Dec
02
2017

Vitamin K For Bones And Arteries

By | heart attack, Mortality, Nutrition, Osteoporosis, Vitamins and supplements

Vitamin K for bones and arteries is gaining a lot of attention as a valuable supplement. Most of all in the blood vessels, but in addition in the heart, lungs and kidneys the matrix GLA protein is a key substance. Vitamin K2 is crucial for removing calcium from these organs, as matrix GLA protein is carboxylated. Carboxylation of the GLA protein functions much as a broom. This removes all superfluous calcium from blood vessels and organ tissues. If there is a lack of vitamin K2 intake, matrix GLA protein is uncarboxylated, which as a result invites vascular calcification. Essentially vitamin K2 has emerged as an important player in the regulation of bone conditions like osteoporosis, but also in the prevention of hardening of arteries. Vitamin K2 removes calcium from blood vessels and deposits calcium in bone preventing osteoporosis. I will review some key publications, which support this.

Arterial stiffness study in postmenopausal women

Aging blood vessels become stiff from calcification. By removing calcium it seems like the arterial wall becomes more flexible again. Dr. Knapen and colleagues from Maastricht University, The Netherlands followed 244 healthy, postmenopausal women for 3 years in this double blind, placebo-controlled 2015 study.

120 women received 180 micrograms of vitamin K2 (as MK-7) once daily. 124 women received placebo pills. Next researchers checked arterial stiffness through two types of tests. First of all, carotid intima-media thickness was evaluated by echo tracking. In addition aortic stiffness was tested by carotid-femoral and carotid-radial pulse wave velocity. After 3 years there was a significant reduction of uncarboxylated matrix GLA by 50%. This was missing in the placebo group. All of the markers for arterial stiffness showed a reversal improving flexibility above the median. This shows that hardening of arteries in postmenopausal women is reversible with the help of vitamin K2.

Bone metabolism study in Japanese men and women

This 2015 Japanese study investigated what the minimum amount of necessary vitamin K2 would be to improve osteocalcin carboxylation.

First of all, study 1 examined the effect of 0, 50, 100, or 200 micrograms of vitamin K2 (=menaquinone-7) daily. A group of 60 postmenopausal women received vitamin K2 for 4 weeks. Only the 200 microgram per day dosage showed an effect of carboxylating osteocalcin.

Second part of study

Furthermore, study 2 consisted of 120 men and women. Measurements involved the ratio between carboxylated and uncarboxylated osteocalcin to demonstrate the effect of vitamin K2. As a result of study 1 only a placebo group, a 100-microgram and a 200-microgram daily vitamin K2 group was part of the investigation. Both, the 100 microgram and the 200 microgram doses, reduced the circulating uncarboxylated osteocalcin fraction. Hence they concluded that vitamin K-2 effectively keeps the calcium in the bones and prevents osteoporosis. The investigators recommended taking more than 100 micrograms of vitamin K-2 per day to improve osteocalcin carboxylation.

You can find more detail regarding the interaction of calcium, vitamin D3 and vitamin K2 in this link.

Trabecular bone structure preserved in postmenopausal women

148 postmenopausal women were participating for 12 months in a randomized, placebo-controlled, double-blinded clinical trial. All these women had osteopenia. All of them received supplements with calcium and vitamin D3. In addition they received 375 micrograms of vitamin K2 or placebo pills. Examination involved tests for bone mineral density with dual X-ray absorptiometry (DXA). Furthermore a high-resolution CAT scanner determined the microarchitecture of the tibia bone.

After 3 months the uncarboxylated osteocalcin decreased by 65.6% rather than the placebo group of only 6.4% decrease. The trabecular number, spacing and thickness in the tibial bone were unchanged in the vitamin K2 group. In contrast to that there was a clear deterioration of the bone structure in the placebo group.

Summary of trabecular bone study

The bone density studies showed no detectable difference between the groups. The deterioration of the trabecular microstructure in the placebo group was consistent with expected age-related changes. On the other hand, the vitamin K2 group clearly demonstrated preservation of the trabecular bone structure in the tibial bone.

Vitamin K2 helps to eliminate toxic effects of calcium

This 2015 publication from Krakow, Poland explains rather well how vitamin K2 is important to reduce calcium from blood vessels.

At the same time the article points out that vitamin K2 is important for depositing calcium into bones to prevent osteoporosis. The removal of calcium from blood vessels occurs by carboxylation of matrix GLA protein. This functions like a shield to protect blood vessels from calcium entering into the arterial wall. This way the arteries are probably safe from calcification, and hardening of the arteries cannot take place. On the other hand calcium is binding to the bone. As explained above the hormone osteocalcin is responsible for this.Vitamin K2 is the main player in the process of carboxylization. As a result vitamin K2 makes it happen that calcium travels into the bone, where it belongs.

Rotterdam Study: reduced heart attack rates from vitamin K2

4807 subjects from the Rotterdam Study in the Netherlands were part of a study for considerable time (about 10 years) with no sign of any heart attack in the beginning.

The investigators were interested to correlate the effects of various doses of vitamin K1 and K2. How would this impact the frequency of heart disease, hardening of the aorta and all-cause mortality? Researchers adjusted the data for smoking, age, gender, body mass index, diabetes, education, and dietary factors. Next they compared the middle and upper tertile groups of vitamin K1 and K2 to the lower tertile of vitamin K1 and K2.

Results of Rotterdam Study

Most noteworthy, the relative risk for coronary heart disease was lower for the middle and upper tertile of the vitamin K2 group. They found that the middle tertile vitamin K2 intake lowered heart attacks by 27%. It was especially relevant that the upper tertile of vitamin K2 intake lowered heart attack rates by 57%.

In addition, all-cause mortality also showed a reduction for the middle tertile of vitamin K2 by 9% and for the upper tertile by 26%. Finally, severe aortic calcification was 29% less for the middle tertile of vitamin K2 and even 52% less for the upper tertile. Intake of vitamin K1 (=phylloquinone had no impact on any of the outcomes. The investigators concluded that adequate intake of vitamin K2 (=menaquinone) was crucial for anybody’s health. First of all, vitamin K2 lowers heart attack rates, in addition it reduces hardening of the arteries including the aorta and finally, it lowers all-cause mortality.

Vitamin K For Bones And Arteries

Vitamin K For Bones And Arteries

Conclusion

This review shows evidence that vitamin K2 supplementation is important for the prevention of osteoporosis and heart disease. It prevents heart attacks and hardening of arteries, including the aorta. The dosage necessary to achieve this is only 200 micrograms of vitamin K2 per day. However, in Japan higher doses like 375 micrograms per day are the common protocol for prevention of osteoporosis.

Effect of vitamin K2 for bones and arteries

How does vitamin K2 work? In the blood vessels vitamin K2 carboxylates the matrix GLA protein. Essentially this keeps calcium out of the arterial wall and prevents hardening of the arteries. This reduces heart attacks and significantly lowers mortality from heart attacks as well. The second effect of vitamin K2 is on bones. Vitamin K2 prevents osteoporosis to a large extent. It does so by binding calcium to the bone. The hormone osteocalcin, which is carboxylated by vitamin K2 effectively moves calcium from the bloodstream into the bone and keeps it in the bone. If you take vitamin K for bones and arteries, you double the benefit from this simple vitamin. Remember to take 200 micrograms of vitamin K2 daily. The benefits are certainly remarkable!

 

Sep
12
2015

Ageless Aging

By | Anti-aging medicine, Arthritis, Cancer, Cardiovascular disease, fractures, heart attack, Hormones, Inflammation, lifestyle, Menopause, mitochondria, Nutrition, Osteoporosis, Prevention, Vitamins and supplements

We have been exposed to a lot of clichés about aging, which makes it more difficult to dispel rumors and to clearly focus on what can and what cannot postpone aging and the associated disabilities. Here I will attempt to summarize what is known about this topic.

