Vitamin K : Deficiency, Supplements, Precautionary measures & Scientific Studies

(Vitamin K also helps in maintaining our bone health by transporting calcium throughout our body)

Recalling Vitamin K

We read at my previous article that, Vitamin K1 is the natural form of vitamin K. Found in plants, it is the primary source of vitamin K that humans obtain through foods. Vitamin K1 is also the preferred form of vitamin K because it is less toxic, works faster. It is also stronger and works better for certain conditions. As an essential vitamin, vitamin K does have deficiency states and our body attempts to regulate its levels. 

Deficiency

While vitamin K deficiencies are rare in adults, they are very common in newborn infants. Newborns who are premature or those whose mother had to take seizure medications during pregnancy prone to vitamin K deficiency. Sometimes taking antibiotics can kill the bacteria that produces vitamin K in our gut and lead to a mild deficiency, mostly in people with low levels to begin with. Vitamin K deficiency occurs to people who are suffering from liver disease, gallbladder/biliary disease, cystic fibrosis, celiac disease, and Crohn's disease. Vitamin K deficiency occurs to people who are going through Hemodialysis, taking blood thinners or in a condition of serious burns. People who are severely malnourished and people who drink alcohol heavily they are also found in a stage of Vitamin K deficiency. When we are deficient in vitamin K, below mentioned things happen to us.

• Low levels of vitamin K can raise the risk of uncontrolled bleeding. 
• Low levels of vitamin K can make bones weak and tooth decay.
• low levels of vitamin K are associated with a higher risk of osteoarthritis.
• Low levels of vitamin K can lead to Heart disease and Cancer.
• Very low levels of Vitamin K are known to lead to muscular and subcutaneous hemhorrhages.
• Very low levels of Vitamin K can lead to excessive bleeding, which may begin as oozing from the gums or nose.
• With low levels of vitamin K, various enzymes can not perform well that require vitamin K to perform.

Supplements

Unfortunately, it is difficult to obtain high levels of vitamin K from food alone because the average intake of this important nutrient is incredibly low in the modern diet. Unlike many other vitamins, vitamin K is not typically used as a dietary supplement but supplementation of vitamin K is a wise decision. There have been no adverse effects of vitamin K seen with the levels found in food or supplements. 

• Vitamin K is used to counteract an overdose of the blood thinners.
• Mothers on seizure medications are often given oral vitamin K for 2 weeks before delivery. 
• Vitamin K improves bone health and reduces the risk of bone fractures, particularly in postmenopausal women who are at risk of osteoporosis.
• Backed by research, Japan officially recommend vitamin K supplementation for the prevention and treatment of osteoporosis.
• Male and female athletes also get benefit in their bone health with vitamin K supplementation.
• The effect of supplementing vitamin K2 can be better by combining with a vitamin D supplement, as the two vitamins have synergistic effects.
• People whose bodies can’t absorb enough vitamin K or suffering from gallbladder/biliary disease, cystic fibrosis, celiac disease and Crohn's disease can get more benefit from a multivitamin tablet/capsule containing vitamin K than an individual vitamin K supplement.
• Women who are experiencing excess menstrual bleeding, they can be benefited by supplementing vitamin K as it helps in reducing the blood flow out of their body.
• Pregnant women who are suffering from vomiting and nausea can be benefited by supplementing Vitamin K. 
• Asthmatic children can be treated through continuous intake of oral supplements of vitamin K.

Precautionary measures

One can cure his/her vitamin-K deficiency by taking normal multivitamin minerals supplement as in recommended doses, vitamin K has no side effects. But people with certain health conditions must take precautionary measures for example :

• Vitamin K crosses the placenta and found in human breast milk. So, pregnant women and women who are breastfeeding should talk to their physician before taking vitamin K supplements.
• People with Glucose-6-phosphate dehydrogenase (G6PD) deficiency should avoid vitamin K.
• People who take warfarin (Coumadin) should not take vitamin K.
• People who are receiving dialysis for kidney diseases must not take too much vitamin K.

