Vitamin K2 and the bone heart connection
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Published 2023-04-10
As we age, there are a couple of pathologies that start becoming more prevalent - Frailty and heart disease.
Our bones become thinner and weaker due to a lack of calcium and this leads to osteoporosis and makes us more susceptible to fractures.
Coronary artery disease also becomes significantly more prevalent and is characterised by increased calcification in the walls of our coronary arteries.
This is interesting because the osteoporosis is characterised by a lack of calcium and coronary disease, characterised by too much calcium and both pathologies are often found in the same patients.
To prevent osteoporosis, many patients take calcium supplements. This is even when body calcium levels are not reduced. However recent research suggests that calcium supplementation could actually increase the risk of coronary artery disease. In a recent publication, researchers conducted a systemic meta-analysis of 13 double blind placebo controlled randomised control trials and found that a dietary calcium intake of 700-1000mg per day or supplementary calcium intake of 1000mg per day significantly increased the risk of coronary heart disease.
www.ncbi.nlm.nih.gov/pmc/articles/PMC7910980/#B42-…
Even more interestingly, a recent meta-analysis found that calcium and/or vitamin D supplementation did not seem to reduce fracture incidence in community-dwelling older adults anyway.
www.ncbi.nlm.nih.gov/pmc/articles/PMC5820727/
So this is all very interesting. Could it be that as we get older, the calcium which is meant to get deposited in our bones, gets deposited in our coronary arteries instead? Could this therefore be the reason why increasing calcium intake does nothing for our bones but actually increases heart disease?
Since these observations,a lot of interest has focussed on Vitamin K and in particular a sub-type of vitamin K called Vitamin K2. Vitamin K2 is a fat soluble vitamin and helps activate osteocalcin which helps take calcium out of the blood and deposits in the bone. So if there is a shortage of vitamin K2, the calcium does not bind to the bone and therefore the bones get thinner.
In the tissues especially in the smooth muscle cells, there exist proteins called matrix GLA proteins and they have the function of removing calcium from the tissues but to do so they need to be activated by Vitamin K2 and vitamin D. So if there is a shortage of vitamin K2, these matrix GLA proteins do not get activated and therefore become non-functional and calcium does not get removed from the blood vessels and therefore get accumulated there and cause heart artery narrowings.
Interestingly there was a study in the journal of vascular research in 2008 that the amount of non-functional matrix GLA protein (I.e that which had not been activated by vitamin K2) was directly correlated with the magnitude of vascular calcification. The more non-functional matrix GLA protein concentrations, the higher the likelihood of vascular calcification.
So is there any evidence that making a concerted effort to increase vitamin K2 can be helpful?
Well - yes - there have been several studies that have confirmed this.
The Rotterdam study took unto 5000 men and women above the age of 55 and followed them up for 8-11 years and found that diets rich in Vitamin K2 were associated with a 50% reduction in arterial calcification and cardiovascular death. In fact mortality from all causes was reduced by 25%!
Another study, known as the PROSPECT study looked at dietary K2 levels and coronary disease in 16000 women and found that with each additional 10mcg/day of K2 supplementation, there was a 9% reduction in cardiovascular mortality.
In 2015, there was another really another very interesting study known as the knapen study which showed that increased Vitamin K2 levels (doses of 180mcg day) resulted in reversal of coronary artery calcification and restore arterial flexibility.
www.ncbi.nlm.nih.gov/pmc/articles/PMC3648717/
All Comments (21)
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Dr Gupta is a treasure, a role model for physicians, and a GREAT TEACHER.
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As someone who wishes to become a Cardiologist you've been a great influence and almost like a role model on how medicine should be practised!
