Many clinicians and patients now know that vitamin D plays an important role in immune health, bone health and brain health.
However, most physicians and patients are unaware that vitamin D can create some problems.
…or that menatetrenone (K2mk4) is a key partner in bone, cardiovascular health, and brain health.
That ignorance is putting people’s hearts, brains, blood vessels and bones at risk. Are yours at risk?
Vitamin D is a vitamin with hormone-like properties. When ultraviolet light hits the cholesterol molecules in our skin, the light on our skin will begin the initial step in making vitamin D3 (cholecalciferol).
Mushrooms that are exposed to ultraviolet light make ergocalciferol. (Vitamin D2). Both Vitamin D3 and Vitamin D3 are biologically inactive until they are activated, first by the liver, and then by the kidneys to make 1,25 dihydroxycholecalciferol or calcitriol.
This is the biologically active form of vitamin D. Calcitriol has a major role in regulating calcium and phosphate and the mineralization of teeth and bones. Vitamin D receptors are found throughout the body and the central nervous system. Low vitamin D blood levels are associated with an increased risk of a cardiovascular event, autoimmune diagnoses, and multiple sclerosis diagnosis.1-6
Because most people work indoors, away from sun exposure, and are covering their skin with clothing or sunscreen to reduce the risk of skin cancer, many are no longer having sufficient sun exposure to generate enough vitamin D3 by their skin. Physicians are often measuring vitamin D levels and advising their patients to take vitamin D supplements or get blood levels to reach the top half of the reference range.
That is helpful, but there are still major health risks that are not being sufficiently addressed. Nutrition and physiology are complex with multiple interacting pathways. Calcitriol, the active form of vitamin D, increases the absorption of calcium from the gut into the bloodstream. Calcium supplementation may be beneficial for bone, however calcium supplementation may increase the risk of ectopic calcification in blood vessels.7 The increased absorption of calcium from the gut into the bloodstream increases the risk of calcification of blood vessels which can increase the risk of atherosclerosis, cardiovascular, and or cerebrovascular disease.7Vitamin K2 is a key contributor to calcium and phosphate metabolism and is involved in the uptake of calcium and phosphate into teeth and bones and out of blood vessel walls.8-12 Vitamin K2mk7 is the bacterial form and vitamin K2mk4 is the mammalian form of vitamin K and is highest in the brain. Vitamin K2 is increasingly recognized as important in cardiovascular,10,12 bone,10,12 tooth,13 and healthy aging.8,14,15
There is relatively little vitamin K2 in the modern Western diet. This is due to the radical change in the current farming practices for raising meat and dairy livestock in the United States.To increase the efficiency of livestock production, meat animals and dairy cattle are typically grown in concentrated animal feeding operations (CAFOs). Although cattle have a digestive system that evolved from eating grasses and green plants and hogs and chickens evolved from eating plants and insects and are actually omnivores. Now, cattle, hogs, and chicken are fed corn, kept indoors and no longer consume green plants. The result is that the meat and milk from these animals has very little vitamin K2 with a significant decline in vitamin K2 intake in the typical Western diet.12 Vitamin K2 is present in fermented soybean Natto and fermented cheeses from animals that consumed grass.16-18 Taking the combination of vitamin D and vitamin K2 is associated with improved bone mineral density compared to taking only vitamin D.19
In addition to the benefits of vitamin K on mineralization of teeth and bone and prevention of calcification of blood vessels, vitamin K is involved in the maturation of oligodendrocyte precursor cells (brain stem cells) into oligodendrocytes (the cells that build and repair myelin, the insulation on the wiring between brain cells.20,21 Vitamin K2 levels are significantly lower in multiple sclerosis patients compared to controls.22
In my clinical practice, I advise my patients to protect their bone and tooth health by monitoring their vitamin D blood levels with the goal of having their vitamin D level in the top half of the laboratory reference range for vitamin D.
I recommend strength training and vibration plate training for bone health and chewing food thoroughly and avoiding added sugars and flour-based foods for tooth health.
In addition, for tooth health, bone health, blood vessel health and brain health I recommend regular intake of vitamin K2. Include fermented soybean or fermented black bean natto in the diet. Include clarified butter in the diet.
For my patients who take vitamin D supplements to achieve the targeted vitamin D levels, I have them take a vitamin D supplement that also includes vitamin K2 in the product.
This is the vitamin D and K2 supplement I recommend from The Wahls Protocol® Supplement line.
