Should You Take Vitamin K and Vitamin D Together

Summary

In this video, Dr. Brad and Dr. Paul discuss the relationship between vitamin D and vitamin K2, emphasizing the potential dangers of high vitamin D doses. They explain that vitamin K2, found in foods like chicken, cheese, and natto, helps regulate calcium levels in the body, promoting bone health and potentially reducing arterial plaque. While observational studies suggest benefits, randomized control trials are lacking. They advise caution with supplements and recommend a balanced diet, suggesting K2's safety but urging skepticism without definitive evidence.

Takeaways

• 💊 Vitamin D and K2 are often discussed together, but their relationship and necessity for supplementation is complex.
• ⚠️ High doses of vitamin D can be dangerous, unlike non-fat soluble vitamins which are excreted in urine.
• 🥬 Vitamin K1 is commonly found in green leafy and cruciferous vegetables.
• 🩸 Vitamin K plays a crucial role in blood clotting, interacting with medications like Warfarin.
• 🐓 Vitamin K2, specifically MK4 and MK7, is found in foods like chicken, cheese, butter, eel, and fermented soy products like natto.
• 📉 The natural sources of Vitamin K2, particularly in animal products, are decreasing due to changes in animal diets.
• 🚫 There is no reliable test for vitamin K2 levels in the blood.
• 🦴 Vitamin K2 helps regulate calcium in the body, promoting its absorption into bones and reducing it in the bloodstream.
• 🔬 While there are potential benefits of K2 for bone health, especially in postmenopausal women, its effects on arterial health are less clear.
• 💼 The vitamin K2 supplement industry is large and growing, but lacks definitive proof from randomized control trials.
• 🥗 A healthy diet rich in green leafy vegetables and fermented foods is a safer and potentially more effective approach than supplementation.

Q & A

What is the main topic discussed in the video?

The video discusses vitamin D and vitamin K, their functions, and the potential benefits and safety of taking them as supplements.

What are the potential dangers of taking large doses of vitamin D?

Large doses of vitamin D can be dangerous because it is a fat-soluble vitamin that can accumulate in the body, unlike water-soluble vitamins that are excreted in urine.

What is the difference between vitamin K1 and K2?

Vitamin K1 is commonly found in green leafy vegetables and is associated with blood clotting. Vitamin K2 has different subtypes like MK4 and MK7, and it is involved in regulating calcium in the body.

Why should people taking warfarin be cautious with vitamin K consumption?

Warfarin, also known as Coumadin, is an anticoagulant that works by depleting vitamin K, which is essential for blood clotting. High vitamin K intake can counteract the effects of warfarin.

What are some dietary sources of vitamin K2?

Dietary sources of vitamin K2 include chicken, cheese, butter, eel, natto (a fermented soy product), and fermented foods like sauerkraut.

Why is it challenging to get vitamin K2 from animal sources today?

Many animals are fed grains instead of grazing on greens, which leads to lower K2 content in their meat and dairy products.

How does vitamin K2 help regulate calcium in the body?

Vitamin K2 aids in the carboxylation of proteins like osteocalcin and Matrix GLA protein, which helps promote calcium absorption into bones and reduces calcium in the bloodstream.

What is the current evidence regarding the benefits of vitamin K2 supplements?

The evidence for the benefits of vitamin K2 supplements is primarily from observational studies, and there is a lack of randomized control trials to definitively prove their effectiveness.

Who might benefit from taking vitamin K2 and vitamin D3 together?

Postmenopausal women with osteoporosis might benefit from taking vitamin K2 and vitamin D3 together to improve bone quality and density.

What is the stance of the doctors in the video on taking vitamin K2 supplements for the average person?

The doctors suggest that the average person should proceed with caution when considering vitamin K2 supplements, as there is no definitive evidence that they are better than a healthy balanced diet.

Why are there no large randomized control trials for vitamin K2 supplements despite the industry's size?

The absence of large randomized control trials could indicate that supplement companies are not confident in the results proving the effectiveness of their products.

Outlines

00:00

💊 Vitamin K2 and D: The Synergy Debate

Dr. Brad and Dr. Paul discuss the common belief about the need to take Vitamin K2 with Vitamin D supplements. They clarify that while Vitamin D is popular and can be dangerous in large doses, Vitamin K (specifically K1 and K2) is a fat-soluble vitamin that can accumulate in the body. Vitamin K1 is prevalent in green leafy vegetables and is crucial for blood clotting, which is why people on blood-thinning medications like Warfarin need to monitor their intake. The doctors also touch on the confusion between Vitamin K and the element Potassium (K). Vitamin K2, with its subtypes MK4 and MK7, is found in foods like chicken, cheese, butter, eel, and natto. They note the decrease in K2 levels due to animals being fed grains instead of greens and emphasize the lack of a direct test for K2 levels.

