Is vitamin K2 required when taking Vitamin D?

rayban

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Hi, I want to buy a vitamin D supplement for the 3 months where the weather is too cold to sit for 15 minutes to get sun outside. I've seen that many vitamin D supplements come with vitamin K too (vitamin K2 mk7 they say its the best)

Anyway, I just don't understand why is this the case. I've never tested my vitamin K in a lab, but if you had a defecit wouldn't it be obvious?

Isn't there an higher chance you are overdosing by taking a supplement than not taking it? I have tested for vit D and it was low, but wouldn't low levels of vit K give you horrible obvious sides?

Which markers would be needed in a lab to test for vitamin K anyway? For vit D I tested both OH25 and 1,25 metabolites and both came back on the lower end.

I just don't want to take a vitamin that I may not even need and do more harm than good (I only supplement stuff if I get a bloodwork first but I wasn't sure what to get to accurately measure vit K)
 

Ben.

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Good question. I was wondering about that too. It is also said about magnesium/clacium that should be supplemented with it among other cofactors ...
Low vitamin D comes from the lack of sun exposure right? Not because the diet is bad.


If i were to use very simplified logic here (just an idea, not saying this is true) then a person with a high vitmain d level due to living or being in the sun alot, doesn't change the amount of vitmain k needed because where it is derived from is so fundamentally different. You dont eat 3-4 times the normal amount of food wether you are in the sun or not. The complex biological changes due vitamin d could theoreticly change the need of vitamin k in both direction depending on what processes are actually happening. Maybe vitamin d changes the amount absorbed/assimilated of other vitamins/cofactors without the person consciously changing his/her intake and diet.

Perhaps vitamin k supplementation makes sense when one is generally low due to lack of it from the diet and/or health issues raising the amount needed? Im just thinking the people living in a sunny place year round don't necessary indulge in more vitamin k1 from plants nor k2 from fermentation/animal foods than we do in the north. And apparantly the skin makes around 20k iu per day with enough sun exposure. Evoultionary speaking there may be an argument that we ate more towards fermented foods/animals foods during the winter. But that would imply that we ate more vitamin k2 while having lower vit d levels. Not the other way around.

I realy should look more into some nutritional science ... fascinating stuff.
 

Blaze

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Hi, I want to buy a vitamin D supplement for the 3 months where the weather is too cold to sit for 15 minutes to get sun outside. I've seen that many vitamin D supplements come with vitamin K too (vitamin K2 mk7 they say its the best)

Anyway, I just don't understand why is this the case. I've never tested my vitamin K in a lab, but if you had a defecit wouldn't it be obvious?

Isn't there an higher chance you are overdosing by taking a supplement than not taking it? I have tested for vit D and it was low, but wouldn't low levels of vit K give you horrible obvious sides?

Which markers would be needed in a lab to test for vitamin K anyway? For vit D I tested both OH25 and 1,25 metabolites and both came back on the lower end.

I just don't want to take a vitamin that I may not even need and do more harm than good (I only supplement stuff if I get a bloodwork first but I wasn't sure what to get to accurately measure vit K)
When it comes to vitamin K I would not worry about it harming you unless you are taking some ridiculous extreme dose.

Vitamin K toxicity is extremely rare. The only reported toxicity comes from menadione, which has no use in humans. When toxicity does occur, it manifests with signs of jaundice, hyperbilirubinemia, hemolytic anemia, and kernicterus in infants.

Currently no commonly available blood test for K, only for Vitamin D. I think there is only one type of test available and is rarely given by doctors only when you have strange excessive bleeding or clotting issues.

My personal use of supplemental vitamin K is to offset the aspirin intake Ray Peat recommends. I use Jarrow K Right formula. That being said, If I was not taking aspirin I would not take much vitamin K and rely on my food for that vitamin.
D is another vitamin that has very few examples of toxicity. You can take D and K in conservative doses without it being risky at all. The concern with D & K is that they are oil soluble and retained by the body as opposed to water soluble vitamins that are easily excreted. The only other concern is if you are using Warfarin or other blood thinners.
You must get some K (and calcium) though, the best source is dietary unless using higher doses of aspirin.
 
