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Few people have heard of Vitamin K2, but it could be one of the most important, emerging stories in nutritional health to date. Most everyone has heard of Vitamin K, the fat soluble vitamin that is associated with our blood clotting mechanism. Vitamin K2 (also known as Menaquinone) is a completely different nutrient. It is also fat soluble but its main function is to control the distribution and use of calcium. Another fat soluble vitamin that has had a great deal of press and new found awareness (and rightfully so) is Vitamin D which also has a strong connection to calcium. As it turns out, these two have a very close working relationship.

So what exactly does vitamin K2 do for us and why should we be concerned?

The research is still coming in, but information published to date reveals an extremely important role in bone density and the prevention of heart disease. K2 acts like many vitamins in that it is a cofactor in a biological reaction. In this case it enables an enzyme to activate two very important proteins, Osteocalcin and Matrix Gla Protein (MGP). The primary function of Osteocalcin is to attract calcium into the bones and teeth while MGP helps remove and keep calcium out of soft tissue, especially arteries and veins. When arterial plaques are examined they are consistently about 20% calcium and look histologically just like bone. Unfortunately our new awareness and focus on taking Vitamin D could be making this worse. Vitamin D increases our absorption of calcium which is good, but if we do not have enough Vitamin K2 to manage the calcium, it ends up in places like arteries and other soft tissue instead of bones and teeth where we need it.

What is more exciting is early research showing MGP’s ability to actually reverse hardening of the arteries by breaking down and removing calcium from the soft tissue. Animal studies show a 37 percent decrease in arterial calcium content after only six weeks on a vitamin K2 rich diet. If a person is deficient in K2 these valuable proteins (MGP and Osteocalcin) remain dormant or inactive.

In studies, mice deprived of any MGP die within two months of birth from massive arterial calcification leading to blood vessel rupture. In April of 2011 researchers published some shocking findings in the prestigious British Medical Journal on the results of a calcium and heart health study. The study revealed women who supplement with calcium to prevent osteoporosis are at a higher risk of atherosclerosis (formation of calcium plaques in the arteries), heart attack and stroke than those who don’t. Based on this research, for every one bone fracture prevented by calcium supplements, two potentially fatal cardiovascular diseases were precipitated. Evaluation of the participants K2 level was not part of the study.

Researchers are also looking at other related health issues outside of bone and heart. Of particular interest is K2s effect on blood sugar and diabetes. It appears that K2 acts like a hormone increasing the output of insulin as well as making the tissue more insulin sensitive. Problems like kidney stones and gallstones often have a calcium component that could be due to a lack of active MGP. Another area of enormous interest is the connection between K2 deficiency and cancer cell growth. Studies also show that Osteocalcin plays a major role in the prevention of dental cavities by increasing the amount of calcium in the teeth and decreasing the amount of bacteria in the saliva. The famous dentist, Dr. Weston Price, (who did a great deal of research on diet and dental health) discovered this in the early 30s but he called it Factor X. He knew it was a nutrient in butter fat, but it was many years later before it was identified as K2.

Why is this information just now coming to the surface?

Vitamin K was actually discovered in the early 1930s by a Danish biochemist. Scientists realized early on that there were two forms of the vitamin but they assumed they both did the same thing which was to control blood clotting. There was nothing to tie Dr. Price’s work to this discovery because he did not know his Factor X was a K vitamin. It wasn’t until 1975 that researchers at Harvard Medical School discovered the protein Osteocalcin but it was another 20 years before research revealed that the second form of Vit. K (K2) had nothing to do with blood clotting and was instead essential for activating Osteocalcin. Even with this new knowledge scientists failed to realize the importance of this, mostly because there was no evidence at the time of a shortage of K2.  It wasn’t until 2007 that a paper was published revealing that Vit. K2 deficiency is actually widespread and is having a major impact on human health.

Why do we have a shortage of K2 in our food supply?

Like many of our foods, modern farming techniques have changed the nutrient content of what reaches our table. We have traditionally ingested K2 from animal products. It was most abundant in butter from dairy cows that actually grazed on green grass. Green grass is full of chlorophyll, the pigment that makes green plants green. The chloroplast, the part that captures sun for photosynthesis, is full of Vitamin K1. Animals have the unique ability to convert K1 to K2 via the bacteria in their gut. When they do beta-carotene hitches a ride; this is what gives grass-fed animal fat a deep yellow/orange color. You can also see this in chicken eggs that are truly free range. Anyone remember when chicken fat used to be more yellow instead of white?  Unfortunately, the bacteria in the human digestive system can only convert a very small amount of K1 to K2 and many who have poor digestive bacteria cannot convert at all. Our push to get people on low fat diets over the last 30 years has only made this problem worse.  