05:00

🩺 Vitamin K2: Beyond Coagulation

The doctors delve into the functions of Vitamin K2 beyond its role in blood clotting. They explain that K2 aids in regulating calcium levels in the body, which is vital for maintaining bone health and preventing arterial issues like atherosclerosis. Vitamin D increases calcium in the bloodstream, but K2, through carboxylation of proteins osteocalcin and Matrix GLA protein, helps direct this calcium into the bones and out of the blood vessels. Despite the known biochemical effects, clinical trials have not conclusively proven the health benefits of K2 supplementation, especially for conditions like osteoporosis. They highlight the discrepancy between observational studies, which often lack causative evidence, and randomized control trials, which are more reliable but scarce for K2.

10:01

🥗 Vitamin K2 Supplementation: Necessary or Not?

In this segment, the doctors address whether the average person without specific medical conditions should supplement with Vitamin K2. They discuss the lack of solid evidence from randomized control trials on the effects of K2 on arterial health and valve calcification. They also mention that while K2 might help with bone health, particularly for postmenopausal women, its impact on vascular health is less clear. The doctors suggest that a healthy diet rich in green leafy vegetables and fermented foods might be more beneficial than supplementation. They advise caution with K2 supplements due to the lack of definitive trials and the potential for industry bias in research. They conclude by emphasizing the importance of a balanced diet over supplements and invite viewers to share their experiences or opinions on the matter.

Keywords

💡Vitamin D

Vitamin D is a fat-soluble vitamin that is essential for the absorption of calcium and phosphorus, which are necessary for maintaining healthy bones. In the video, it is discussed as a common supplement that people take, but the doctors also caution about the potential dangers of taking too much, highlighting the importance of moderation and safety.

💡Vitamin K

Vitamin K is another fat-soluble vitamin that plays a crucial role in blood clotting and bone metabolism. The video emphasizes the difference between Vitamin K (a nutrient) and potassium (K), an element on the periodic table. Vitamin K is further divided into K1 and K2, with K2 being discussed in more detail regarding its potential health benefits.

💡Vitamin K1

Vitamin K1, also known as phylloquinone, is primarily found in green leafy vegetables and is important for blood clotting. The video mentions that people on blood-thinning medications like warfarin need to be cautious with their vitamin K1 intake, as it can affect how these medications work.

💡Vitamin K2

Vitamin K2, or menaquinone, is discussed as having potential health benefits beyond blood clotting, such as helping regulate calcium levels in the body and supporting bone health. The video points out that while there is a lot of anecdotal evidence and some observational studies, there is a lack of definitive proof from randomized control trials.

💡MK4 and MK7

MK4 and MK7 are specific forms of Vitamin K2 that are thought to be most responsible for the health benefits associated with this vitamin. The video discusses these forms in the context of their potential role in bone health and arterial health, although it also notes the lack of strong evidence to support these claims.

💡Coagulation

Coagulation refers to the process of blood clotting, which is crucial for stopping bleeding when blood vessels are injured. Vitamin K plays a key role in this process, as discussed in the video, particularly in the context of people who are on blood-thinning medications.

💡Fermented Foods

Fermented foods like natto and sauerkraut are mentioned as dietary sources of Vitamin K2. The video highlights the importance of dietary sources for obtaining vitamins and the potential decrease in Vitamin K2 content in animal products due to changes in animal feeding practices.

💡Arterial Stiffness

Arterial stiffness is a condition where the arteries become less flexible and more rigid, which can contribute to heart disease and stroke. The video discusses the potential role of Vitamin K2 in reducing arterial stiffness, although it notes that there is no solid evidence from randomized control trials to support this.

💡Randomized Control Trials (RCTs)

RCTs are considered the gold standard in scientific research for determining the effectiveness of treatments or supplements. The video emphasizes the importance of RCTs and the lack of them for Vitamin K2, which leaves questions about its effectiveness open to debate.

💡Observational Studies

Observational studies are a type of research where researchers observe groups of people and their behaviors or conditions without intervening. The video contrasts observational studies with RCTs, noting that while they can suggest associations, they do not provide definitive proof of causation or effectiveness.

