Tag Archive | health

Take Two on K2

When I posted previously about Vitamin K2 I knew enough to say that if we’re not eating natto, we all need a K2 supplement. But how much? What kind? I really didn’t know.

A few months later an exciting new book caught my eye: Vitamin K2 and the Calcium Paradox: How a Little-Known Vitamin Could Save Your Life, by Canadian naturopath Dr. Kate Rheaume-Bleue.

The apparent contradiction the title’s referring to is that a calcium deficiency in the bones often exists at the same time there’s a calcium excess in the arteries of the same people, as osteoporosis and heart disease frequently show up together. There’s really the right amount of calcium, it’s just in the wrong places. The incidence of both these conditions has increased dramatically in the past century. What’s going wrong, and what’s changed?

Rheaume-Bleue points to a deficiency in Vitamin K2 in our modern diet. K2 is very different from the K1 that’s known for clotting. The function of Vitamin K2 is to move calcium around the body, guiding it into the bones and teeth where it belongs, and out of our arteries, where it causes problems.

What does K2 deficiency look like? Osteoporosis, heart disease, cancer, diabetes, varicose veins, wrinkled skin, dental cavities, Crohn’s disease, kidney disease, narrow crowded dental arch, alzheimer’s, arthritis, MS, infertility – all these and more point to a K2 deficiency. And the author goes on to conclude that essentially everyone who eats a standard North American diet is deficient; how the deficiency manifests is the only question.

So what’s changed to cause such a widespread shortage? It was largely the shift from pasture-feeding to grain-feeding animals that happened in the middle of the last century. Until then, farm animals grazed on grasses that were high in Vitamin K1, which they converted to K2 for us, and we then consumed. We can get our own K1 from greens, so a deficiency of K1 is rare in humans, as long as they eat vegetables; but our bodies don’t effectively convert it to K2. Our best sources of Vitamin K2 used to be meat, eggs, and butter from pasture fed animals, but now most animals eat grain, so they are deficient and so are we.

If you’ve ever come across the work of Dr. Weston Price – he was a dentist in the early 20th century who studied the diets of isolated primitive cultures – he identified an ingredient that he named “Activator X” that was responsible for keeping people in those cultures healthy until they left their traditional ways and adopted processed diets. That ingredient is now known as Vitamin K2.

So if you think you’re deficient in Vitamin K2, what can be done? The high road would be to source all your meat, eggs, and butter from pasture-raised animals, thus eating the way our ancestors did. That may be outside your budget.

There is one more food option, the traditional Japanese superfood called natto made of fermented soybeans. In the eastern part of Japan where it’s commonly eaten the incidence of hip fractures is much lower than in the rest of the country, pointing to natto’s major impact on K2 supply. Unfortunately, though, not everyone can get used to natto. It has a strong smell that has been likened to gym bags, and a stringy slimy texture that some people call mucousy.  It’s actually not hard to make – it cultures something like yogurt, with a particular inoculant. I learned to eat it to be polite when I lived in Japan. There it’s said to be the one food a foreigner can never love, and I don’t love it; but I make it and eat it.

If trying new foods with foul smells and disturbing textures is not for you, then Dr. Kate Rheaume-Bleue strongly recommends a Vitamin K2 supplement. It turns out there are two main forms of K2, which are abbreviated MK4 (menatetrenone) and MK7 (menaquinone). MK4 is the form in meat sources, and its supplements are synthesized from a tobacco extract. MK7 is extracted from natto, the soybean food. If you’re sensitive to soy, you won’t want to take MK7.

Here’s where it’s particularly helpful that the author’s Canadian: She explains a dose discrepancy that I hadn’t been able to resolve between studies I’ve read and what’s on the shelves of stores. It seems that Health Canada doesn’t know there is a Vitamin K2, so the limit they’ve put on Vitamin K1 supplements – 120 mcg per dose – also applies to Vitamin K2 sold in Canada. This works quite well if you’re taking the MK7 form, as 120 mcg is an effective daily dose according to many studies. But with MK4, it would take about 38 of the legal Canadian dose pills per day to have a measurable impact on our bodies. The price alone is prohibitive. For those who are sensitive to soy, MK4 is the only form you’ll be able to tolerate, so it might be worth a drive across the border to where you can buy MK4 in therapeutic doses at a reasonable price.