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Perry Staltic

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As I understand it, vitamin K is needed to ensure that calcium gets deposited in the right places (bones) rather than in the arteries. Combination vitamin D3/K2 supplements are available.
 

Mito

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For vit D I tested both OH25 and 1,25 metabolites and both came back on the lower end.
Ideally you want to test parathyroid hormone (PTH) at the same time as 25(OH)D because the reference range for 25(OH)D is set based on maximal suppression of PTH. Peat consistently seems to recommend 50 ng/mL for a 25(OH)D level. 1,25-dihydroxy vitamin D acts similar to PTH, so low is probably good.

Which markers would be needed in a lab to test for vitamin K anyway?
“Unfortunately, there are no useful tests for measuring vitamin K status that are available to the general public at this time. However, good tests are on the horizon. VitaK will be releasing innovative medical devices to allow health care practitioners to monitor vitamin K status in patients, and ImmunoDiagnostic Systems will be releasing a blood test for dp-ucMGP, a protein that circulates in the blood when blood vessels become deficient in vitamin K.”
 

rei

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Doses over 10 or 15k IU daily require it to be safe, otherwise no need.
 

rayban

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When it comes to vitamin K I would not worry about it harming you unless you are taking some ridiculous extreme dose.

Vitamin K toxicity is extremely rare. The only reported toxicity comes from menadione, which has no use in humans. When toxicity does occur, it manifests with signs of jaundice, hyperbilirubinemia, hemolytic anemia, and kernicterus in infants.

Currently no commonly available blood test for K, only for Vitamin D. I think there is only one type of test available and is rarely given by doctors only when you have strange excessive bleeding or clotting issues.

My personal use of supplemental vitamin K is to offset the aspirin intake Ray Peat recommends. I use Jarrow K Right formula. That being said, If I was not taking aspirin I would not take much vitamin K and rely on my food for that vitamin.
D is another vitamin that has very few examples of toxicity. You can take D and K in conservative doses without it being risky at all. The concern with D & K is that they are oil soluble and retained by the body as opposed to water soluble vitamins that are easily excreted. The only other concern is if you are using Warfarin or other blood thinners.
You must get some K (and calcium) though, the best source is dietary unless using higher doses of aspirin.
I've read that excess vitamin D supplementation can block the vitamin D receptor long term. Im looking at 200 UI supplement daily, not these insane 50k UI dosages.

I eat a varied diet including meat and I drink milk every day so I doubt I have a deficiency but who knows. Which is the test for vitamin K? I can pay for it, but like I said I doubt I have a problem but perhaps is not at the ideal range even if it's not a problem, an accurate test could tell me that. With vitamin D I was 21 for OH 25 and 27 for 1,25 which both are on the lower end range, those are with diet only (no sun) so I need an extra push for these months where I can't be bothered to sit in a cold climate with a t-shirt. I think 200 UI could be enough to get me on the middle of the range.

I may just pick it with vitamin D only and no k2. It is a liquid vitamin D supplement and the vehicle is a base of EVOO which seems ideal assuming you need fats when you take vit D, however I will take it in the breakfast where I usee EVOO myself with bread anyway.
 

rayban

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Ideally you want to test parathyroid hormone (PTH) at the same time as 25(OH)D because the reference range for 25(OH)D is set based on maximal suppression of PTH. Peat consistently seems to recommend 50 ng/mL for a 25(OH)D level. 1,25-dihydroxy vitamin D acts similar to PTH, so low is probably good.

“Unfortunately, there are no useful tests for measuring vitamin K status that are available to the general public at this time. However, good tests are on the horizon. VitaK will be releasing innovative medical devices to allow health care practitioners to monitor vitamin K status in patients, and ImmunoDiagnostic Systems will be releasing a blood test for dp-ucMGP, a protein that circulates in the blood when blood vessels become deficient in vitamin K.”

I've got PTH in there too.