The American Academy of Anti-Aging Medicine (also known as A4M) has published a book where all of this is discussed in detail (Ref.1). But there are yearly conferences as well in Las Vegas and other places where further details regarding anti-aging are discussed. Since 2009 I have been attending the conferences in Las Vegas regularly every year.

Based on this knowledge let me start by reviewing the tools of anti-aging that can be used to slow down the process of aging significantly.

  1. Mitochondria

At the center of anti-aging is the preservation and metabolic optimization of the mitochondria. Each of our cells contains little particles called mitochondria, which is where our energy metabolism takes place. Mitochondria function like mini-batteries.

The citric acid cycle builds up ATP, which is subsequently hydrolyzed into ADP and orthophosphate releasing energy for cell metabolism.

Old people who shuffle when they walk and have difficulties climbing stairs have lost significant amounts of mitochondria and simply run out of energy. The key to prevent this from happening is to preserve our mitochondria. We inherited them from our mother, because only the head of the sperm, which does not contain mitochondria entered the ovum when the egg cell that was destined to become you was fertilized. Subsequently the mitochondria from mother’s egg have provided all of the mitochondria in the cells of our body.

  1. Preserving mitochondria

There are supplements that specifically preserve mitochondria: PQQ (=Pyrroloquinoline quinone) helps mitochondria to multiply. A typical dose to take every day is 20 mg. Mitochondrial aging is slowed down by ubiquinol (=Co-Q-10, 400 mg per day is a dose that I recommend). Co-Q-10 repairs DNA damage to your mitochondria.

There are simple lifestyle changes that you can make: eat less calories as this will stimulate SIRT1 genes, which in turn stimulate your cell metabolism including the mitochondria.

Resveratrol, the supplement from red grape skin can also stimulate your mitochondria metabolism. 300 to 500 mg of trans-Resveratrol once daily is a good dose.

Build in regular exercise into your day – and I mean every day– as this will also stimulate your mitochondria to multiply similar to the effects of PQQ. Lipoic acid is an anti-oxidant that counters the slow-down of mitochondrial metabolism. I recommend 300 mg per day.

L-arginine is an amino acid that is a precursor of nitric oxide (NO). Red beet is a rich source of nitric oxide, which is directly released into your system. There are also commercial products for NO. This keeps the arteries open, prevents high blood pressure and also hardening of the arteries and has a direct effect on preserving mitochondria.

Researchers from the McKusick-Nathans Institute of Genetic Medicine of the Johns Hopkins University School of Medicine in Baltimore, MD found that mitochondrial DNA content varies according to age (less mitochondrial DNA in older age), sex (yes, women have more than men) and mitochondrial DNA; it even has an inverse relationship to frailty and a direct relationship to life expectancy. This paper was published in February of 2015.

Each mitochondrion has its own mitochondrial DNA contained in 2 to 10 small circular chromosomes that regulate the 37 genes necessary for normal mitochondrial function.

In multi ethnic groups it was apparent that mitochondrial DNA content was dictated by the age of a person.

Frailty was defined as a person who had aging symptoms including weakness, a lack of energy compared to the past, activity levels that were much lower than before and loss of weight. When persons with frailty as defined by these criteria were identified, they were found to have 9% less mitochondrial DNA than nonfrail study participants.

Another subgroup were white participants; when their bottom mitochondrial DNA content was compared to the top mitochondrial DNA content, the researchers found that frailty was 31% more common in the bottom DNA content group. This means that white people are more prone to frailty and they should take steps early on to prevent this from happening.

  1. Slowing down hardening of our arteries

It makes sense that young people who do not have signs of hardening of their arteries have better blood supply to their cells and thus supply their mitochondria with more oxygen and nutrients than frail, older people. The same is true for people who exercise regularly.

Vitamin D and vitamin K2 have been shown to lower calcium in the blood vessels and to retain calcium in the bone preventing osteoporosis. This is particularly useful in postmenopausal women. This October 2014 publication mentions that apart from vitamin D and vitamin K2 resveratrol and inositol are additional factors helping to prevent heart disease and osteoporosis.

This September 2013 publication confirms that a deficiency for vitamin K2 is common in the general population. This deficiency leads to osteoporosis and calcification of the arterial wall and causes heart attacks, strokes and bone fractures. Supplementation with vitamin K2 at 200 micrograms per day every day is recommended to prevent this from occurring.

  1. Sugar and starchy foods

You need to understand that starchy foods equal sugar, once digested. As a result a refined cereal breakfast=sugar, pasta=sugar, bread=sugar, donuts=sugar, potatoes=sugar and so on. It has to do with the glycemic load. When you cut out sugar and starchy foods (meaning that the glycemic index of the foods you eat is below 50) you will shed 30 to 50 pounds of weight within 3 to 5 months, if you are overweight or obese. You will feel a lot more energy. Your blood vessels will be cleaned out as the oxidized LDL cholesterol will disappear and the HDL cholesterol will mop up what cholesterol deposits were there before.

It is certainly good for you, if you are not into the sugar and candy stuff, but the seemingly harmless pizza and all the other starchy foods mentioned above are of concern as well. All of the high -glycemic carbs stimulate the pancreas to produce insulin. This in turn produces inflammation in tissues including the brain. Alzheimer’s disease is one of the complications of this.

Where does this leave us? For decades we have been told that saturated fats and cholesterol in our diet were the culprits and we replaced them with sugar that is part of a low-fat diet. We need to pay attention to the glycemic index and cut out high glycemic foods. However, it is OK to eat some carbs from the medium glycemic food list and most of our carbs from the low glycemic food list. With regard to fat it is important to consume only the healthy fats like olive oil, coconut oil and omega-3 fatty acids. As you make these adjustments to your life style you will also prevent many cancers, as you normalize the body’s metabolism and help prevent chronic inflammation, which can cause arthritis and cancer. Finally, pay attention to stress management. The body and the mind work together. Uncontrolled stress leads to heart attacks and strokes.

  1. Cut down on processed foods

Processed foods contain the wrong type of vegetable oils that are composed of omega-6 fatty acids. This disbalances the ratio of omega-6 fatty acid versus omega-3 fatty acids. This is typical for all the processed foods, but also fast food places in the industrialized world. The consequence of this disbalance is the formation of arachidonic acid and inflammation of tissues. This causes high blood pressure from inflammation of the arteries, arthritis from inflammation in the joints and can irritate the immune system to the point of causing autoimmune diseases. The end result after decades of exposure to a surplus of omega-6 fatty acids are disabilities from end stage arthritis, as well as heart attacks and strokes from inflammation of the arteries due to the hardening of the arteries.

The remedy for this is to cut out all processed food and stick to the basics of preparing your own food from healthy ingredients with no food preservatives.

Use olive oil for salads and coconut oil for cooking. Take omega-3 supplements to restore the omega-6/omega-3 fatty acid balance.

  1. Replace hormones with bioidentical ones

When I watch postmenopausal women, many look prematurely aged with sagging skin in their faces. Had they replaced their missing hormones when they entered menopause, the bioidentical hormones used for replacement therapy would have helped their skin to remain younger looking, hardening of the arteries would have been postponed and osteoporosis in the bones would also have been prevented.

With men it is now known that testosterone is vital for prevention of prostate cancer, but it is also important to prevent heart attacks, strokes and dementia as they age.

I would recommend that you see a naturopath or an anti-aging physician to have your hormones checked and if necessary start replacement with bioidentical hormones.

Ageless Aging

Ageless Aging

Conclusion

Slowing down aging and avoiding disabilities from aging are now a possibility, if we manage our lives in a way that the biochemistry of our bodies remains the same and our mitochondria continue to function, even when we get older. I discussed the details of how to do that above. I have also written a book on the subject of anti-aging, which deals with these topics in more detail.