There are some other potential issues with MK7 that the author doesn’t identify. Some people develop heart palpitations when they take it. Personally, I stopped sleeping well after taking it for a while, and the problem went away when I gave up the supplement. Natto doesn’t seem to bother me, though. Of course, as with all these things, your experience may be very different from mine.

The book contains a wealth more information on the interactions between nutrients.  The author firmly believes, as I do, that no one nutrient can solve all our problems, and that supplements can’t take the place of a healthy diet and lifestyle. She devotes a fair bit of time to discussing the interaction between Vitamin D, Vitamin A, and Vitamin K2, as none of these fat-soluble vitamins can work if there’s a shortage of one of the others. She also has sections on magnesium and Vitamin E.

For me, my particular interest in Vitamin K2 has to do with turning around osteoporosis, but my family line is riddled with the other conditions that are linked to a K2 deficiency. I’d started taking a lot more Vitamin D for the sake of my bones, but it’s very helpful to know that all this extra D is useless with inadequate K2.

The author presents an enticing statistic, in case you still need convincing: She quotes studies that showed a 50% reduction in arterial plaque after only six weeks of taking Vitamin K2 as menaquinone (MK7). That’s impressive! Also, she says that K2 supplementation seems to reduce hip fracture rates more than increases in bone density can explain. That is, it appears to improve the strength or flexibility of bones.

You don’t have to have osteoporosis or heart disease to learn something useful from this book. I suggest you read the book. But if you aren’t going to do that, then buy some Vitamin K2 and start taking it.

I passed the test!

First, I should apologize for the long gap between posts. My writing time has been absorbed into 1400 square feet of gardening bliss, which legitimately counts as bone-building activity. But now that we’ve had our first heavy frost, I’m down to a couple of short rows of greens under covers, and it’s time to get back to my desk.
It’s also time to announce that my bones passed their big test – the one that really counts: They held together beautifully when I had a bad fall. The scene was the garden, and the accident involved me recklessly trying to move an oscillating sprinkler while outrunning it to stay dry. I scrambled onto the half-meter high stile to get over a fence, but when my wet feet met the slick top step I crashed down – very hard – my entire weight on my hip onto the packed path. There I lay, stunned and wetter, but suddenly very excited: Nothing broke!!!  I wore a mammoth bruise for a long time, yet wasn’t even stiff the next day. Despite my doctor’s dire warnings, and the High Risk of Fracture on my chart, my bones were able to do their job and absorb the impact.
Now, a year after my bone density T-score of -4, I can reflect on the approach I’ve taken, as my bones seem to be serving me well:
  • Exercise: I changed my gym workout, now choosing the treadmill over an elliptical trainer. This causes more impact to my bones, which should challenge them to grow stronger. I’ve continued using weight machines to work my lower body, but now choose free weights for upper body work, and do those exercises standing up so my spine can carry the extra weight. On days I don’t get to the gym I go for a brisk walk. Keep moving.
  • Supplements: I added strontium citrate (680 mg per day), Vitamin K2 (100 mcg per day of the MK7 or menaquinone form), silica, and 3 mg per day of boron. I was already taking B complex, a balanced mineral supplement, fish oil, magnesium, Vitamin D, and Vitamin C.
  • Diet: I gave up most dairy products. Yup, to improve my bones I stopped drinking milk. I found out through testing that I’m sensitive to milk (not that I noticed any symptoms) which means it would have tended to cause inflammation, and that is bad for bone health. Also, dairy products metabolize to form acidic residue, which increases bone loss. I get my calcium from leafy greens, nuts, and salmon, with about 600 mg per day from a supplement. (The 1500 mg per day supplement my doctor recommended is way too much!) I put more emphasis on making and drinking mineral-rich bone broths. I already ate a lot of vegetables, and that hasn’t changed. I had already given up gluten, and any foods that contain it. Since lower body weight is one of the major risk factors for osteoporosis, I gave myself permission to abandon my life-long pursuit of weighing a little less. That must have been effective, as I have gained about 3 kg, and mostly feel fine with that :).
  • Reading: I devoured some excellent books that helped form my understanding. My favourites are Your Bones by Lara Pizzorno, The Whole Body Approach to Osteoporosis by R. Keith McCormick, The Myth of Osteoporosis by Gillian Sanson, and Vitamin K2 and the Calcium Paradox by Kate Rheaume-Bleue.
  • Support: I joined an online community of people who share what they’re learning about osteoporosis. I also continue to meet with a local Health Pursuits Reading/Study Group where lots of wise people have spurred me on with their insights into natural approaches.
  • Drugs: I have not taken any. I don’t plan to take any. Since I haven’t needed to return to my nice well-meaning doctor who told me I had no choice but to take Actonel, she doesn’t know. I have a choice, and I’m exercising it by venturing into realms that are beyond her training.
  • Followup bone density test: Although I was told I would get an automatic recall, that hasn’t happened. I considered initiating the appointment  myself, but then wondered: What would I do differently if I got a worse test result? I’m already doing everything I know how to improve my bones. Since I’m very numbers-oriented, I know I’d obsess over the new scores, way beyond their accuracy or their ability to predict fractures. So I’ve let it go, and I’ve stopped having bad dreams in which I’m about to get my retest scores. One day, if the test centre calls, I’ll go for a repeat test. But I am more than a test score.
Still, I made a note to myself to avoid risky activities like outrunning sprinklers in wet obstacle courses. Instead I should focus on developing true superpowers that will allow me to leap over garden stiles in a single bound.