💡Supplements

Supplements are products taken in addition to regular food intake to provide nutrients that may be missing or in insufficient quantities in the diet. The video discusses the补充维生素 K2 supplements industry and the need for caution, as much of the evidence for their benefits comes from observational studies rather than rigorous clinical trials.

Highlights

Vitamin D is not as safe as people think, especially in large doses.

Vitamin K is a fat-soluble vitamin that can build up in the body if taken in excess.

Vitamin K1 is commonly found in green leafy vegetables and cruciferous vegetables.

Vitamin K plays a role in blood clotting and is important for those on blood-thinning medications.

Vitamin K2 has different types, with MK4 and MK7 being the most significant for health benefits.

Sources of Vitamin K2 include chicken, cheese, butter, eel, and fermented foods like natto and sauerkraut.

Vitamin K2 helps regulate calcium in the body, promoting its absorption into bones and reducing it in the bloodstream.

There is no reliable test for Vitamin K2 levels in the blood.

Vitamin K2, along with D3, may benefit postmenopausal women's bone density, but its impact on fracture reduction is unclear.

Observational studies suggest a link between high Vitamin K2 intake and less arterial calcification.

There is no solid evidence from randomized control trials that Vitamin K2 reduces arterial stiffness or valve calcification.

Vitamin K2 is safe even in high doses, with the exception for those on blood-thinning medications.

The supplement industry for Vitamin K2 is large and growing, yet lacks definitive proof from randomized control trials.

Eating a healthy, balanced diet may be more beneficial than taking Vitamin K2 supplements.

There is a need for more research and randomized control trials to establish the benefits of Vitamin K2.

The hosts encourage viewers to rely on randomized control trials for evidence and to maintain a healthy diet.