I hope that you incorporate at least some of these steps in your life to prevent suffering from disabilities as you age and to avoid premature aging.

References:

Ref.1: Ronald Klatz, MD, DO and Robert Goldman, MD, PhD, DO, FAASP, Executive Editors: “Encyclopedia of Clinical Anti-Aging Medicine & Regenerative Biomedical Technologies”. American Academy of Anti-Aging Medicine, Chicago, IL, USA, 2012.

Apr
19
2014

Measuring Your Heart Function

By | Anti-aging medicine, Fitness, heart attack, Heart Disease, Nutrition, Prevention, Stroke

Recently I came across a book by Dr. Steven Masley, cardiologist (fellow of the American Heart Association, see Ref.1). The heart’s function is to pump your blood reliably all your life. It is a complicated organ, but it works well, if we treat it well. Western medicine has taught us that with complicated machinery and tests we can assess how the heart is doing. But until recently there was no reliable easier way to assess our cardiac health function. The purpose of this blog is to summarize a three-pronged approach to measure your heart and blood vessel health. It is described in detail in Ref.1, but I doubt that many people have yet read this important reference book. It is also important to FIRST see your doctor whether you are able to do the Bruce protocol (treadmill test, the third component below). If you neglect to be cleared by your doctor you run the risk of possibly getting angina pains or getting a heart attack.

1. Carotid IMT or carotid intimal-medial thickness test: You measure the degree to which there is hardening of the coronary arteries indirectly by measuring the thickness of the lining of the carotid arteries (carotid IMT or carotid intimal-medial thickness test). Dr. Masley has showed over a period of 10 years and more in many patients at his Health Center that there is a close correlation between the degree of coronary artery hardening and the degree of hardening of the carotid arteries. He stated that his research has shown that “90% of the time, the carotid arteries, the coronary arteries, and even the arteries of your legs all grow plaque at the same time”. The gold standard for checking the condition of your coronary arteries is a heart catheterization as Dr. Masley explains (page 58). But he adds: “IMT testing should be the new gold standard for cardiovascular plaque testing. However, this is not yet the case. Despite its usefulness, 95% of doctors are not ordering this screening test for their patients. You can rest assured that this is a situation I am to change“.

Measuring Your Heart Function

Measuring Your Heart Function

2. A detailed lipid analysis called the VAP test: A detailed laboratory test analyzing your lipid fractions (LDL, HDL, total cholesterol and VAP test). The buoyant HDL fraction, called HDL2 is the key to having a low risk for hardening of the arteries. HDL2 is large, fluffy and is designed to remove garbage from within the lining of the arteries. Also, the cholesterol ratio is another measurement for a low risk for hardening of the arteries when it is less than 3.0. The first two tests assess how much hardening of the arteries there is present and when they are normal, there is a relative reassurance that nothing drastic (like a heart attack or stroke) should happen within the next 10 years provided you keep up a regular exercise program and healthy food intake.

3. Bruce protocol (Treadmill test): The Bruce protocol (treadmill test) is often done by a cardiologists, but can also be done through many gyms, where a trainer with experience in exercise physiology will do it. This functional test measuring cardiac output has been developed many decades back and has withstood the test of time. Here is an overview what this is. As the slope of a treadmill and the speed of the belt are increased, the heart needs to do more work to maintain blood flow to your extremities and vital organs. The trainer or exercise physiologist measures the response of the heart activity in relation to the increase of the exercise load. A complicated formula allows calculating how much your maximal cardiac output is. This test has several variations and can be complicated to understand. Essentially, the higher the numbers you can create, the better. Here is a table with various results of the VaO2max from Bruce protocols and how they are interpreted.

4. Treating abnormalities found with the three basic tests: These are the necessary tools that tell you where you are in regard to your heart function. People with heart failure should not do this third test, because their heart muscle is too weak to sustain this and they would get heart failure meaning that blood gets backed up into the lungs and there could be severe breathing problems leading to a lack of oxygen (anoxia) in the heart tissue, which in turn can cause irregular heart beats (fibrillation of the heart muscle) and a heart attack. Assume that the first two tests were within the normal limit for your age, then the Bruce protocol would give you the maximum heart output at the peak level of your treadmill test. At this point you are measuring directly the cardiac output (in other words what your heart is capable of pumping for you in a certain time unit). This measurement is what physicians call the VaO2 max  or maximal oxygen consumption. This is the best index for maximal heart capacity. If your levels are higher than normal, you have extra reserves with respect to your heart as a pump for times when you need it. If this latter tolerance test shows poor results, it usually means that you were inactive and you would benefit from an exercise program. If the first test shows hardening of the arteries more than is appropriate for your age, you would need to look at your eating habits. At the same time often the VAT values and the cholesterol ratio is off meaning that you are eating the wrong foods and it shows in your blood test results.

5. Advise regarding diet, exercise and relaxation: Dr. Masley’s book has several sections that explain what needs to be done when things are not normal. For instance, the author does not mince words when it comes to eating the right fats and cutting out sugar and starchy foods. For instance on page 199 there is a neat table that lists the fiber content of different foods. We need more fiber to slow down the absorption of sugary substances, which will minimize the insulin response following a meal. Dr. Masley also mentions that omega-3-fatty acids from fish and good seafood choices will balance the omega-6-fatty acids that would lead towards the arachidonic acid pathway, which causes arthritis, inflammation and cancer. There are many more dietary recommendations, too numerous to repeat them all here. Suffice it to say that molecularly distilled omega-3 fish oil, vitamin D 1,500 to 3000 Units daily, and magnesium supplements are all good for you heart. Vitamin K2 gets calcium out of your blood vessels and into the bone (100 micrograms per day). Other worthwhile supplements mentioned in the book are CoQ-10 (50 to 200 mg twice per day), but it would be wise to have blood levels drawn, which should be above 2.5mcg/ml to which the CoQ-10 intake could be titrated. Curcumin and Resveratrol are also recommended. Most of all, it seems that regular physical exercise such as a balanced gym program is the single most effective way to reverse hardening of the arteries as measured by the carotid IMT testing.

Conclusion: Times have changed. It used to be thought that our lives were following a one-way street downwards. During periods of malnutrition, lack of exercise, being sessile and abusing alcohol and drugs this may well be the case. However, we now know that this is reversible. Change to healthier food, start smoothies with organic vegetables in a mixer, get going and walk. Jog or use a gym to get regular exercise. Physical exercise reverses the fat deposits inside the lining of the arteries. The HDL-2 fraction rises and helps counteract the elevated LDL cholesterol. Even the mood of the person who exercises regularly becomes more stabilized. Using these simpler three tests the physicians will not need the more complicated Thallium heart scans, heart catheterization etc. These three tests described above are well worth being done every two years, so that you can monitor what’s going on with your heart and blood vessels in general. What questions do you have? You could ask them below.

More information on heart disease: http://nethealthbook.com/cardiovascular-disease/heart-disease/

References: 1. Dr. Steven Masley, MD: “The 30-day Heart Tune-Up – A Breakthrough Medical Plan to Prevent and Reverse Heart Disease”, Center Street, A Division of Hachette Book Group Inc. New York, Boston, Nashville, USA © 2014.

Last edited Nov. 8, 2014

Jan
18
2014

The Superpowers Of Vitamin D

By | Alzheimer’s disease, Arthritis, Asthma, Autism, Cancer, fractures, heart attack, Heart Disease, High Blood Pressure, Infectious Disease, Infertility, Medical Condition, Multiple sclerosis, Nutrition, Osteoporosis, Other neurological conditions, Prevention, Vitamins and supplements

Introduction

This article deals with the superpowers of vitamin D. Originally, researchers found that vitamin D was the missing ingredient in preventing rickets in growing children. They established that 400 IU of vitamin D daily prevented rickets. Medical investigators determined that the active metabolite was vitamin D. The body has receptors on all vital organs for vitamin D. This includes the heart, brain, bones, kidneys and liver. In recent years new findings showed that the RDA of 400 IU of vitamin D3 daily was too low for many diseases. In other words, many diseases can develop when vitamin D intake is too low, particularly in the aging population. Researchers showed that higher doses of vitamin D3 in the range of 800 to 1000 IU per day prevent osteoporosis, falls and fractures in older adults and in nursing home populations.

