Tag Archive | Vitamin K2 and the Calcium Paradox

In Defense of Vitamin A

In the bone health world, vitamin A has a bad reputation. Some studies have suggested that it’s toxic to bones because it increases the activity of the osteoclasts. These are the cells that do the important work of cleaning away old bone. If they get carried away, though, there can be a net loss of bone if they outpace the osteoblasts that are working to build new bone.

But recent research has found that this isn’t actually the fault of vitamin A itself, but of a failed partnership. If there’s a shortage of vitamin D or vitamin K2, then A can’t do its job properly; the three fat-soluble nutrients are meant to work together for bone care. If we absorb too much of one of them, that creates a corresponding need for more of the others. Since a huge percentage of people are deficient in both D and K2, this means that for the bones of some people, taking preformed vitamin A can be detrimental.

Too little vitamin A, though, is also a problem. A deficiency can also cause bone loss, as well as impaired vision, dry eyes, and a pre-disposition to a host of diseases, including cancer. The key is having good nutritional balance.

As for my story, I was able to bring my vitamin D level into a healthy range with supplements. Check. And I added vitamin K2 to my diet by eating natto three times a week. Check. My vitamin A, though, persistently tested low, even though I eat a lot of foods with beta-carotene, which is supposed to convert to vitamin A. What was that about? Why couldn’t I raise my level of vitamin A?

It turns out that many people can’t process beta-carotene much or at all, for a variety of reasons. For some, the problem is a diet lacking the healthy fats needed to stimulate absorption. For others, it may be that they drink too much alcohol, or that they have inadequate bile flow. Or their gut ecology may be out of balance, perhaps because of low stomach acid levels, celiac disease, or parasites. And to complicate the issue, a large percentage of the population were just born with a genetic variation that prevents them from absorbing beta-carotene or converting it into the active form.

So what can we do to get enough vitamin A in our systems? First, get tested to determine whether you’re in the majority who need some more. If you are, then make sure you eat plenty of retinol foods. The top of this list is cod liver. The second, third, and fourth options are other kinds of liver. If this makes you shudder, then you may benefit from taking preformed vitamin A, or retinol, as a supplement. It often comes in tiny capsules made from cod liver oil, but you won’t taste a thing. It’s also available in dry tablets. But since vitamins A, D, and K2 are fat-soluble, which means they can build up in our tissues, it’s important not to overdo them.

And here’s a side note if you’re hoping to see your hundredth birthday: vitamin A sufficiency is now recognized as a key contributing factor to longevity.

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.