Transcripts

do you need to take vitamin K2 with your

Vitamin D supplements like a synergistic

effect or something a lot of people

think you do okay well let's figure it

out okay welcome to talking with docs

I'm Dr Brad weening and I'm Dr Paul Z

okay so today we're going to talk about

vitamin D which is a very common common

topic we're actually do another video

later on about some of the dangers of

vitamin D because it's not as safe as

everybody thinks that's the first thing

no and big doses it can be dang big

doses can be dangerous and then we're

going to talk about vitamin K and how

they work together to do a bunch of

different things in our body okay I see

what you did

there the beginning okay so K when we

talking about vitamin K we're talking

about vit K1 or K2 right but don't get

this confused with K which is potassium

potassium right right so don't get

confused with the element on the

periodic table I think 19 possibly but

its symbol is a capital K capital K A

little plus sign yeah right so we're not

talking about vit we're not talking

about potassium we're talking about

vitamin K which is a fat soluble vitamin

we've talked before there are four of

them a d e k or ad mhm um problem with

fat soluble vitamins is they can store

up and build up in your body if you take

too much of it right unlike the nonfat

soluble vitamins that you're excreted in

your urine so you can take as much as

you want and you'll pee out the excess

not the case with a d e or k not the K

right you did it again question okay so

K1 is the one that's most common this is

the one that we're familiar with um and

this is is commonly found in green leafy

vegetables and cruciferous vegetables so

you can imagine people that have a high

consumption of these Foods often have

better health indices and are going to

have vitamin K levels that are okay

right interesting about vitamin K

another thing within medicine is that it

relates to your clotting Factor we've

talked about this before that German

word coagulation so people that are on

warrin or cumin typically for something

called atrial fibrillation to thin their

blood or prevent from clotting have to

be careful with their vitamin K

consumption right we and as residents

and because you know and early in our

careers we used to administer quite a

lot of vitamin K a lot because a lot of

people were using warin which is rat

poison um also known as Coumadin uh to

thin their blood if they had conditions

that needed it to be done like you

mentioned atrial fibrillation and that

there are newer anti-coagulants now

indicated for those things so it's we're

seeing less and less and less people on

war print uh however when some came in

on Warf their blood was thin but we had

to do surgery on them so to reverse it

one of the ways we would reverse it was

to give vitamin K IV or orally and

because it competitively inhibits they

they compete with each other for for

receptors so if you're on Warf you've

depleted your vitamin K and so we used

to give vitamin K to counteract the

orphin so that we could operate on them

and they wouldn't bleed excessively yeah

and competitive inhibition is kind of

like two people having a key and trying

to get to like a lock and if cumin in's

there vitamin K come in kind of push it

out of the the way or or assume the

position of that lock to help your blood

coagulate normally because obviously we

can't do surgery if people don't have

the ability to stop beding competitive

inhibition which is what we often try

and do with each other when we're try to

say the same thing on a video that's

right appr it happens it happens let me

say it okay so then so that that's

mostly the the K1 side so K2 because

it's not confusing enough you have come

with the K subscript wait so K subscript

2 there's actually like 10 some people

would say even 12 different types of K2

okay so there's two important ones ones

that you'll see a lot on videos like

these or on other research uh number

four MK4 and mk7 and MK2 is called

menaquinone and K one's called phin so

good with the big words they really like

the big names so MK4 and mk7 are the

ones that are thought to be most

responsible for the health benefits that

we're going to talk about so before we

do that where where do where do we find

K2 can we find it in our diet yeah we

can really okay where this is one where

the chicken wing may have a role chicken

has a high concentration of K2 compared

to other Foods right so particularly

compared to Pork and Beef so in the in

the meat category the chicken wing is

better but things like cheese and butter

and eel and then a soy a fermented soy

product called natto apparently it's not

very good to eat a lot of people talk

about how it's slimy and tastes weird I

like to put that on my eel when I eat

the eel yeah that's right and then the

last one is other fermented foods like

sauerkraut so the trouble with relying

on animal sources for this is that as

mammals what happens is they take in

Greens like grass and then they bowels

convert them through bacteria and every

specific enzyme that converts the K2 but

because more and more animals are being

fed grain as opposed to just grazing

around their K2 continents are going

down um so that makes it a little bit

tricky that's why I only eat the chicken

wing from a kale fed chickens so yes

it's hard to find yes interesting one

cup of kale actually has all of your

daily requirement of vitamin K which and

Zero taste that's right is your the RDA

for Vitamin K is actually 90 to 120

depending on male or female um and they

actually don't specifically address the

RDA for K2 because um a lot of of

research does not necessarily show a

specific benefit at this point can you

imagine K2 in the blood so very good

question there's not a reliable test so

if I'm a supplement company I'm pretty

happy about that saying listen I think

your K2 is low want to take the

supplement how do I know why I can't

test it there are some indirect ways to

test um kils and that's car o ilation of

ocalin but because if you have a bunch

of ocalin that's around and not

carboxilate then some people say well

that can translate into yeah low K2 but

there's not a good direct test so this

is one of the plights of the whole K2

argument really right okay so what does

K2 do what is what does K2 do different

than coagulation what's the purpose of

it uh K2 helps you regulate the calcium

in your body right it helps you

um with and and and calcium in the body

is stored mostly in the bones yes and we

like it in the bones it's not so great

if it gets out into the bloodstream and

gets very high levels of calcium in the

bloodstream because that can go into

your arteries that can cause plaques and

that contribute to atherosclerosis heart

disease stroke and all those vascular

diseases that we talk about right so

vitamin D gets that calcium up when it's

consumed with fat gets that calcium up

into our bloodstream and we talked in

another video about how calcium

supplements cause high spikes of this

and that's an issue but what happens is

there are two proteins called

osteocalcin and Matrix GLA protein where

they require vitamin K2 to carboxilate

them and make them active and this helps

promote calcium going into the bones and

actually out of the bloodstream um into