The immune system requires higher doses of vitamin D3

But the immune system of everybody is dependent on higher doses of vitamin D3. Recently (Dec. 12 to 15, 2013) I attended a lecture at the A4M conference in Las Vegas where Dr. Eisenstein reviewed the latest on vitamin D3. It is now known that 2/3 of the US population is deficient for vitamin D as measured by blood tests (less than 25 ng/ml).  The standard test is the 25-hydroxy-vitamin D level (abbreviated as 25(OH)D level). It is now known that you require at least a level of more than 40 to 60 ng/ml of 25(OH)D as measured in the US, which translates to more than 100 to 150 nmol/L measured in metric units in other countries, to prevent cancer.

The Super Powers Of Vitamin D

The Super Powers Of Vitamin D

Metabolism of vitamin D3

90% of the vitamin D3 that we need comes from exposure to sunlight. This transforms a cholesterol metabolite (7-dehydrocholesterol) into the vitamin D precursor (vitamin D3 or cholecalciferol). We absorb this from naturally occurring fish oil and oily fish. Otherwise this does not naturally occur in foodstuffs (Ref. 1). Dr. Eisenstein pointed out that it is well known that people living north of the 37th degree latitude lack vitamin D3 because of a lack of sun exposure, particularly in the winter season. People south of the 37th degree latitude have enough sun exposure. But wherever you live, it is advisable to have your vitamin D3 level measured (as 25(OH)D level). If you do not eat enough fish or fish oil, the levels likely are too low as is the case for 2/3 of the US population.

Oral vitamin D3 supplements

Patients whose vitamin D levels are too low have to take vitamin D3 supplements. Vitamin D3 is further metabolized by the liver and then by the kidneys into the active vitamin D compound, called 1,25(OH)2D3 (which is called “calcitriol”). The main effect of calcitriol is to absorb calcium and phosphate from the intestine into the blood stream. Together with vitamin K2 as explained in a prior blog these minerals are then taken up by the bone to prevent osteoporosis or rickets in the growing child. What has not been known for a long time is that vitamin D3 is also necessary for normal cell metabolism by most of your body cells, but particularly by the vital organs like the brain, the heart, the kidneys, the liver, the immune system and the bone.

Some people require higher doses of vitamin D3

However, doses of 5000 IU to 10,000 IU of vitamin D3 capsules per day are necessary for optimal vitamin D3 health. This leads to levels of below 150 ng/ml of 25(OH)D levels, which were shown by researchers to be safe. According to Dr. Eisenstein no toxicity has been found below 30,000 IU of vitamin D3 per day, but based on other authors a dose of 10,000IU should be adequate for most people. Strangely enough colored people also have to take vitamin D3 supplements as the higher melanin pigment in the skin filters out UV light so effectively that their 25(OH)D level can be low. Always err on the cautious side and have your vitamin D3 blood level taken. Vitamin D3 has a characteristic stereotactic configuration (cis-triene structure), which allows it to bind free radicals and function as an antioxidant (Ref.2).

What are some of the clinical effects of vitamin D3?

  1. Vitamin D3 has diverse effects on organs systems as Dr. Eisenstein summarized: vitamin D3 lifts depression and is of particular value for drug resistant depression. Take 5000 to 10,000 IU of vitamin D3 per day.
  2. Muscle power increases with vitamin D3, particularly in those who work out regularly.
  3. Many fertility clinics pay attention to vitamin D3 levels, as the higher the blood levels of vitamin D3 in a man, the faster this sperms move! And the more vitamin D3 she has on board, the better she ovulates. The end result is a higher pregnancy success rate when both partners take 5000 to 10,000 IU of vitamin D3 per day

Vitamin D improves teeth in offspring, helps with chronic pain

  1. Also, if a woman takes vitamin D3 during her pregnancy, the first set of teeth in the offspring will have fewer cavities.
  2. Brain development in autistic children is much improved with vitamin D3 in higher doses. This needs to be combined with detoxification methods and supervised by one of the DAN physicians.

6.Chronic pain typically improves when physicians treat vitamin D3 deficiency, which almost always is present in patients with chronic pain.

Prevention of flus and Covid-19, asthmatics improve

  1. To prevent flus and colds and other infectious diseases, take higher doses of vitamin D3. When you come down with a flu, it is safe to increase your daily vitamin D3 intake to 30,000 IU of vitamin D3 for a few days until your symptoms improve, then resume your maintenance dose of 5000 IU to 10,000 IU per day.  This year’s dominant flu is the type A, subtype H1N1 – also known as the swine flu. Children should get 50% of the dose regimen detailed for adults when they develop a flu (for children: 15,000IU for three to five days , with tapering to a maintenance dose of 2500 to 5000 IU until blood levels of 25(OH)D are available). Here is a website about the pros and cons of vitamin D where dosages are also discussed.
  2. Asthmatic patients do better with vitamin D3 supplements requiring less maintenance anti-asthmatic medicine to keep them balanced with regard to their airways.

Partial prevention of Alzheimer’s disease with vitamin D

  1. Chronic low vitamin D3 levels cause brain damage including Alzheimer’s disease. In this context it is important to know that the enzymatic conversion in the liver and kidneys slow down as we age.  Older patients require higher doses of vitamin D3. This may have been the reason for the confusion about relatively low doses of 400 IU of vitamin D3 preventing rickets in children versus the need for much higher doses of vitamin D3 in middle aged and older patients.
  2. There is a link of high blood pressure to vitamin D3 deficiency and it is better manageable with medication when vitamin D3 levels are normal.

Vitamin D lengthens telomeres and increases longevity

  1. Live longer with vitamin D3. How is this possible, you might ask: the answer has been found in the telomeres, the shoelace like structures at the end of the DNA strand of each cell. Vitamin D3 lengthens the telomeres and promotes telomere repair; there is an association of vitamin D3 and a longer life span. Centenarians have longer telomeres. You can measure telomere length, but it is a pricey test, which is not for everyone, contrary to supplementation with vitamin D3 that should be taken by everyone!

Vitamin D fights inflammation

  1. As already indicated, vitamin D3 strengthens the immune system. But it also modulates the inflammatory response from muscle damage, so athletes can perform better. Patients with multiple sclerosis will improve as it slows down the inflammatory process. But other inflammatory diseases like arthritis, inflammatory bowel disease and even cancer respond favorably to higher doses of vitamin D3. In these cases physicians use 20,000 to 30,000 IU of vitamin D3 daily. This information has not yet percolated into mainstream medicine.
  2. Higher percentages of cardiovascular disease occur in patients who have lower than 15 ng/ml  25-Hydroxy-vitamin D levels in their blood meaning that vitamin D3 supplementation prevents heart disease (Ref.3).

What are toxic vitamin D levels?

What is known about the safety of vitamin D3, particularly the higher vitamin D3 doses? First, it is wise to have your 25(OH)D blood levels taken from time to time. If vitamin D blood levels exceed 150 ng/mL reducing the vitamin D dose or stopping supplementation is prudent. Otherwise it has been difficult to establish a toxic range. Most publications about toxic levels of  vitamin D point out that anything above 150 ng/mL would be in the toxic range.

This website claims that 40,000 IU of vitamin D3 or more would lead to toxic levels where the blood calcium levels would be increased, which can be measured as hypercalcemia. However, another study done in 2007 showed in MS patients that took 40,000 IU per day and that led to a blood level of 400 ng/ml of 25(OH)D did not lead to increased calcium levels and did not lead to hypercalciuria (too much calcium in the urine).