PTHi: 50.1 pgr/ml (18.5 - 88.0)
VitD OH25: 20.1 ng/ml (Deficiency < 12, Insuficiency 12-30, Suficiency 30.1 - 100, Toxicity > 150)
VitD 1,25: 27 pg/ml (25.00 - 66.00)

My TSH is rather high at around 4-5 and I have thyroid antibodies. I take 75mcg of Euthyrox at night. Doctors don't do anything but raise your t4 every X months, they don't research why you have antibodies, just diagnose you as hashimotos. Im lean and only sides I have is low tolerance to cold and sluggish in the morning, but since im very lean low tolerance to cold may not be that abnormal and most people are sluggish in the morning so it's hard to say.
Also with confinement I barely ever go out since months so that doesn't help.

Cortisol came back high too. I can post my entire bloodwork if anyone is interested, it's pretty long. The thing with cortisol is im not sure if that is accurate since you just measure at a certain moment and you can't draw a proper curve, I would need the saliva test which I think may be more accurate.

For now I just want to correct the vitamin D deficiency and test again and see if other things improved due fixing this.

About the vitK link you posted, that was 2016, still no tests?
 

Blaze

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I've got PTH in there too.

PTHi: 50.1 pgr/ml (18.5 - 88.0)
VitD OH25: 20.1 ng/ml (Deficiency < 12, Insuficiency 12-30, Suficiency 30.1 - 100, Toxicity > 150)
VitD 1,25: 27 pg/ml (25.00 - 66.00)

My TSH is rather high at around 4-5 and I have thyroid antibodies. I take 75mcg of Euthyrox at night. Doctors don't do anything but raise your t4 every X months, they don't research why you have antibodies, just diagnose you as hashimotos. Im lean and only sides I have is low tolerance to cold and sluggish in the morning, but since im very lean low tolerance to cold may not be that abnormal and most people are sluggish in the morning so it's hard to say.
Also with confinement I barely ever go out since months so that doesn't help.

Cortisol came back high too. I can post my entire bloodwork if anyone is interested, it's pretty long. The thing with cortisol is im not sure if that is accurate since you just measure at a certain moment and you can't draw a proper curve, I would need the saliva test which I think may be more accurate.

For now I just want to correct the vitamin D deficiency and test again and see if other things improved due fixing this.

About the vitK link you posted, that was 2016, still no tests?
I wouldn't worry too much about the D or K in my opinion. Don't think supplementing it does much good unless you have a deficiency and don't think there is risk for harm either.
Blood test would be a waste of time for the Vitamin K as it is just a snapshot of that vitamin at that moment. And in reality , they don't even really test for vitamin K at all. They look at something called prothrombin time related to bleeding which you do not have. If the result of the PT is prolonged it is suspected to be due to low levels of vitamin K, then oral supplements or injections of vitamin K are administered.
My philosophy is kind of anti supplementation (with a few exceptions) and focus on dietary fixes wherever possible.
Your thyroid medicine is only T4 and the one I previously used was T3. I think you (and I) would benefit far more from a balanced med that contains both T3 and T4 together so talk to your Doctor about that. Some of us do not convert between T4 and T3 easily....some of us do.

Keep it simple and focus on proper thyroid function first and when you get that one thing as good as you can....see what bloodwork and other conditions remain and attend to them.
The body is a harmony of a myriad of things working together and so many systems compensating for things that are off. That makes it impossible to address all conditions at once since there are so many variables to account for. Try one thing at a time starting with the thyroid function. No supplementation that is not necessary and no extreme diets. Listen to your body. Your body is always at work trying to heal things (not the opposite) , so trust your body and try to be very self aware what foods and supplements makes it feel better and what makes it feel worse.

We all have some level of stress in this existence. Don't discount that as nonsense and try your best to get any stress or anxiety under control. Wishing you well.
 
Last edited:

Mito

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About the vitK link you posted, that was 2016, still no tests?
It looks like they have the test for dp-ucMGP now (InaKtif MGP (dp-ucMGP) Immunoassay | IDS (idsplc.com).