the into the bones rather than sitting

in those vessels or calcifying the walls

because we talk about arterial stiffness

being an issue and calcification of the

plaques being in is shoe so you can see

those two good things because if you

have osteoporosis you have poor bone

mineral density increasing the calcium

in the bone helps that strengthens your

bone and helps you resist fragility

fractures at the same time getting it

out of the blood keeps it out of your

artery right so those seem like really

good things obviously everyone should

take vitamin D and calcium and K2 right

well that's the problem we we know some

of the mechanisms that happen but so so

much of the time we know mechanisms of

things and then when we go to translate

to health benefits that's where the link

is broken right and you can say oh yeah

we see all the biochemical things that

happen so if we just give a supplement

less people should die and less people

should break their bones that is what

we're having difficulty proving

especially with K2 and a lot of the

studies for K2 to um particularly our

observational studies so where they

assess people's dietary patterns and

sometimes they'll give them supplements

and a lot of these studies are sponsored

by the supplement company so K2

supplement business in 2022 was about

$700 million estimated to get to $2

billion by 2030 and a lot of it is

driven by social media and videos

exactly like this where people be like

hey click on the link and get 10% off my

K2 Brad and Paul's K2 um we do not have

any of those types of products or

sponsorships and really complicates the

landscape so observational daa where you

say well look this group of people we

think they look like this and they don't

have this so it's because of this well

here's an example give us an example so

if you're watching professional golf on

a Sunday you say well these guys all

have long pants they got shoes with

little spikes on the bottom they're

wearing a golf shirt they have a hat

they're professional golfers well if I

put on a hat and a golf shirt long pair

of pants and some golf shoes that does

not make me a professional golfer it

makes me look like a professional golfer

but I'm not a professional golf and

that's the difference between

observational research and a randomized

devil blind control trial in a human

which is the gold standard so until you

have that you can't really say

definitively that something uh has proof

however it doesn't mean that K2 does not

do this stuff it just means that we

can't prove it definitively at this

point these observational studies Are

One Step Up from observational humor

Jerry Seinfeld style right I like Jerry

St to so if you go to Pub M the National

Library of Congress where they document

all the papers and the research articles

if you limmit it to randomized control

trials it comes up with actually 15 and

all of them are about about bone right

now right so when you're doing K2 and D3

together and so what does it show

looking through all of them my takeaway

is that the one group of people that has

shown to benefit from K2 and D3 together

would be postmenopausal women with

respect to

osteoporosis and Bone quality bone

density but it does not necessarily

reduce the incidence of fractures right

right that's the thing we can see

biomechanical biochemical effects but we

can't translate it into a good clinical

outcome and that's like many of the

supplements right interesting but there

are some people in cases where we do

administer K2 we talked about well we

talked about vitamin K1 we give uh when

people came in on warrin with the thin

blood and newborns as well often we get

a k injection as well because it doesn't

cross the placenta very well and there

may be medical conditions that you are

on okay for those medical conditions

prescribe by your family doctor or your

Healthcare professional that's fine

we're talking about supplements for the

average person uh with no significant

related medical conditions should they

be taking vitamin K right can we go to

the bottom line yet or we there no not

yet with respect to the Cardiology side

so things like arterial stiffness

calcification of the ortic valve as well

as calcification of the vessels

themselves a lot of observational data

no good solid randomized control trial

to prove this actually recently there

was a trial for Ric valve calcification

that did not show a difference that was

very very disappointing for a lot of

people who thought certainly it was

going to and there are specific

populations where the incidence of valve

calcification is very high particularly

renal patients and dialis patients

they've done some studies in this group

of people to say hey if we give them K2

can we suck some of that calcium out of

their vessels and it has not been proven

so I think there's more to learn about

this I think if you're so I guess the

take- home for me is that taking K2 I

think has some potential benefits I

think it could help your bones at this

point more than it can help your vessels

but not sure about the vessel side

because a lot of the people that have

healthy vessels are already eating

healthy diets green leafy vegetables

cruciferous vegetables wide variety of

of plants as well as less animal

products this leads to better yeah

that's my take-home that's now after all

the research and all these supplements I

go into it thinking is this thing going

to prove to me that this supplement is

better than eating a healthy balanced

diet right and then that's sort of the

benchmark I said and no definitely K

doesn't meet that requirement for me and

if and if you think about it why is

there no double blinded randomized

control trial it doesn't make sense that

there isn't one because the companies

that make these supplements have a lot

of money because it's a big industry

they could easily fund one of those

trials but you wouldn't fund one of

those trials if you were one of those

companies and not confident that the

results would prove that your supplement

tricky is is good and then they so you

should be a little bit weary that there

aren't big randomized control trials

proving these things that's right and

time's going to show because there are a

lot of ongoing ones and like we said

there's been some observational data

that's shown like there's one that a lot

of people quote the Rotterdam study

where they shown that people with high

K2 intake do have less um calcification

of their vessels but it's not an RCT

it's observational data so the good news

is vitamin K2 is very safe um so even if

you took very very high doses the odds

of it causing damage to you would be low

unless you're on cumin um it does have

an Associated cost um but I think I

think proceed with caution and I think

we'll we'll keep our eyes and ears open

and if something else comes up happy to

share yeah and leave a comment if you

have some experience or anecdotal data

or you agree or completely disagree but

don't get mad people are going to get

mad and say well I saw this guy and he

said I have to take K2 um we're all

about the randomized control trials so

show us show us the data show me the

evidence there now you know if you like

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charge of your own health just eat a

good diet there you go we'll see you

next time