Toxic vitamin D levels difficult to find

The papers that indicated that it would be unsafe or unnecessary to take vitamin D3 were untrue. It seems that they had other agendas than communicating the truth. There was no release of calcium from the bones and calcium absorption from the gut was not too high. This would have caused calcification of the bones, soft tissues, heart and kidneys. Also, kidney stones would have developed. However, a low calcium diet combined with corticosteroid drugs usually leads to a full recovery within a month. Interesting that all of the dire predictions regarding toxic vitamin D3 levels did not materialize. Here is another website discussing vitamin D3 dosing.

Patient taking unintentional high doses of vitamin D3 survived

I talked to a participant of the conference with a fellowship degree in anti-aging medicine what knowledge we have about vitamin D3 toxicity. He told me that there has been an unintentional overdose. In this case a compounding pharmacy made a mistake. A patient accidentally received a dosage of 500,000 Units of vitamin D3 per day for a full three months. The patient felt sluggish, but did not have any other symptoms. His physician told him to stop the vitamin D3 compound. He had an uneventful recovery with no detrimental effects. At this point no documented overdose of vitamin D3 exists.

Conclusion

Vitamin D3 is a vital supplement. Initially researchers showed that it prevents rickets in children. Subsequently physicians found that it also prevents depression, MS, infections and many cancers (Ref. 4). As usual there will be many critiques that doubt the validity of the above statements. But I have found that all of these effects described above were confirmed in several sources of various medical information. Keep in mind that negative rumours have a tendency to linger on for years.

More information on vitamin D3 for prevention of osteoporosis and hardening of arteries: https://www.askdrray.com/calcium-vitamin-d3-and-vitamin-k2-needed-for-bone-health/

Vitamin D3 deficiency can cause pancreatic cancer: http://nethealthbook.com/news/insufficient-vitamin-d3-linked-to-pancreatic-cancer/

References

1. McPherson: Henry’s Clinical Diagnosis and Management by Laboratory Methods, 22nd ed.,  © 2011 Saunders

2. Rheumatic Diseases Clinics of North America – Volume 38, Issue 1 (February 2012) , © 2012 W. B. Saunders Company

3. Wang TJ, Pencina MJ, Booth SL, et al:  Vitamin D deficiency and risk of  cardiovascular disease.   Circulation 117. (4): 503-511.2008.

4. “Recognition and Management of Vitamin D Deficiency”: American Family Physician – Volume 80, Issue 8 (October 2009),  © 2009 American Academy of Family Physicians

Dec
07
2013

Slow Down Aging And Prevent Disabilities

By | Alzheimer’s disease, Anti-aging medicine, Arthritis, Cancer, Diabetes, Fitness, Health, Heart Disease, Hormones, Nutrition, Obesity, Other neurological conditions, Prevention, Stress management, Weight loss

You have seen it many times before: a man or a woman retires at age 65; for a while you see them around at social functions; then they are not seen any more and they return in a wheel chair only to die prematurely. You ask yourself: what can I do better to avoid this death trap?

There are several aspects to this equation: first, we would like to slow down the aging process. Part of this is to retain our physical functioning. In the following I am discussing the ingredients that are necessary to achieve the goal of aging in dignity, but avoiding disability.

It starts with a healthy mind set

You need to be optimistic and have a mindset of believing in yourself that you can do it. With a negative attitude, you will manage to find something to complain about, no matter how perfect the day has been. Negative thinking is rampant, and depression tends to be higher in the older population. If you suffer from depression or you had negative events such as accidents or abuse in the past, it is important to do some house cleaning. Do not be hesitant seeking professional help and counseling from a health professional to help you build up your self-esteem.

Regular exercise is important

A regular exercise program helps you to get your day organized. If you think that you are too busy to find the time to exercise, you are sacrificing your wellness and in fact you sabotage your health. It’s time to rethink your lifestyle! The reason you need exercise is to set the automatic pilot on staying healthy and active. If you are accustomed to sitting down in front of the computer or television set for hours, your muscles do not get the exercise they need. Fast-forward several decades and you will be one of those who rely on walkers, wheel chairs and assisted living establishments. Without training your muscles you are more prone to falls and injuries. Your balance organ is not getting the impulses it needs on an ongoing basis to prevent you from falls later in life. People in their 80’s are often stable up to the point where they trip and fall. I have seen many patients like this arrive in an ambulance where I was doing my shift as the emergency physician in a community hospital. When I summarize the fate of all of the people in their 80’s who had falls and broke their hips over the years, 50% of them made it through the surgery and went back home (often with a walker or in a wheel chair) or ended up in a nursing home; the other 50% died from complications of the surgery, often from heart attacks during the surgery or from clots in their pelvic veins or in the leg veins that dislodged and turned into pulmonary emboli. A fracture and in particular a hip fracture in your 80’s is a serious, potentially deadly accident. So, you need strong muscles and joints and you need strong bones. All of this comes free to you from years of regular exercise in your 60’s and 70’s.

Slow Down Aging And Prevent Disabilities

Slow Down Aging And Prevent Disabilities

You guessed right: good nutrition is important!

Eat right and your body will function right. This is where a lot of people are sent on the wrong path due to clever advertising from the Agro Industry, Big Pharma, the American Dietetic Association and the United States Department Of Agriculture. So they preach that wheat and wheat products are good for you, but the lab tests show that it induces hyperinsulinemia and leads to diabetes. The genetic changes of wheat (“accomplished” through forced chemical hybridization in the 1970’s) are responsible for the metabolically very active wheat belly (accumulation of visceral fat) that Ref. 1 has described in detail. But others have researched this topic as well. Ref. 2 for instance confirms that gliadin, the glue in wheat, which allows dough to stick and makes it easy to create bread, bagels and pasta, is responsible for neurological issues like numbness of fingers and feet (peripheral neuropathy), balance problems and cognitive decline all the way to Alzheimer’s disease. If you continue to eat wheat and wheat products (all contained in conveniently packaged “processed” foods), you may very well find that your balance and muscle control will deteriorate by the time you are in your eighties. This condition is not new: one of the lecturers I listened to at McMaster University in Hamilton, Ontario in 1977 referred to those unfortunate individuals who were severely disabled as the “tea and toasters”. The tea in this case was probably the lesser evil, but the wheat induced malabsorption and malnutrition was a reality already in the mid and late 1970’s.

However, if you start eating organic foods to avoid the chemicals and estrogen-like xenoestrogens from pesticides, and you cut out sugar, high-density carbs and wheat products, you will no longer have problems with weight control and you will maintain your muscle, brain and nerve function. This is not what you learn from the regular agencies mentioned at the beginning of this paragraph, but Ref. 1 and 2 will fill you in on the details. Essentially, I follow a Mediterranean diet without sugar, starchy foods and wheat or wheat products. Ref. 2 stressed the importance of enough saturated and healthy fat (omega-3 fatty acid rich oils) in a balanced diet consisting of 20% protein and low carbs. No specific numbers were given regarding the %-age of fat. I would say that a limit of about 25 to 35% for fat would be reasonable except for the Inuit who are used to a fat content in their diet of 80%. The new thinking is that healthy fats are good for your brain and heart. Healthy fats are omega-3 fatty acids (EPA and DHA) derived from fish oil as they are very protective (anti-inflammatory) oils, so is olive oil and coconut oil. These latter two are anti-inflammatory monounsaturated fatty acids. Keep in mind that you want to change the ratio of omega-3 to omega-6 fatty acids (the ratio in this link is cited as omega-6 to omega-3) more in the direction of omega-3 fatty acids, so that the ratio will be between 1:1 and 1:3. Most Americans are exposed to ratios of 1:8 to 1:16 (too many omega-6 fatty acids in fast food and processed foods), which leads to inflammation of the arteries as well. Omega-6 fatty acids, found in safflower oil, sun flower oil, grape seed oil and canola oil are bad for you when not balanced by enough omega-3’s (flax seed oil and fish oil) as they lead to inflammation through the arachidonic acid system in the body. It may be a surprise to you that saturated fats are OK: animal fat like butter, lard, cream, ghee (clarified butter), and other animal fats provided they come from clean (not antibiotic or bovine growth hormone treated) animals. Buy organic and buy organic meats as well such as grass fed beef and bison, chicken and turkey.