That way they have both vitamin K and vitamin D. For those who get their vitamin D through sunshine, I have the patient either consume natto daily or take a vitamin K2 supplement.
References
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Duan S, Lv Z, Fan X, et al. Vitamin D status and the risk of multiple sclerosis: a systematic review and meta-analysis. _Neurosci Lett._ 2014;570:108-113.
Norman PE, Powell JT. Vitamin D and cardiovascular disease. _Circ Res._ 2014;114(2):379-393.
Lin J, Liu J, Davies ML, Chen W. Serum Vitamin D Level and Rheumatoid Arthritis Disease Activity: Review and Meta-Analysis. _PLoS One._ 2016;11(1):e0146351.
Makrani AH, Afshari M, Ghajar M, Forooghi Z, Moosazadeh M. Vitamin D and fibromyalgia: a meta-analysis. _Korean J Pain._ 2017;30(4):250-257.
Lee YH, Song GG. Association between circulating 25-hydroxyvitamin D levels and psoriasis, and correlation with disease severity: a meta-analysis. _Clin Exp Dermatol._ 2018;43(5):529-535.
Wang J, Zhou JJ, Robertson GR, Lee VW. Vitamin D in Vascular Calcification: A Double-Edged Sword? _Nutrients._ 2018;10(5).
Schwalfenberg GK. Vitamins K1 and K2: The Emerging Group of Vitamins Required for Human Health. _J Nutr Metab._ 2017;2017:6254836.
Arnold A, Dennison E, Kovacs CS, et al. Hormonal regulation of biomineralization. _Nat Rev Endocrinol._ 2021;17(5):261-275.
Hariri E, Kassis N, Iskandar JP, et al. Vitamin K2-a neglected player in cardiovascular health: a narrative review. _Open Heart._ 2021;8(2).
Hartley L, Clar C, Ghannam O, Flowers N, Stranges S, Rees K. Vitamin K for the primary prevention of cardiovascular disease. _Cochrane Database Syst Rev._ 2015(9):CD011148.
Maresz K. Proper Calcium Use: Vitamin K2 as a Promoter of Bone and Cardiovascular Health. _Integr Med (Encinitas)._ 2015;14(1):34-39.
Southward K. A hypothetical role for vitamin K2 in the endocrine and exocrine aspects of dental caries. _Med Hypotheses._ 2015;84(3):276-280.
Grober U, Reichrath J, Holick MF, Kisters K. Vitamin K: an old vitamin in a new perspective. _Dermatoendocrinol._ 2014;6(1):e968490.
Simes DC, Viegas CSB, Araujo N, Marreiros C. Vitamin K as a Diet Supplement with Impact in Human Health: Current Evidence in Age-Related Diseases. _Nutrients._ 2020;12(1).
Gille D, Schmid A, Walther B, Vergeres G. Fermented Food and Non-Communicable Chronic Diseases: A Review. _Nutrients._ 2018;10(4).
Katsuyama H, Ideguchi S, Fukunaga M, Fukunaga T, Saijoh K, Sunami S. Promotion of bone formation by fermented soybean (Natto) intake in premenopausal women. _J Nutr Sci Vitaminol (Tokyo)._ 2004;50(2):114-120.
Yamaguchi M, Kakuda H, Gao YH, Tsukamoto Y. Prolonged intake of fermented soybean (natto) diets containing vitamin K2 (menaquinone-7) prevents bone loss in ovariectomized rats. _J Bone Miner Metab._ 2000;18(2):71-76.
Kuang X, Liu C, Guo X, Li K, Deng Q, Li D. The combination effect of vitamin K and vitamin D on human bone quality: a meta-analysis of randomized controlled trials. _Food Funct._ 2020;11(4):3280-3297.
Goudarzi S, Rivera A, Butt AM, Hafizi S. Gas6 Promotes Oligodendrogenesis and Myelination in the Adult Central Nervous System and After Lysolecithin-Induced Demyelination. _ASN Neuro._ 2016;8(5).
Popescu DC, Huang H, Singhal NK, et al. Vitamin K enhances the production of brain sulfatides during remyelination. _PLoS One._ 2018;13(8):e0203057.
Lasemi R, Kundi M, Moghadam NB, Moshammer H, Hainfellner JA. Vitamin K2 in multiple sclerosis patients. _Wien Klin Wochenschr._ 2018;130(9-10):307-313.