I've got PTH in there too.

PTHi: 50.1 pgr/ml (18.5 - 88.0)
Chris Masterjohn advocates getting into the lower half of the PTH reference range.
Mastering Nutrition 9: Balancing Calcium and Phosphorus in the Diet, and the Importance of Measuring Parathyroid Hormone (PTH) | (chrismasterjohnphd.com)

My TSH is rather high at around 4-5 and I have thyroid antibodies. I take 75mcg of Euthyrox at night. Doctors don't do anything but raise your t4 every X months, they don't research why you have antibodies, just diagnose you as hashimotos. Im lean and only sides I have is low tolerance to cold and sluggish in the morning, but since im very lean low
@Hans has posted that he thinks Hashimotos may be related to gut problems.

The T4 could be converting to rT3, which is blocking the effect of T3, thus you don't feel better.
Hashimoto is usually due to inflammation caused by the diet (such as gluten, dairy, PUFAs, beans, legumes, nightshade, etc.) and lifestyle.
Although you didn't mention that you tested testosterone, it might be low, because thyroid and vitamin D is low. Focusing on optimizing thyroid first is key, and then focus on testosterone and dopamine.
SSRI drugs, which increase serotonin and noradrenaline inhibit T3 entry into cells. Lowering those would help. You're already using cypro, so elevated noradrenaline might still be an issue.
 

DrJ

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Don't forget A and E also. All the fat soluble vitamins need to be taken in balance.
 

baccheion

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Vitamin D3 supplementation is associated with decreased bone mass without either vitamin K2, or resistance training.
 

rayban

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I wouldn't worry too much about the D or K in my opinion. Don't think supplementing it does much good unless you have a deficiency and don't think there is risk for harm either.
Blood test would be a waste of time for the Vitamin K as it is just a snapshot of that vitamin at that moment. And in reality , they don't even really test for vitamin K at all. They look at something called prothrombin time related to bleeding which you do not have. If the result of the PT is prolonged it is suspected to be due to low levels of vitamin K, then oral supplements or injections of vitamin K are administered.
My philosophy is kind of anti supplementation (with a few exceptions) and focus on dietary fixes wherever possible.
Your thyroid medicine is only T4 and the one I previously used was T3. I think you (and I) would benefit far more from a balanced med that contains both T3 and T4 together so talk to your Doctor about that. Some of us do not convert between T4 and T3 easily....some of us do.

Keep it simple and focus on proper thyroid function first and when you get that one thing as good as you can....see what bloodwork and other conditions remain and attend to them.
The body is a harmony of a myriad of things working together and so many systems compensating for things that are off. That makes it impossible to address all conditions at once since there are so many variables to account for. Try one thing at a time starting with the thyroid function. No supplementation that is not necessary and no extreme diets. Listen to your body. Your body is always at work trying to heal things (not the opposite) , so trust your body and try to be very self aware what foods and supplements makes it feel better and what makes it feel worse.

We all have some level of stress in this existence. Don't discount that as nonsense and try your best to get any stress or anxiety under control. Wishing you well.

Im also not big in supplementing but in this case seems appropiate. I mean I spend pretty much 3 months without sun and I have bloodwork to back it up, seems to me I would benefit from a low dose of 200 UI per day to try to get at the midrange.

Im from spain so the doctors will never prescribe t3, that is the problem. I only have t4. I also was told by doctor that t3 is too unstable and synthetic t4 is the most accurate to know what dose you are taking. If I wanted to try t3 I would need to buy online somehow and im not sure about that.

My diet is mediterranean diet varied with meat, fish, vegetables. Fish is one or two times a week salmon and sometimes some sardines and that's about it. Unfortunately due mercury and people in general ruining sea im not big on fish.
 

rayban

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It looks like they have the test for dp-ucMGP now (InaKtif MGP (dp-ucMGP) Immunoassay | IDS (idsplc.com).