Scientific studies 

• As per an observational study continued over a 7 to 10 year period revealed that, people who had the highest intake of Vitamin K2 were 52% less likely to develop calcification of the arteries and had a 57% lower risk of dying from heart disease.
• A study conducted on some postmenopausal women for three year found that those taking vitamin K2 supplements had much slower decreases in age-related bone mineral density. 
• According to some research comparisons, Along with helping our blood to clot properly, Vitamin K plays critical roles in protecting our heart, building our bones and optimizing our insulin levels. It is sometimes referred to as "the forgotten vitamin" because its major benefits are often overlooked.

Vitamin K : Crucial for Normal Blood Clotting

 (Freezing foods may destroy vitamin K, but heating does not affect it)

Overview  

Vitamin K is a fat-soluble vitamin and an essential vitamin for our good health. The name "K" derives from its German word, Koagulationsvitamin. Discovered in 1929, it is actually a group of compounds. The most important of these compounds appears to be vitamin K1 and vitamin K2. One’s vitamin K level can depend religiously on the health of his/her gut flora balance because much of the vitamin K in their diet made by the intestinal bacteria that he/she already has. Vitamin K2 is mainly produced by the bacteria in one’s gut. It is often seen that vitamin K2 rich foods or supplements have greater health benefits than K1. Research has revealed that vitamin K is an anti-calcification, anticancer, bone-forming and insulin-sensitizing molecule. Because of limited vitamin K storage capacity, our body recycles vitamin K in the vitamin K oxidation-reduction cycle in order to reuse it multiple times.

Functions

• Vitamin K1 activates the protein that clots the blood and also helps in preventing excessive bleeding. 
• Vitamin K2 is required for the synthesis of bone proteins. That means it modifies proteins to give them the ability to bind calcium.
• It is believed that vitamin K2 may prevent heart disease by helping to prevent calcium from being deposited in the arteries.
• It helps in reducing the threat of bleeding in the liver, poor nutrient absorption and jaundice.
• It helps in the proper functioning of the hormones for regular periods in women aged 19 to 50, which will help in reducing menstrual pain.
• It helps in restoring oral health, improving digestion and reducing infections.
• It acts as an antioxidant thereby preventing our body from oxidation stress.
• It helps in the proper functioning of brain and nervous system.
• It may helps in improving insulin sensitivity.

Food Sources

Sources of Vitamin K are divided into plant based (phylloquinone) and animal based/bacterial based (menaquinone). I have mentioned some food names below that contain the highest levels of vitamin K.

Fruits and Nuts

Avocado, Bananas, Apples, Grapefruit, Mangoes, Melon, Pineapple, Grapes and raisins, Cranberries, Bilberries, Plums, Peaches, Pears, Tomatoes, Strawberries, Nectarines, Pistachio nuts and Walnuts.

Vegetables and Legumes 

Leafy greens and some other vegetables for example Asparagus, Cucumber, Cabbage, Komatsuna, Kale, Broccoli, Cauliflower, Brussel sprouts, Spinach, Carrots, Raw kidney beans, Raw sugar peas, Runner beans, French beans, Broad beans, Chick peas, Peas, Deep-fried bean curd and Fermented soybean products such as Natto.

Herbs

Turmeric, Dried basil, Green tea 

Animal based

Hen egg yolk, Beef chuck, Pork, Chicken thigh, dairy products like cheeses and fermented foods i.e. synthesized by bacteria.

Oils and Condiments

Mayonnaise, Olive oil, Soybean oil, Mixed vegetable oils, Rapeseed oil and Margarine.

RDAs

There is a lack of consensus from one country to another regarding vitamin K. The RDA of vitamin K is fairly reasonable at 1mcg/kg. A list is given below for RDA according to age. 

