Preventing Arterial Plaque?

You would think that if a specific vitamin had actually been shown in clinical study to reduce cardiovascular disease risk by 50% (yes, half!) that it would be a major news headliner, right?  Right up there with the latest drug?  Not so much!  But I expect we will start to hear much more from the mainstream about the power of Vitamin K2 in the next few years.

In the body, many vitamins serve as cofactors for enzymes and thus play major roles in catalyzing (that is, speeding up or increasing) key biochemical processes.  Vitamin K is a cofactor.  Most of my clients haven’t even heard of Vitamin K.  Or if they have, it’s about the high level of Vitamin K1 (Phylloquinones) found in green leafy vegetables vs. Vitamin K2 (menaquinones).  Unfortunately, Vitamin K2 is prevalent mostly in foods that many of our clients have shied away from due to nutritional myths e.g. butter (but only if it’s grass-fed), cheeses, fatty red meats (e.g. grass-fed ribeye steak), liver, and egg yolks.  The food containing the highest amount of Vitamin K2 is a highly fermented soy food called natto, which very few people can tolerate given its strong odor and flavor.

Bacteria in the human gut can produce Vitamin K forms, but not in sufficient quantity to prevent calcification in a Vitamin K-deficient diet.   While it appears that animals can easily convert Vitamin K1 into Vitamin K2, this has not been well demonstrated in humans.  And our modern epidemics of osteoporosis and heart disease would seem on some level to be evidence of our K2 insufficiency and also our overall poor intake of foods high in Vitamin K1.  Unlike other fat-soluble vitamins, the body does not store Vitamin K, so it must be taken in regularly.

Among other roles, Vitamin K is responsible for modifying a class of proteins in the body called Gla proteins.  These proteins play a variety of functions such as blood clotting and managing calcium in the body.  There are still many medical practitioners who rely on “old school”, outdated know-how that Vitamin K is only key for blood clotting and thus should be minimized in cases of high-risk for or diagnoses of cardiovascular disease.  Indeed, Vitamin K1 is preferentially used by the liver which is where clotting proteins are made.   However, the rest of the body preferentially uses the K2 form which is where it is needed to keep bones, arteries, kidneys, brain, etc. healthy.  Minimizing Vitamin K2 can increase the risk of bone density loss and dramatically increase the risk of cardiovascular disease, specifically via calcification of arteries, especially the aorta.

In blood vessels, Vitamin K2 is necessary to form a protein which strongly inhibits vascular calcification.  But studies show only Vitamin K2 does this effectively, not Vitamin K1!    In the famous Rotterdam study, sufficient Vitamin K2 intake was shown to prevent both cardiovascular disease and aortic calcification more than 50% of the time!!!  Are you surprised to learn that sudden death from heart attack is much more highly correlated with calcification of the aorta than with cholesterol levels?  For my clients with concerns about atheroscloerosis and/or arteriosclerosis, I recommend at least 90 ug/day (with food) of the MK-7 form of Vitamin K2 in these cases (in addition to increasing Vitamin K via food).

vitamin MK7In bones, Vitamin K2 is necessary to modify osteocalcin, so it can effectively attract calcium ions and put them into the bone matrix.  If you are taking Vitamin D in order to absorb more calcium from your food, it’s critical to ensure that calcium is captured in bones vs. running amok in the body and “mineralizing” other tissues such as arterial walls or creating kidney stones.   For all of my clients over age ~45 who are taking Vitamin D (and especially if they are using calcium supplements), Vitamin K2 is vital in ensuring the calcium they mobilize actually helps to increase bone density (and doesn’t harm the rest of the body).   I recommend at least 45 ug/day (with food) of the MK-7 form of Vitamin K2 in these cases (in addition to increasing Vitamin K via food).

Unfortunately, measuring total Vitamin K in the blood is not necessarily helpful in assessing your status because it won’t distinguish between K1 and K2.  But it’s a start!  And most people need to be eating more dark, leafy greens regardless (which will promote K1).  Many people do not sufficiently convert Vitamin K1 to Vitamin K2.  In fact, the amount of Vitamin K required for normal blood clotting (as could be measured with bloodwork such as PT/INR) is substantially less than what is required for optimal calcium management.  Thus a normal or healthy PT/INR is not indicative of sufficient Vitamin K for whole body needs.

magnesium glycinateWhile we’re speaking of bone health, remember that I’ve written recently about the risks of calcium supplements, especially if not taken alongside  Vitamin D, Vitamin K2, and magnesium.  Most of us are very aware of the importance of Vitamin D for immune system health.  Taking high doses of it (especially in the winter) can be very healthy, but it needs to come along with Vitamin K2 and magnesium to maximize its benefits.  In fact, supplementing with Vitamin D can cause magnesium deficiency symptoms if your level isn’t sufficient, as magnesium is required to convert Vitamin D into its final active form.  The lessons of Vitamin K and Calcium management and Vitamin D-magnesium interdependence are a great reminder of how nutrients work in a symphony in the body, not as individual forces.

Of course many other key factors are involved in the etiology of arterial plaque, so certainly more support is needed than just Vitamin K2 to fully address the root causes.   If you’d like to learn more about the real root causes of heart disease (hint:  it’s not cholesterol), you might enjoy our self-paced Cardiovascular Myths & Truths seminar.  Or if you’re ready for some personalized, 1:1 attention in radically improving your own wellness, please contact us to set up an initial consultation.