Chris Masterjohn advocates getting into the lower half of the PTH reference range.
Mastering Nutrition 9: Balancing Calcium and Phosphorus in the Diet, and the Importance of Measuring Parathyroid Hormone (PTH) | (chrismasterjohnphd.com)


@Hans has posted that he thinks Hashimotos may be related to gut problems.
Will see if the private clinic I go to to get the bloodworks can give me the K measurement next time. For now im going to only take vit D without the k2 and test again in 3 months to see if I maintained good levels on 200 UI daily with no sun.

So can you summarize how to get into middle PTH range and why?

About hasimotos and diet.. I've heard people suggesting lowering gluten and dairy yet I haven't seen evidence that their antibodies went lower, so I wouldn't like taking stuff out of my diet that I like to find it out does nothing, and maybe even get a gluten intolerance out of spending months without taking it when I don't have digestive problems.

What I should do tho is fix my sleeping schelude. It's 6:50 AM and I still haven't sleep, I'll wake up at 3 PM lol.
 

Mito

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Will see if the private clinic I go to to get the bloodworks can give me the K measurement next time. For now im going to only take vit D without the k2 and test again in 3 months to see if I maintained good levels on 200 UI daily with no sun.

So can you summarize how to get into middle PTH range and why?
I’d recommend listening to Masterjohn’s podcast on balancing calcium and phosphorus in the diet. Basically he is saying that the parathyroid hormone is continuously monitoring your blood calcium level. If the parathyroid gland judges the blood calcium level to be too low, PTH will increase which then increases blood calcium by mobilizing it from bone, signaling the kidneys to conserve existing calcium, and stimulating 1,25-dihydroxy vitamin D to increase. Increasing your 25(OH)D in the context of a diet with sufficient calcium and not too much phosphorus should bring the PTH down. Peat has said that PTH in the blood can lead to soft tissue calcification (especially in the context of poor Vitamin K status), is inflammatory in itself, and interferes with oxidative metabolism.

About hasimotos and diet.. I've heard people suggesting lowering gluten and dairy yet I haven't seen evidence that their antibodies went lower, so I wouldn't like taking stuff out of my diet that I like to find it out does nothing, and maybe even get a gluten intolerance out of spending months without taking it when I don't have digestive problems.
I don’t know much about it, you can search for Hans posts about it and ask questions or just wait to see if it improves with better vitamin D and PTH status.
 

rayban

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I’d recommend listening to Masterjohn’s podcast on balancing calcium and phosphorus in the diet. Basically he is saying that the parathyroid hormone is continuously monitoring your blood calcium level. If the parathyroid gland judges the blood calcium level to be too low, PTH will increase which then increases blood calcium by mobilizing it from bone, signaling the kidneys to conserve existing calcium, and stimulating 1,25-dihydroxy vitamin D to increase. Increasing your 25(OH)D in the context of a diet with sufficient calcium and not too much phosphorus should bring the PTH down. Peat has said that PTH in the blood can lead to soft tissue calcification (especially in the context of poor Vitamin K status), is inflammatory in itself, and interferes with oxidative metabolism.

I don’t know much about it, you can search for Hans posts about it and ask questions or just wait to see if it improves with better vitamin D and PTH status.

So you wouldn't buy the vitamin d + k2 supplement only the d supplement?

I've got these two options:

Judging from what im reading vitamin k defficiency is very unlikely. Who knows but without bloodwork one can just guess.

I reckon I eat enough calcium tho. I drink milk and eat cheese everyday, and at night I eat vanila cream or yogurt for desert.
 

Mito

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So you wouldn't buy the vitamin d + k2 supplement only the d supplement?

I've got these two options:

Judging from what im reading vitamin k defficiency is very unlikely. Who knows but without bloodwork one can just guess.

I reckon I eat enough calcium tho. I drink milk and eat cheese everyday, and at night I eat vanila cream or yogurt for desert.
There is a database of Vitamin K content in foods at the end of this link The Ultimate Vitamin K2 Resource | (chrismasterjohnphd.com), so you could check that to judge if you're getting enough K.
 
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