Other traditional sources of K2 were meat from animals who grazed on green grass. (Wild game is also a good source although it is usually lower in fat so will have less than beef.) Unfortunately today’s modern farming techniques have eliminated most all sources of chlorophyll from the diets of our farm animals. There is a movement, especially in the west, to buy from local farmers who are getting back to traditional farming. Grass-fed beef is readily available in natural food markets in Portland, so if you eat beef, I highly recommend making this your choice. You can also buy grass-fed butter or Ghee which is the pure butter fat that has all of the solids removed. Both are very high in K2 but Ghee has a very high smoke point that is ideal for high heat saute-ing. Ghee is also very stable; it can be stored up to 3 months on the counter top or up to 12 months in refrigeration. It is available in natural food markets as well as online. (I recommend the company Pure Indian Foods.)

Animal fat is not the only source of K2 (vegetarians will be happy to hear). It can also be produced by certain bacteria that are commonly used to ferment food. I won’t take the time to list the different types of fermented foods as they are available online. One of the most powerful ones by a factor of 10 is Natto, a fermented soy product consumed mostly in Japan (at least certain parts of Japan). The bacteria used to make Natto have the unique ability to produced huge amounts of K2.

There are supplements available as well. Vitamin K2 produced by bacteria is known as MK7, while K2 produced from animal fat is known as MK4. The biggest advantage of one over the other is K7 has a longer half-life, meaning each dose lasts longer in the body. Another factor is MK4 is prohibitively expensive to make as a natural supplement from animal fat so what you will find on the market has been synthetically produced.The MK7 supplements on the market are both of natural food base and some synthetic. I would recommend at this point a product by Jarrow Formulas called MK-7 which is derived from Natto (the fermented soy product). The company assures me it is from GMO-free soy. Amazon has one of the best deals on this product. Recommended doses vary as well; the dose for MK4 is about 45 milligrams (which should be divided up in three doses/day) while MK7 is 150-250 micrograms. Post-menopausal women should go with the higher dose.

How do you know if you are deficient in K2?

The problem with K2 deficiency is that it is sort of like high blood pressure, a silent killer. It takes years for demineralization of bone to occur and it has become such a common problem that we associate it with natural aging. Hardening of the arteries and heart disease also take years to manifest and have been associated with many things including cholesterol, high blood pressure, stress, obesity, smoking and the list goes on. All of these things can play a part, but this information on K2 is truly exciting in my opinion. Our healthcare system has been focusing on low cholesterol as the focal point of heart disease prevention despite the fact half of all heart attack victims have totally normal cholesterol. Cholesterol can be an important issue but many question if it is the primary issue we make it. A more valuable test to assess your risk of heart disease is something called the “Coronary Artery Calcium Scoring (CAC scoring) test. It is a specialized type of ultra-fast X-ray imaging that measures the presence and amount of calcium buildup in the arteries that supply blood and oxygen to your heart. It makes some sense that the hardening of arteries has a lot to do with the body actually building bone inside the arteries and it looks like K2 plays a major role in preventing this. Scientists are currently trying to develop a reliable test for K2 deficiency; some of the early tests are measuring the amount of uncarboxylated (inactivated) Osteocalcin and MGP in the blood. To my knowledge, this test is not yet available but it is safe to say that most of us are probably deficient.

I would encourage you to do a little research on your own and try to incorporate some of these foods in your diet as much as possible. This becomes more important for those of you who suffer from Osteopenia, Osteoporosis, dental diseases, diabetes, or heart disease.  A great resource for more information is a book by Dr. Kate Rheaume-Bleue ND, Vitamin K2 and the Calcium Paradox. The printed copy is expensive but you can get a digital copy for under ten dollars if you have a Kindle or a tablet of some kind. There should be a copy in the library as well.

NOTE: If you are on any type of blood thinners, please consult your prescribing doctor before starting any type of Vitamin K2.

As always, you can email me with any questions.

Yours in Health

Dr. Roy