Here is an example of what a day would look like nutritionally in terms of a breakfast, lunch and dinner (recipes by Christina Schilling):

Breakfast:  Great Greens Omelet

(2 servings)

1 tablespoon olive oil or coconut oil

3 chopped green onions

3 cups spinach leaves or a mix of greens: kale, spinach, Swiss chard

1 red pepper cut into strips

3 eggs and 3 egg whites

2 tablespoons grated Parmigiano

In non-stick pan sauté green onion, greens and pepper strips in oil, stir eggs and egg whites and pour over the vegetables, sprinkle with Parmigiano. Cook on medium heat, till the egg mixture has started to set. Turn over and briefly let cook. Remove from pan, divide into two portions and sprinkle with a bit of salt (optional). Serve with salsa and guacamole.

Lunch: Oriental Salad

(2 portions)

1 small Sui choy cabbage (Napa cabbage)

2 cups mung bean sprouts

1 small daikon radish, shredded to yield 1 cup

1 red pepper, cut into thin slices

3 green onions, chopped

1 medium sized carrot, cut into matchstick size pieces

1 can sliced water chestnuts, rinsed.

Dressing: 2 tablespoons sesame oil,

2 tablespoons rice vinegar,(light balsamic vinegar works too)

1-tablespoon tamari soy sauce

1 tablespoon Thai sweet chilli sauce

1-teaspoon fresh grated ginger

3 tablespoons chopped fresh cilantro

Prepare all vegetables and put into salad bowl. Stir all dressing ingredients together and pour over vegetable mix. Stir gently, cover and refrigerate. This salad can be consumed immediately or kept refrigerted for a day. To complete the salad with a protein portion add your choice of 6 oz. cooked shrimp or the same quantity of cubed or sliced grilled chicken.

Dinner:  Florentine Chicken

(2 servings)

1 large boneless chicken breast

1 tablespoon of chopped fresh basil-alternatively use 1 teaspoon dried basil.

1 tablespoon grated Parmigiano

4 thin slices prosciutto

1 tablespoon olive oil

2 tomatoes- cut into halves

3 chopped green onions

2 cups baby spinach leaves

pinch of salt

Spread chicken breast flat and top it with the basil, Parmigiano and prosciutto slices. Fold into half an hold the stuffed chicken breast together at the edges with a toothpick or two. Heat olive oil in frying pan, add onion and tomato slices and put the chicken breast on top. Put lid on the pan, and cook at medium heat till the chicken is cooked through. If you test with a fork, the juices will be clear. Remove vegetables and chicken from pan, put on serving plate and keep warm. Remove toothpicks from meat, and cut chicken breast into two portions. Put spinach into pan and let the leaves wilt at medium heat (cover with lid). Put spinach on the side of the chicken and tomatoes, and sprinkle with a bit of salt.

Dessert after dinner: Berry Sorbet

(2 servings)

2 cups of deep frozen berries (strawberries, blueberries or a berry mix, no sugar added)

¾ cup of organic yogourt or goat’s milk yogurt

a few drops of liquid stevia or small amount of powdered stevia-to taste.

Put into blender and process till smooth. You will have to open the blender jar to stir the contents in between. Serve with a dollop of whipped cream,  if desired.

What about the “slow down” of menopause and andropause?

It is a fact that as we age, our hormone glands do not produce as much hormones as when we were in our 20’s and 30’s. But if you find a health care provider who is interested in anti-aging medicine (there are about 26,000 physicians, chiropractors and naturopaths who are members in the A4M), your hormones can be measured accurately from saliva and blood tests. This will tell whether you are hypothyroid, deficient in sex hormones and whether you should be supplemented with the missing hormones in adequate doses through bio-identical hormones. For instance, women are often deficient in progesterone in menopause and men deficient in testosterone. Treatment needs persistence and patience, as it often takes months for the patient to feel better and up to 2 years, to find the exact balance for you where the hormones are re-balanced and your symptoms of tiredness, insomnia, hot flushes etc. disappear. All our body cells have hormone receptors that require stimulation for the cells to function normally. Your health professional needs to pay attention to this and not just treat your symptoms symptomatically. When your hormones are in balance and you take a few supplements, your bones will be strong (no osteoporosis), your brain will be clear, your hearing perfect, and your balance great. You will be much less likely in your eighties to fall and break a bone and your mind will be clear and sharp.

Stress management

As the baby boomers age, they need to be aware of the stress in their lives. You may have been accustomed to having lots of energy when you were in your child rearing years or in your active professional career. Often we do not even notice that there may be stress in our lives. But your adrenal glands know. This is really a subpart of what I said of hormones: they need to be in balance. But cortisol, which is produced in your adrenal glands, is different from the menopause/andropause hormones. Corticotrophin-releasing hormone (CRH) from the hypothalamus and adrenocorticotrophin hormone (ACTH) from the pituitary gland are the rulers of the adrenal glands. And it is how you handle stress when you are in your 40’s, 50’s and 60’s which will determine whether you come down with adrenal fatigue, various degrees of adrenal insufficiency or not. Ref. 3 is a whole book that deals with this topic. Here I like to mention only that the best test to diagnose adrenal problems is a four-point saliva hormone test for cortisol. You connect the four points and get a curve where the cortisol level is expressed as a function of time. If this curve is below the lower normal range, which the laboratory provides for you, you need to be managed by a knowledgeable health care professional in order to build up the reserves of your adrenal glands. Yoga, meditation, deep prayer, self-hypnosis and enough regular sleep are all proven methods to overcome any stress related issues. Sometimes more effort is needed to rebuild the adrenals by specific herbs or porcine adrenal gland cortex extracts. Your health care provider can tell you more regarding this.

Useful supplements

1. On March 17, 2013 I wrote in a blog about prevention of osteoporosis the following summary:

“The best combination is 1000 mg (or 1200 mg as per National Osteoporosis Foundation recommendation) of calcium per day together with 400 to 800 IU of vitamin D3 (for cancer prevention you may want to take 4000 IU to 5000 IU of vitamin D3 per day instead monitored by a 25-hydroxyvitamin D blood level test through your physician) and 100 micrograms of vitamin K2 (also called MK-7). In the age group above 50 missing hormones such as bioidentical testosterone in men and bioidentical progesterone/estrogen combinations in women should be given as well. This works best, if you also watch your weight, cut down your alcohol consumption to a minimum (or better cut alcohol out altogether), exercise regularly (this builds up bone and muscle strength) and stick to a balanced diet resembling a Mediterranean or zone type diet (low-glycemic,  low fat, wheat free and no sugar).” I would add in view of Ref. 1 and 2 that “low fat” should now be replaced by “balanced fat diet”. With this I mean that nuts, almonds, olive oil, unsalted butter are allowed within reason. Lately there have been new insights that some cholesterol is needed for normal hormone production. What needs to be cut out are omega-6 fats and trans fats.

2. Omega-3-fatty acid supplements from molecularly distilled fish oil at a good dosage (3 to 6 capsules a day) will prevent chronic inflammation that often causes arthritis. Chicken cartilage (UC-II) from the health food store will desensitize your system in case you have rheumatoid arthritis or osteoarthritis. This will prevent crippling arthritic disease down the road.