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My own personal experience with K2-Mk7. Four years ago I had a CT scan of my lungs due to a prolonged cough and they found calcifications on my coronary arteries giving me a score of 70. On my on accord, I made an appointment with a cardiologist. He then sent me to another specialist to do a more in depth carotid artery scan. This showed one very small deposit on my right carotid, but it had yet to cause any narrowing. Because I also have slightly high cholesterol and triglyceride levels, I was subscribed a statin. He also prescribed 5000 iu of D3/ day as my level was below 40. Then, on my on after some research, I began taking the K2 about six months later. After a year on the statin and the D3/K2 my now annual carotid scan showed no progression of my small spot, nor any new areas. However, due to severe side effects from the statin ( dysphasia, muscle atrophy, pre diabetes), I had to discontinue. Forward another year and I was quite anxious to see the results of my annual carotid being that I hadn’t been on the statin and my cholesterol levels were still considered high. But, to my doctor’s surprise, there had been no progression and no new developments. Atherosclerosis is a progressive disease. Once diagnosed, they expect the plaque to continue to build up at a certain rate/ percentage each year and they expect to see it develop in other areas as well. Too, I had another CTscan of my heart. In the comments from the first scan I had 4 years ago, they specified percentage of calcium in each artery and noted CAD, as well as a slightly enlarged opening on my descending aorta.Two years later, this scan, simply specified mild arterial calcification and noted no aortic embolism- within range. I know there can always be a different opinion written according to the doctor interpreting the scan. But, the main take away was that, again, I had no progression. So, I’ll never stop taking my D3/K2-Mk7, ever. Update/side note: my BP has been slowly inching up- the highest it’s gotten is 140/96. After watching a video by cardiologist James Roberts linking vitamin C and lipoproteins which recommended that patients with high cholesterol, CAD, heart disease, etc should supplement 6-10 thousand mg of C daily; I upped my intake to 6,000 mg/ day and now my BP is consistently 121 or lower systolic and 83 or lower dystolic. Anyone else have these results with vitamin C?
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It's like a breath of fresh air to hear a physician who is open minded to alternatives other than pharmaceuticals. I brought up recently the use of certain supplements to my cardiologist and she had no knowledge of it and discouraged me from using them. I wish the medical community could work together!
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I’m here in the US, Northwest Washington State. At 76 and in good health, I was recently prescribed statins by my usually reasonable doctor (he recently started taking statins himself and I think that influenced his prescription for me as well). My recent blood work showed borderline high cholesterol. My cholesterol levels, over the last 30 years, have gone up and down and always been supposedly too high, but I have not taken statins. This last time my doctor was more insistent that I should take statins. Instead of doing that, I had a vascular ultrasound of the carotid arteries performed and the results showed that the arteries were fine…actually below the average for my age for any plaque build up. I have taken Vit D for years and it was always coupled with K2. My diet is great…lots of plants and some meat and fish…low refined carbs. I liked your presentation and it has given me further ammunition for my argument against using statins and compromising my liver, brain and muscles. I live in an area that is far away from large cities and use well water. Between walking in the fresh air and swimming in Puget Sound, I have it pretty good. At least, I will die happy❤
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I have been taking k2 for years Dr Gupta with 4000iu vit D, but please note it should be k2 mk7 which is the natural k2 and not mk4 which is synthetic. Could I also say that it's so good to hear a cardioligist talk about K2. Usually you only get this advice from naturpathic doctor's. Thank you Dr Gupta.
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Undoubtedly, you are by far the most amazing Dr I have come across in 33 years of my medical career. Someone who truly cares about humanity and is pure to the core of his heart. Thank you and bless you 🙏
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Most traditional doctors aren’t trained in nutrition, therefore not likely to recommend vitamins. I tried nato and for me it was awful slimy beans. What a conundrum to take calcium for the bones and instead it builds up in the arteries. Thank you for being one of those rare doctors who look for new information
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I've been supplementing with 100 ug of MK7 for about 20 years, back when the first benefits were noted. My diastolic readings used to be too low (isolated systolic hypertension); that has corrected and is no longer observed in my diastolic BP. I interpret this as an improvement in arterial elasticity. I am 86 years old.