• Infants in the age of 0 to 6 months requires 2 micrograms/day
• Infants in the age of 7 to 12 months requires 2.5 micrograms/day
• Toddlers in the age of 1 to 3 years requires 30 micrograms/day
• Children in the age of 4 to 8 years requires 855 micrograms/day
• Children in the age of 9 to 13 years requires 60 micrograms/day
• Girls in the age of 14-18 years requires 75 micrograms/day
• Women in the age of 19 years and up requires 90 micrograms/day
• Women, pregnant or breastfeeding in the age of 19 to 50 years requires 90 micrograms/day
• Women, pregnant or breastfeeding in the age of less than 19 years requires 75 micrograms/day
• Boys in the age of 14 to 18 years requires 75 micrograms/day
• Men in the age of 19 years and up requires 120 micrograms/day

Intake Suggestions 

• Take 2 to 3 of vitamin k rich foods daily.
• Never take the synthetic version of Vitamin K which is known as vitamin K3 and phytonadione i.e. the synthetic type of K1.
• As the vitamin K1 to K2 conversion is inefficient in human body, Its better to eat vitamin K2 rich foods directly.
• Vitamin K should be supplemented alongside fatty acids, so it’s better to take vitamin K at lunch/dinner.
• Eating foods containing dietary fats, such as butter in combination with vitamin K-containing foods, such as spinach, may increase vitamin K absorption.
• If one can take only plant-based sources of vitamin K, then he/she may cook that in Microwave, as Microwaving increases the absorption rate of this vitamin.

Vitamin D : Absorption, Deficiency, Supplements, Overdose & Research Studies

(With vitamin D supplementation, people experience increased testosterone levels)

How Vitamin D is absorbed in our body?

Vitamin D goes through several processes in our body to be absorbed. First, it converts to calcidiol in our liver. Here vitamin-D lies in the storage form. Second, it converts to calcitriol in the kidneys. Here vitamin D lies in the active steroid hormone form. Calcitriol moves all over our body and goes into the nuclei of our cells. Then it interacts there with a receptor known as the vitamin D receptor (VDR). VDR found in almost every single cell of our body. When the active steroid hormone form of vitamin D binds to this receptor, it turns genes on or off, which leads to changes in the cells.

Vitamin D Deficiency

Worldwide, an estimated 1 billion people have inadequate levels of vitamin D in their blood and deficiencies can be found in all ethnics and age groups. Actually, only a handful of foods contain significant amounts of vitamin D, hence deficiency is extremely common. But the symptoms are usually subtle and may take years or decades to surface. Vitamin D found insufficient in Pregnant and breastfeeding women, especially teenagers and young women, Infants and children under 5 years of age, People of 70 and over, People with darker skin, overweight or obese and people living at higher latitudes or who get little sun exposure.

• With vitamin D deficiency weak bones diseases like osteoporosis, bone pain disease osteomalacia and bone loss disease hyperparathyroidism develops.
• An inherited disease osteogenesis imperfecta in which the bones are especially brittle and can be easily broken also develops in vitamin D deficient people. 

  

  Deficiency

• Skin issues like eczema and psoriasis may be seen in some cases. 
• Vitamin D deficiency is central to a recent 'epidemic' of disturbed sleep pattern.
• The vitamin D content of human milk is related to the mother’s vitamin D status, so mothers who deficient in vitamin D may have correspondingly low levels of this nutrient in their milk and vice versa. 
• Rickets, a disease formed in children that is caused by not having enough vitamin D. It leads to bowed legs and knock knees.
• Greater amounts of the pigment melanin in the epidermal layer result in darker skin and reduce the skin’s ability to produce vitamin D from sunlight in case of dark skin people. 
• Not getting enough of vitamin D may linked to Heart conditions, Diabetes, Asthma, Cognitive impairment reducing Mineral density and risk of falls and fractures in older adults. 