Calcium Supplements: After the Scary Story

Calcium supplement use may raise heart attack risk

Did you catch this headline? Last week all the media outlets reported the results of a German nutrition study that tracked 24,000 people over an 11-year period. Participants who took calcium supplements had almost double the heart attacks of those who didn’t take calcium. The authors concluded that we should ditch the supplements and meet our calcium needs from food sources. While that is generally a very good approach with most nutrients (a handful of supplements can’t atone for a junky diet!), there’s some missing information here: How much calcium were the un-supplemented participants getting from their diets? How much of what forms of calcium were the others taking, and how much were they also getting from their diets? What were their bodies able to absorb?

More important, were they taking vitamin K2? As I mentioned before, it’s responsible for directing calcium to our bones, and away from our arteries. Although bacteria in our intestines can convert some vitamin K1 (the renowned blood-clotter) into K2, even if we ate several cups of leafy greens a day, without a good serving of Japanese natto or a supplement, we’d still be deficient. If the calcium-popping participants weren’t also taking K2 then it’s not surprising their arteries were overloaded.

And what were the participants’ vitamin D levels? There’s an important partnership between vitamin D and vitamin K2; too little of one prevents the other from doing its best work. If the supplementing group had vitamin D levels in any way typical of people in Germany’s northern latitude – their calcium may well have wandered into their hearts.

And what were they all eating? Adding calcium supplements to a highly-processed diet might well have compounded other issues.

In the absence of definitive answers, how is a diligent bone-lover to respond? It was just months ago that my own doctor advised me to take 1500 mg per day of calcium supplements, with no discussion of how I eat or any other supplement than magnesium; I don’t feel at all inclined to go back and ask for her updated advice, especially since she also insisted I take bisphosphonate drugs!

The approach that makes sense to me is to continue with a non-processed  diet, based largely on a wide variety of fresh vegetables, with some meat, fish, nuts, fruit, eggs, yogurt, cheese, healthy fats, and non-gluten grains. Consistent with the COMB study I mentioned before I also take K2, D, magnesium, and fish oil. (That report recommended strontium citrate, which I took for a month. However, I figured out it was the cause of some daily headaches that developed, so stopped. I’ll try strontium again soon, as other support nutrients may be better balanced now.) I also take silica, boron, a multi-mineral supplement that includes 500 mg calcium,  a vitamin B complex, and vitamin C.

When new information comes out it can be hard to make sense of it. Personally, after reflecting on this news I don’t find it too scary after all.

Low Density History

My grandmother probably never heard of osteoporosis. For most of her life the disease was rare and largely unknown.  But in 1982, right around her 90th birthday (and by then she was too old to care) the word osteoporosis was suddenly thrust into the common vocabulary. A massive public information campaign began, warning post-menopausal women by every means possible of imminent danger and disfigurement from weakened bones. The pharmaceutical companies, pushing their lucrative hormone replacement therapy (HRT), sponsored the campaign that sent a generation of fearful women scurrying to their doctors for prescriptions. No one seemed concerned about the absence of studies that proved HRT could prevent or reverse osteoporosis. Soon, though, a problem did emerge: there was no easy way to test the strength of bones in living people. So the Dual Energy X-ray Absorptiometry (DEXA) machine was developed in 1988, and finally our bones could all be compared on the basis of density.