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While viewing the x-rays of our patients, my attending made a remark I never forgot: (this patient was >85 years old). “This man is walking on his aorta. His aorta has way more calcium than his spine”. It was so true. It made me think about the role of calcium in coronary artery disease and osteoporosis. Several year (!) later I learned about vitamin K2 in atherosclerosis and osteoporosis.
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When you said you were supplementing with vitamin K2 yourself , then I was convinced. Thank you for giving up your time to help advise and educate us poor laymen who are frequently misled by unqualified bloggers. ❤
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Thanks Dr Gupta, At 81, and quite fit, I was dismayed when my doctor reacted with alarm when my blood pressure registered in the 159/90 area (I had taken it many times and it was often 130 and lower) He prescribed the pills. I bought them but never used them. I started walking a lot more as well as working out at the gym. This has had a beneficial effect on my blood pressure. My diet has always been extremely modest in animal products of all kinds. Lots of fruits and vegetables. I learned about good diet from an old Scotsman who worked with my father at the New York Times. He gave me my first book on diet: The Sun Food Way To Health. Thank you for your advice. I share your videos with my patients
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Great job, Doc! If you have a friend in dentistry you might convince them to make a video discussing the effect of K2 on calcium uptake in the teeth. Perhaps even re prevention / healing of dental caries. Re fermented foods, I’ve heard lots of K2 is contained in unexpected areas, like the brine in sauerkraut having more K2 than the kraut itself. Thank you for using your fantastic Med training in such an open-minded, even-handed way. More, please!
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GPs are just not interested in looking at nutrition (vitamin deficiencies) there's no money there! In my experience it's either ppis and antidepressants under 40, with statins thrown in over 40. One size fits all money making pills when supplements can fix so much with a change in diet! I strongly recommend most people follow the vitamin D protocol and B12 protocol. I've been injecting B12 for a while now, as well as taking folate, vit D with K2. I have M.E and POTS and it's really helped!
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My doctors have been telling me for years that I need to take a statin and that I was at high risk of a heart attack and/or a stroke because of my very high cholesterol. I refused and 3 years ago stopped having check ups because of the pressure they piled on to take that statin. I started to take D3/K27 along with my usual magnesium. Last week I had a blood test for upcoming surgery and all results were within "acceptable parameters" including ldl, triglycerides and hdl. My sister had the same high cholesterol and took the statin, then medication for angina, high blood pressure and was told it was because of calcified arteries. She paid for a private calcium scan and it was completely clear. They told her there was nothing there and did not have angina. She quit the statin.
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Thank you Dr Gupta, I love how you never stop learning, searching, researching, never content to just sit back, I wish more doctors were like you 👍😎👍💜
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I deeply appreciate that you want to press further and find real ANSWERS as to why do these conditions arise and what can turn it around ! You are a special kind of doctor! 👏👏🙏
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I worked in the cath lab in the 1990s. It was clear on fluoro, osteoporosis with calcific vascular disease. I used to say out of the bones into the vessels. I have never thought calcium supplements were a good idea...thank you for this. I have wondered about K2.
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A few years ago, my wife and I started taking D3 and K2 MK7 (8,000 to 12,000 IU D3, and 100-600mcg respectively). One potentially related improvement has been a definite reduction in my wife's Diastolic pressure, which is now almost always under 80, when it used to be much higher. Her Systolic is also much lower and now normal when she did have pretty high BP. However, the Diastolic has improved far more relatively, suggesting her arteries are now more flexible and, hopefully, less calcified in effect. This observation has been based upon carefully logged pairs of readings taken twice a day (so 4 in total each), every day, and weekly averages noted. There's a clear and steady improvement since taking K2 MK7. That may not be the only factor, but it seemed worth mentioning, because so few people have any actual evidence to work on. I have it all in a Spreadsheet, and there is a quantifiable improvement.
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Thank you very much to Dr Gupta for his dedicated efforts in treating my mother Lai Tang during her hospital stay. He was not only professional, but also very responsible and helpful in accommodating our family's requests.Many thanks.