Who need it religiously?

in general, people with very dark skin, obese or overweight/obese people and older adults with certain risk factors are always at risk for Vitamin D. Besides this, other cases are:-

• Low calcium and bone loss disease renal osteodystrophy in people with kidney failure required Vitamin D very much.
• People diagnose with high blood pressure and high cholesterol also need it.
• It is also used for diabetes, obesity, muscle weakness, multiple sclerosis, rheumatoid arthritis, chronic obstructive pulmonary disease (COPD), asthma, bronchitis, premenstrual syndrome (PMS), and tooth and gum disease.
• People who are deficient in vitamin D will be deficient in calcitriol (the steroid hormone form), so in effect they are deficient in one of the body’s critical hormones.
• If one has liver or are on certain medications that affect vitamin D levels, he/she may be also at risk of vitamin D deficiency.

Supplements

Supplements

There are two types of vitamin D supplements i.e. vitamin D2 (ergocalciferol) and vitamin D3 (cholecalciferol). Both types are good for bone health. But make sure to take vitamin D3, not D2 because D3 is more effective in comparison to D2 because it increases blood levels of vitamin D. They can be taken with or without food.

Overdose of Vitamin D

Vitamin D toxicity is very rare. It occurs rarely when one take it as insane dose for a long time. Actually, it is a myth. I personally live a sedentary life style and little exposure to the sun, so I take 1500 IU of a vitamin D3 supplement every day. I have been taking this for many years and I never have a problem of overage. As per a report of The Institute of Medicine, USA, the upper limit of vitamin D can be from 2,000 to 4,000 IU per day, and acknowledged that even at 4,000 IU per day, there was no good evidence of harm. The most accurate way to measure how much vitamin D is in your body is a blood test to measure 25-hydroxy vitamin D in your bloodstream. As final words from me, always take moderate doses of vitamin D regularly, since these have a strong safety record, and avoid extremely high single doses.

Safety Precautions

• People with known allergy or sensitivity to vitamin D or any similar compounds must avoid.
• Use cautiously in pregnant women at risk of high blood pressure associated with pregnancy.
• Use cautiously in breastfeeding women.

Research studies?

• According to a study published in the American Journal for Clinical Nutrition have shown that people with low vitamin D levels have a much greater risk of heart disease, diabetes (both type 1 and type 2), cancer, dementia and autoimmune diseases like multiple sclerosis as well as infectious diseases, such as tuberculosis and even the seasonal flu.
• Several studies have shown that people with lower levels of vitamin D are performing poorly in exams, they may have poor decision making skills, and have difficulty with tasks that require focus and attention.
• Researchers found that high intakes of vitamin D supplements—of about 800 IU per day—reduced hip and non-spine fractures by 20 percent in women.
• A combined analysis of multiple studies found that taking 700 to 1,000 IU of vitamin D per day lowered the risk of falls by 19 percent in elderly people.
• One study found that women who had higher levels of vitamin D on a calorie-controlled diet lost more weight than those with lower levels of the vitamin.

Vitamin D - Helps in Maintaining Healthy Muscles & Strength Throughout Life

(Exposure to the sun is getting inadequate these days, making it necessary for people to get more of it from the diet or supplements) 

Overview

Sunshine Vitamin

Vitamin D, one of the micro nutrients needed for human survival, is a fat-soluble vitamin i.e. dissolves in fat/oil and can be stored in our body for a long time. It is completely different from most other vitamins. Actually it is considered a pro-hormone, a steroid hormone that is produced out of cholesterol when our skin is exposed to the sun. Human body is capable of producing endogenously vitamin D through the action of sunlight on the skin. Therefore it is also known as the sunshine vitamin.

Benefits of Vitamin D 

Vitamin D is absolutely essential for our optimal health. Children need vitamin D to build strong bones whereas adults need it to keep their bones strong and healthy. The major role of vitamin D is to maintain normal blood levels of calcium and phosphorus. It regulates the concentration of calcium in blood plasma. Other benefits are :-

• Adequate vitamin D intake is important for the regulation of calcium and phosphorus absorption from the small intestines in our body.
• This also acts on our bones directly promoting calcification. Thus it maintains healthy bones and teeth. 
• It helps us in protecting against cold & coughs as Vitamin D levels are lowest in the winter months. It also supports the health of our immune system. 