Subsequently, the World Health Organization established a large database of DEXA readings, and in 1994 they announced international standards for osteoporosis. They also changed its definition. It went from being a disease characterized by fragility fractures to a condition marked by low bone mineral density, no fracture needed. Suddenly half of all post-menopausal women – and quite a few other people – were painted with the ominous diagnosis.

But the 1994 definition has some obvious shortcomings. It doesn’t take into account the fact that bone mineral density alone can not adequately predict the quality of our bones or their tensile strength which are most significant predictors of fractures. Also, the standards compare my bones with those of young women on a normal curve, not considering what might be normal and healthy and perfectly suitable for me. Furthermore, the DEXA machine that set the standards has some serious limitations, typically rating larger bones higher than smaller bones of the identical density. (There are more details here.) In other words, being diagnosed based solely on a DEXA score should not be nearly as scary as our doctors tell us.
Of course, fragility fractures truly are a serious problem, and I don’t want any. So I’m taking charge of all the factors that are within my control. I’m optimizing my nutrition and exercise, and minimizing the risk of falling. To reduce stress I’m turning back the clock on history, and living like my grandmother did, letting my bones do their work.

Carry your weight and surprise your bones.

Aside from optimizing our nutrition through diet and supplements, the best gift we can give our bones is weight-bearing exercise. Study after study confirms that putting certain kinds of stresses on bones helps them to grow, or at least to resist shrinking.

So what exercise makes the difference for bones? Weight-bearing exercise includes almost any kind we do on our feet while working against gravity. Some examples are walking, jogging, hiking, dancing, and climbing stairs. Good news for me – gardening also counts! Swimming and biking are great for other reasons, but they are not weight-bearing because they don’t involve working our muscles and bones against gravity; therefore they aren’t the best for building bones.

If it were only as simple as going for a walk each day… But the problem is that our bones quickly adapt to the level of stress they usually encounter, then need new challenges to stimulate them to grow. So it helps to surprise them with new moves and greater intensities; for that reason it’s important to choose a variety of activities, and to alternate between lower and higher intensities. One study found that “inserting a 10-s rest interval between each load cycle amplifies bone’s response to mechanical loading”. That suggests that our bones are more stimulated to grow by a sequence of high intensity short bursts interspersed with 10-second rests, than by longer periods of sustained exercise. So digging the garden – as soon as I can get to it – will be better for my bones than a long run.

Exercise on our feet is vital for our vulnerable hip joints (femoral necks), as well as our spines and femurs. While those are the sites that the DEXA machines scan for density, we have other bones to consider: wrists and upper arms are also prone to fractures. So it makes sense to include a range of activities that stress those bones, like pushups, triceps dips, and carrying heavy groceries. Here’s a link to a site with lots of exercise suggestions.

Anything that improves our balance helps reduce the likelihood of falling. Lately I’ve opted to spend life’s less interesting moments standing on one foot, then switching to the other. It hasn’t taken long for me to develop impressive flamingo skills, which I practise while brushing my teeth, putting on socks, waiting in line, or talking on the phone. One day this should help me catch myself before falling.

But what about all the warnings for people with osteoporosis?  “BE CAREFUL. Don’t run, or jump, or twist, or hug anyone, or sneeze.” Yes, if you have osteoporosis it’s essential that you exercise appropriately for your condition, and with medical approval. Consulting a qualified trainer is a good idea. These warnings are particularly important:

  • Do NOT do any high impact exercises without medical approval. These can result in stress fractures.
  • Do NOT do exercises that involve bending forward at the waist, such as toe-touching. These can result in spontaneous crush fractures of the spine when coming back up from this position.

Personally, I’ve been able to continue hugging and sneezing without breaking anything. I also run gently on a treadmill (lower impact than on the road), and I might have mentioned that I plan to garden…soon. For anyone concerned about bone density – find some activities you can fit into your day and DO THEM. Life as you know it may depend on it.