the K2 analogue via a healthy diet +/- supplements can slow down the rate of bone weakening after menopause; increase bone strength and may decrease the number of fractures in women with osteoporosis; boost the effectiveness of osteoporosis medications; reduce the risk of arterial calcification and hence heart disease and stroke particularly relevant if taking calcium and vitamin D supplements


References

  • Iwamoto J et al. Effects of vitamin K2 on osteoporosis and bone health. Curr Pharm Des. 2004: 10(21):2557-76.
  • Maresz K et al. Proper Calcium Use: Vitamin K2 as a Promoter of Bone and Cardiovascular Health Klinregr Med (Encinitas) 2015: 14(1): 34-39.
  • Beulens JW et al High dietary menaquinone intake is associated with reduced coronary calcification. 2009; 203(2):489-93.
  • Geleijnse JM et al. Dietary intake of menaquinone is associated with a reduced risk of coronary heart disease: the Rotterdam Study. J Nutr. 2004; 134(11):3100-5.
  • Theuwissen E et al. The role of vitamin K in formation of soft-tissue calcification. Adv Nutr. 2012;3(2):166–173.
  • Kanai T et al. Serum vitamin K level and bone mineral density in post-menopausal women. Int J Gynaecol Obstet. 1997; 56(1):25-30.