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Reminder that taking Vitamin D in excess without having enough Vitamin K could lead to vascular calcification, whereas sufficient levels of Vitamin K promotes p

Reminder that taking Vitamin D in excess without having enough Vitamin K could lead to vascular calcification, whereas sufficient levels of Vitamin K promotes proper absorption of calcium into bones. Vitamin K supplementation for the primary prevention of osteoporotic fractures: is it cost-effective and is future research warranted? https://pubmed.ncbi.nlm.nih.gov/22398856/ https://pubmed.ncbi.nlm.nih.gov/22398856/ Matrix Gla protein is an independent predictor of both intimal and medial vascular calcification in chronic kidney disease https://www.nature.com/articles/s41598-020-63013-8 https://www.nature.com/articles/s41598-020-63013-8 Matrix Gla protein https://en.wikipedia.org/wiki/Matrix_Gla_protein https://en.wikipedia.org/wiki/Matrix_Gla_protein

cies 3y ago
I like to refer to Greger (a meta-study researcher in nutrition field): https://nutritionfacts.org/video/the-purported-benefits-of-vitamin-k2-should-you-take-supplements/ https://nutritionfacts.org/video/the-purported-benefits-of-v... His conclusion on VitK: eat your greens.
sBqQu3U0wH 3y ago
Recent studies suggest that taking vitamin K supplements does not help to prevent calcium build up in heart valve. https://www.heart.org/en/news/2022/04/25/despite-hopes-vitamin-k2-supplements-fail-to-slow-calcium-buildup-in-heart-valve https://www.heart.org/en/news/2022/04/25/despite-hopes-vitam...
- snapplebobapple 3y ago
  I don't believe they controlled for vitamin D status. The line has always been you need k and d in sufficient levels to get calcium to the right place so I'm not surprised that one or the other causes problems (although I do really want to see someone redo this with people with clinically validated moderate vitamin d levels).
  - codersfocus 3y ago
    The linked article states they prescribed both vit d and k.
    - snapplebobapple 3y ago
      That's not the same as controlling for vitamin d because people's blood levels vary wildly even with supplementation. To control for vitamin d level you would need to blood test for it and supplement until the blood level is between 20 ng/ml and 50 ng/ml, ideally around 30. Depending on how they were supplementing blood levels could be way too low still (especially for obese people) or way too high with likely different effects on the outcome here.
- raylad 3y ago
  The dosage of vitamin K was probably much too low. In Japan K2 is dosed at 45mg (not mcg) per day, which was found to be the minimum effective dose for osteoporosis. A reasonable dose for coronary calcium is probably at least 5mg or more, a far higher dose than the 750mcg they used in the study. References: https://pubmed.ncbi.nlm.nih.gov/24841104/ https://pubmed.ncbi.nlm.nih.gov/24841104/ https://pubmed.ncbi.nlm.nih.gov/11886767/ https://pubmed.ncbi.nlm.nih.gov/11886767/
flenserboy 3y ago
Don't forget magnesium.
- pazimzadeh 3y ago
  but not the diuretic kind
- 1970-01-01 3y ago
  Mg is better migraine medicine than actual headache medicine. Try it next time you feel one. :)
- canucker2016 3y ago
  from https://pubmed.ncbi.nlm.nih.gov/28471760/ https://pubmed.ncbi.nlm.nih.gov/28471760/: Background: ... Majority of the adults are deficient in both vitamin D and magnesium but continue to go unrecognized by many health care professionals. Conclusions: Vitamin D screening assay is readily available, but the reported lower limit of the normal range is totally inadequate for disease prevention. Based on the epidemiologic studies, ∼75% of all adults worldwide have serum 25(OH)D levels of <30 ng/mL. Because of the recent increase in global awareness, vitamin D supplementation has become a common practice, but Mg deficiency still remains unaddressed. Screening for chronic magnesium deficiency is difficult because a normal serum level may still be associated with moderate to severe deficiency. To date, there is no simple and accurate laboratory test to determine the total body magnesium status in humans. Mg is essential in the metabolism of vitamin D, and taking large doses of vitamin D can induce severe depletion of Mg. Adequate magnesium supplementation should be considered as an important aspect of vitamin D therapy.
mtalantikite 3y ago
What's considered excess for Vitamin D?