3. Mitochondrial aging (the mitochondria are the energy packages in each body cell) is slowed down by the two supplements ubiquinol (=Co-Q-10, take 400 mg per day) and 20 mg of PQQ (=Pyrroloquinoline quinone). Co-Q-10 repairs DNA damage to your mitochondria and PQQ stimulates your healthy mitochondria to multiply. Between the two supplements you will have more energy.

4. Vitamin C 1000 to 2000 mg per day and a multivitamin supplement help to support the rest of your metabolism. Some may want to add PS (Phosphatylserine) 100 to 200 mg per day, which works together with vitamin D3 for Alzheimer’s prevention.

Conclusion

By now you noticed that nothing comes from ignoring the fact that we are aging. We need to pay attention to our body functions and think about what we can do to make us stronger. In the end we are our own caregivers. When we are in our eighties, we should still be active and our brains should function with a lot more experience than in our past. Our bones will be strong and our balance should prevent us from falling. I do not want to use assisted living and I do not like the confinement of a wheel chair. In the meantime I am going to carry on dancing.

More information on:

1. Fitness: http://nethealthbook.com/health-nutrition-and-fitness/fitness/

2. Nutrition: http://nethealthbook.com/health-nutrition-and-fitness/nutrition/

3. Vitamins, minerals and supplements: http://nethealthbook.com/health-nutrition-and-fitness/nutrition/vitamins-minerals-supplements/

References

1. William Davis, MD: “Wheat Belly. Lose the Wheat, Lose the Weight, and Find Your Path Back to Health”. HarperCollins Publishers LTD., Toronto, Canada, 2011.

2. David Perlmutter, MD: “Grain Brain. The Surprising Truth About Wheat, Carbs, And Sugar-Your Brain’s Silent Killers.” Little, Brown and Company, New York, 2013.

3. James L. Wilson, ND, DC, PhD: “Adrenal Fatigue, the 21sty Century Stress Syndrome – what is it and how you can recover”; Second printing 2002 by Smart Publications, Petaluma, Ca, USA

Last edited Nov. 7, 2014

Mar
17
2013

Calcium, Vitamin D3 and Vitamin K2 Are Needed For Bone Health

By | Fitness, fractures, Hormones, Osteoporosis, Prevention, Vitamins and supplements

Introduction

I am reviewing in this blog why calcium, vitamin D3 and vitamin K2 are needed for bone health. Recently there has been a lot of coverage in the press regarding postmenopausal treatment of women to prevent osteoporosis. It is all based on this original publication February 26, 2013.

Essentially, there are a number of studies where researchers did a meta-analysis of several trials. They studied osteoporotic bone fracture frequency in female subjects taking 400 IU vitamin D and 1000 mg calcium daily. The researchers measured the frequency of osteoporotic fractures as the indicator  for osteoporosis in these postmenopausal women. The conclusion was that there was no value in taking these supplements to prevent osteoporosis. Many other media publications carried this story.

No kidney stones in study with calcium and vitamin D3

Just two days earlier (Feb. 24, 2013) another study was released with a much larger patient base of 36,282 postmenopausal women of the Women’s Health initiative in the US who were followed up for 7 years. Initially there confusion how compliant the patients were taking their supplements. The required supplementation consisted of 1000 mg of calcium carbonate and 400 IU of vitamin D3. 7 years into the trial the researchers compared the supplement compliant group with the control group taking placebos.

Calcium and vitamin D3 supplementation significantly reduces risk of hip fractures

The study group had 35% to 38% less fractures of the hip than the placebo group. This supplementation did not cause kidney stones in the study group. This was in contrast to what previous smaller studies showed. Some physicians insisted citing the older studies that vitamin D3 and calcium supplementation would cause kidney stones. But the above study refutes the causation of kidney stones by supplementing with vitamin D3 and calcium. In other words, all of these kidney stone concern you have so often read in the media are not true.

Outline of this review

In order to make sense of supplementation as osteoporosis prevention I will first review what a normal bone metabolism requires.  I will then comment on what is missing in some of the studies and why it still makes sense to supplement to prevent osteoporosis. In addition, at the end of this blog I will also recommend a sensible supplementation regimen.  All this is based on a balanced review of the medical literature.

Calcium, Vitamin D3 and Vitamin K2 Needed For Bone Health

Calcium, Vitamin D3 and Vitamin K2 Needed For Bone Health

Bone metabolism

But vitamin D3, vitamin K2 and strontium together have also been shown to build up bone density within one year.

So, how does vitamin K2 deposit calcium into the bone? Vitamin K2 stimulates a hormone, called calcitonin, which is produced by specialized C cells (parafollicular cells) inside the thyroid gland and released into the bloodstream. Calcitonin arrives in the bone where it binds firmly with receptors of osteoclasts (bone remodeling cells), which stops breakdown of bone. Calcitonin is helped by another hormone, called osteocalcin, which is produced by the bone producing cells with the name osteoblasts.

Vitamin K2 controls osteocalcin, which is a calcium-regulating hormone

The physician can measure osteocalcin levels in the blood and use this as a research tool to see whether a medication is effective in building up bone mass density (BMD). Vitamin K2 control osteocalcin as a calcium-regulating hormone. If vitamin K2 is present, carboxylation of osteocalcin will lead to mineralization of the bone (new bone formation); if vitamin K2 is absent, osteoporosis sets in.

The skeleton of an average adult contains 1–1.3 kg of calcium and 99% of this is mostly in the form of hydroxyapatite.

The key vitamins for bone metabolism are vitamin D and vitamin K2

Calcium absorption from the small intestine requires vitamin D3 (Ref.1). To transport calcium from the blood into the bone we require both vitamin D3 and vitamin K2 (=menaquinone). This blog explains that several studies have shown that vitamin K2 (or MK-7) plays a double role of preventing calcification of the arteries and bringing the calcium into the bones of osteoporotic women.

Apart from Vitamin K2 that is necessary for osteoporosis prevention other factors have shown to be of importance. For instance, testosterone is an anabolic hormone (meaning a hormone that builds up) and it has clearly been shown that it is bone building: It does so by stimulating osteoblasts, which are bone producing cells that reside inside the bone.

Vitamin D3, vitamin K2, Calcitonin and osteocalcin

But vitamin D3, vitamin K2 and strontium together have also been shown to build up bone density within one year.

So, how does vitamin K2 deposit calcium into the bone? It does so by stimulating a hormone, called calcitonin, which is produced by specialized C cells (parafollicular cells) inside the thyroid gland and released into the blood stream. Calcitonin arrives in the bone where it binds firmly with receptors of osteoclasts (bone remodeling cells), which stops breakdown of bone. Calcitonin is helped by another hormone, called osteocalcin, which is produced by the bone producing cells with the name osteoblasts.

Vitamin K2 controls osteocalcin, which is a calcium-regulating hormone

Osteocalcin levels in the blood can be measured and used as a research tool to see whether a medication is effective in building up bone mass density (BMD). Vitamin K2 controls osteocalcin as a calcium-regulating hormone. If vitamin K2 is present, carboxylation of osteocalcin will lead to mineralization of the bone (new bone formation); if vitamin K2 is absent, osteoporosis sets in.

Vitamin K2 also prevents heart attacks and strokes

Vitamin K2 has a second function: it removes calcium from the arterial walls and tissues. How does it do this?

Matrix GLA protein is found in tissues of the heart, lungs, kidneys and blood vessels. When vitamin K2 stimulates carboxylation of this protein, it will function like a broom and clean out calcium deposits (calcification) from blood vessels and organ tissues. As vitamin K2 is needed for this carboxylation process, it appears that nature had in mind to remove calcium from soft tissue organs and blood vessels and form hydroxyapatite in the bone for bone strength.