  

  Benefits
• Children given 1,200 IU of vitamin D per day for 4 months during the winter reduced their risk of influenza an infection by over 40%.
• It supports the health of the brain and nervous system and in fighting depression.
• It regulates insulin levels and aids in managing diabetes.
• It also supports lung function and cardiovascular health.
• It influences the expression of genes involved in cancer development.
• Together with calcium, vitamin D also helps protect older adults from osteoporosis.
• Vitamin D may help in maintaining healthy muscles throughout life and also help increase muscle strength, which in turn helps to prevent falls, a common problem that leads to substantial disability and death in older people.
• Vitamin D supplementation can increase physical strength, in both upper and lower limbs. 

How we gain Vitamin D?

There are two ways one can get vitamin D naturally. They are Sunlight and Vitamin D rich Food. 

Sunlight

Vitamin D formation with sunlight

Sensible sun exposure on bare skin for 5-10 minutes that to 2-3 times per week allows our body the ability to produce sufficient vitamin D. A fair-skinned person with full body exposure to the sun can synthesize up to 20,000 IU of vitamin D3 in 20 minutes. Vitamin D gets stored in our body for a long time i.e. for weeks or months, so we may only need occasional sun to keep our blood levels adequate. But the stores can run low, especially in winter. 

Food Sources

Vitamin D rich foods

Vitamin D is naturally present in very few foods. Vitamin D3 (cholecalciferol) and vitamin D2 (ergocalciferol) are the two main forms, we found from food. We can find Vitamin D3 (cholecalciferol) in some animal foods, like fatty fishes (wild-caught mackerel, salmon, tuna) and egg yolks. We can find Vitamin D2 (ergocalciferol) in some mushrooms. Margarine and fat spreads like butter, cheese, ghee, some reduced-fat dairy products (eg, milk, dried milk and yogurt), plant-based dairy substitutes (eg, soy drinks) and liquid meal replacements also vitamin D added. So one can have them. Dairy products and cereals are often fortified with vitamin D.

Recommended Dietary Allowances
Age	Male	Female	Pregnancy	Lactation
0–12 months	400 IU (10 mcg)	400 IU (10 mcg)
1–13 years	600 IU (15 mcg)	600 IU (15 mcg)
14–18 years	600 IU (15 mcg)	600 IU (15 mcg)	600 IU (15 mcg)	600 IU (15 mcg)
19–50 years	600 IU (15 mcg)	600 IU (15 mcg)	600 IU (15 mcg)	600 IU (15 mcg)
51–70 years	600 IU (15 mcg)	600 IU (15 mcg)
>70 years	800 IU (20 mcg)	800 IU (20 mcg)

Suggestion from the Author

It is a widely accepted thing that nutrients usually don’t work in isolation. They depend on one another. Hence, when we increase our intake of one nutrient, it may increase our need for another. It is proved that fat-soluble vitamins work together. So in order to get maximum benefit of Vitamin D3 we must add vitamin A and vitamin K2 at the time of supplementing. There is no mistake in taking vitamin K2, another fat-soluble vitamin that we don’t get enough from our food. Another thing is Magnesium intake is also important for the optimum functioning of vitamin D. Because of this, one can find calcium, magnesium, vitamin D & K in a supplement like “Unived CalDveg, Algal Calcium, Algal Magnesium, Vitamin D3 & K2-7” for Complete Bone Health. If anyone want to go for only Vitamin D3 and Vitamin K2, he/she choose the supplement “Now Foods, Vitamin D-3 & K-2, 1,000 IU/ 45 mcg” for optimum benefits of Vitamin D. If one go for simple D3 then he/she may choose Inlife Vitamin D3 or Zenith D3. They contain 1000 I.U. and cost effective also.