Vitamin K2 is the key to deposit calcium into the bone

It seems that vitamin K2 is the key vitamin necessary to do this job. Another player is magnesium, which is part of of the normal function of more than 300 cellular enzyme systems. In terms of hormones the three hormones parathyroid hormone (PTH), vitamin D3 and calcitonin need to interact normally, all requiring magnesium as cofactor. In addition, zinc, copper, boron, and manganese are also essential as trace minerals. They act as cofactors with regard to specific enzymes of the bone metabolism (Ref. 1).

Bioidentical hormone replacement essential after menopause and andropause

In the aging person hormonal deficiencies are also factors for causing osteoporosis to develop. As this link shows, Dr. John Lee found bioidentical progesterone topical cream very helpful in women with respect to increasing bone mass density by 15% over 3 years.

When bloods tests show testosterone depletion men need to replace what is missing with bioidentical testosterone. So, bioidentical hormone replacement in both men and women is part of a bone health management program to prevent osteoporosis.

Some trials that demonstrate how you can build up bone

  • In this paper parathyroid hormone  was used in combination with 1000 mg of calcium and 400 IU of vitamin D3 in a group of postmenopausal women with osteoporosis. Within 3 month of treatment there was an increase of bone mass density in the lower back (lumbar spine) of 4.7%, which translates into a yearly increase of bone mass density of 18.8%. In the past when physicians tested other agents for bone regeneration, this type of result never occurred. There is a  variation of this hormone,  a parathyroid hormone look-alike with the name Teriparatide (PTH 1-34). The patient administers this once daily as an injection of 20 mcg up to 2 years. Physicians found this useful in treating fractures of the vertebrae and other fractures in osteoporotic postmenopausal women (Ref.2).

Effect of Vitamin K2, estrogen and calcium citrate supplementation

Calcitonin and calcium strontium

  • Calcitonin is very effective in reducing bone pain when the patient has compression fractures from osteoporosis; the physician can prescribe it as an intranasal spray of 200 units daily (Ref. 2). However, on March 5, 2013 the FDA announced that salmon calcitonin would not be safe for humans as there is a slight risk that cancer can develop as a “side-effect”.
  • According to Ref. 2 physicians sometimes use strontium ranelate in Europe for the treatment of postmenopausal osteoporosis. Researcher showed that strontium ranelate builds up bone and decreases the amount of bone resorption. Side effects include nausea and diarrhea.

The team players of bone metabolism to build strong bone

We are now in a position to analyze why the researchers of the first paper (citation above) concluded that calcium and vitamin D3 supplementation were not enough to make a statistical difference in the treatment of postmenopausal women in comparison to placebos. As explained bone metabolism is a complex process involving several team players, where the key player is vitamin K2, which the researchers of that study ignored completely. The examples I mentioned above in point form show that exercise and calcium are also important. Vitamin K2 by itself worked quite well as it is so powerful. Hormones like PTH and calcitonin are effective, but more difficult to take for the average consumer and the FDA now has banned calcitonin.

Importance of vitamin D3 as a supplement

Vitamin D3 is important for absorption of calcium from the intestine, but also for depositing calcium into the bone in addition to vitamin K2. The WHI study mentioned above is highly significant because of a 1/3 reduction of hip fractures after 7 years of vitamin D3 and 1000 mg of calcium per day supplementation. If you add vitamin K2, exercise and bioidentical hormone replacement in postmenopausal women who need it, the prevention of hip fractures, wrist fractures and vertebral compression fractures likely will be as high as 50% in those who are taking their supplements regularly (compliance issues like forgetting the supplements or deliberately not taking them were mentioned in several of the studies).

Vitamin K2 helps to reduce heart attacks, strokes and osteoporosis

With the right supplementation, which includes vitamin K2 as mentioned above, you achieve that you lower your heart attack and stroke risk as the vitamin K2 removes the calcium from the blood vessels and deposits it into the bones, while at the same time strengthening your bones. Attention to proper nutrition, exercise and your hormone balance (using only bio-identical hormones to replace what’s missing) will also reinforce osteoporosis prevention. The bonus of using bioidentical hormone replacement therapy is that you prevent heart attacks and strokes in addition to preventing osteoporosis. I think that this is a good deal!

An easy-to-follow osteoporosis prevention program

The best combination is 1000 mg (or 1200 mg as per National Osteoporosis Foundation recommendation) of calcium per day together with 400 to 800 IU of vitamin D3 (for cancer prevention you may want to take 4000 IU to 5000 IU of vitamin D3 per day instead monitored by a 25-hydroxyvitamin D blood level test through your physician) and 100 to 200 micrograms of vitamin K2 (also called MK-7). In the age group above 50 several hormones can be missing.

Hormone depletion in menopause and andropause

That’s why the doctor recommends bioidentical testosterone in men and bioidentical progesterone/estrogen combinations in women with hormone depletion. This works best, if you also watch your weight and cut down your alcohol consumption to a minimum. Cutting alcohol out completely would be even better. In addition, exercise regularly as this builds up bone and muscle strength.  It also helps, if you stick to a balanced diet (Mediterranean or Zone type diet). These diets are low-glycemic, low fat, wheat free and without sugar).

If you want to age gracefully, you need not only a healthy heart and a healthy brain. You also need healthy bones as this prevents disabilities.

References

  1. McPherson: Henry’s Clinical Diagnosis and Management by Laboratory Methods, 22nd ed. Copyright © 2011 Saunders, An Imprint of Elsevier
  2. Rakel: Integrative Medicine, 3rd ed. Copyright © 2012 Saunders, An Imprint of Elsevier

————————————————————————————-

I received the following feedback (Originally on Nov. 10, 2013)

 Dr. Ray, I read your March 17 Blog entry which suggested 100 ug of Vitamin K2 with 5000 IU of D3.   I have atherosclerosis and have radically changed my diet (plant only), but also now take an average of about 3000 IU of Vitamin D3. Dr. Kate Rhéaume-Bleue (book on K2) recommended taking about 200 ug per day of K2, but increasing K2 to about 1,000 ug if taking around 5,000 IU of D3 to ensure proper activation of MGP. What is your opinion with regard to a D3/K2 ration?  Thank you

 Answer from Dr. Ray (Originally on Nov. 12, 2013, modified April 29, 2021)

I appreciate your question about what doses of vitamin K2 to take. There are varied recommendations, but I like to go by human trials and what they have actually shown. In this review in 2010 from the Life Extension Magazine a study is cited that showed that only 45 micrograms of vitamin K2 was enough to get the calcium out of the arterial walls and into the bones.

200 micrograms of Vitamin K2 daily

Dr. Mercola reviewed the literature and found that most investigators were now using 180 to 200 micrograms. In the past I took 100 micrograms of vitamin K2 per day. However, a few years ago I increased it to 200 micrograms per day. With regard to vitamin D3 absorption my anti-aging doctor found that I have an absorption problem regarding vitamin D3. This is why I need 10,000 IU of vitamin D3 daily. This brings my vitamin D blood level up into the high normal range (between 50 and 80 ng/mL). Toxic vitamin D blood levels start only above 150 ng/mL.

Avoid sugar and too much starch consumption

Remember that other risks for cardiovascular disease are sugar and starch consumption. The liver turns this into triglycerides and too much LDL cholesterol, which plugs up your arteries. Avoid wheat because of the gliadin content. This causes an addiction to wheat and sugary foods. Here is a summary how leaky gut syndrome and autoimmune illnesses may develop from this. If you want to consume beef, reduce your consumption to once or twice per week. It id best to stick to only eat grass fed, antibiotic free beef). But I rather prefer to eat organic chicken, turkey and lean pork. I understand that you have a plant only based diet, but I would recommend to you to reconsider that. Ask your doctor to check your ferritin from time to time. This way you do not miss an iron deficiency that may develop. For other readers: Don’t forget your vegetables (organic, please).

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