- jodrellblank 3y ago
  UK NHS page says: "If you choose to take vitamin D supplements, 10 micrograms a day will be enough for most people." "Do not take more than 100 micrograms (4,000 IU) of vitamin D a day as it could be harmful. This applies to adults, including pregnant and breastfeeding women and the elderly, and children aged 11 to 17 years." https://www.nhs.uk/conditions/vitamins-and-minerals/vitamin-d/ https://www.nhs.uk/conditions/vitamins-and-minerals/vitamin-...
  - Aerroon 3y ago
    The problem with vitamin D is that there's a lot of wrong information. It's because of this[0]: >A statistical error in the estimation of the recommended dietary allowance (RDA) for vitamin D was recently discovered; in a correct analysis of the data used by the Institute of Medicine, it was found that 8895 IU/d was needed for 97.5% of individuals to achieve values ≥50 nmol/L. Another study confirmed that 6201 IU/d was needed to achieve 75 nmol/L and 9122 IU/d was needed to reach 100 nmol/L. >The largest meta-analysis ever conducted of studies published between 1966 and 2013 showed that 25-hydroxyvitamin D levels <75 nmol/L may be too low for safety and associated with higher all-cause mortality 10 mcg = 400 IU. It's based on the previous (erroneous) daily recommended intake of 20 mcg per day. Also, if you look at how much vitamin D you get from sunlight then [1]: >A minimum erythema dose (1 MED) amounts to about 30 minutes midsummer midday sun exposure in Oslo (=20 mJ/cm2). Such an exposure given to the whole skin surface is equivalent to taking between 10,000 and 20,000 IU vitamin D orally, i.e. as much as 250-500 μg vitamin D, a similar amount as that obtained when consuming 200-375 mL of cod liver oil It makes me wonder if health authorities use a dart board to set recommended amounts for vitamins. But hey, at least they're finally changing things and 4000 IU (100 mcg) seems reasonable. I'm just wondering how they justified keeping recommendations at 10-20 mcg a day when the sunlight study says you can get 250-500 mcg in 30 minutes. Edit: I believe it's 30 minutes of midday sun. You're going to get a lot less vitamin D at other times of the day. [0] https://pubmed.ncbi.nlm.nih.gov/28768407 https://pubmed.ncbi.nlm.nih.gov/28768407 [1] https://pubmed.ncbi.nlm.nih.gov/19667143/ https://pubmed.ncbi.nlm.nih.gov/19667143/
PragmaticPulp 3y ago
Fitness influencers and podcasters took the Vitamin D story and ran with it to extremes. The number of people who think more is better with vitamin D or assume that their levels are severely low without checking is scary. Taking a nominal amount of Vitamin D is probably a good idea for those of us who spend a lot of time indoors. Taking 10s of thousands of IUs every day for years is probably a bad idea for anyone who isn’t regularly checking their Vitamin D levels.
- cmcaleer 3y ago
  > Taking 10s of thousands of IUs every day for years is probably a bad idea for anyone who isn’t regularly checking their Vitamin D levels. This extreme is obviously bad but if you spend most of your time indoors and you're located somewhere that doesn't get much sun without government fortifying your food with vit D (like some Scandi countries do), I don't see the harm in taking somewhere around low 1000sIU per day.
  - SOLAR_FIELDS 3y ago
    I’m indoors most of the time (previous skin cancer so I’m really careful about sun exposure these days) and I’ve been on 5000 IU daily for years and my levels show up basically perfect on the blood test every year
    - ikekkdcjkfke 3y ago
      "The average content of vitamin D 3 found in wild caught salmon was 988 ± 524 (mean ± SEM) IU of vitamin D 3 /3.5 oz which is a typical amount that is served for dinner (Table) In contrast, farmed salmon had approximately 25% of the vitamin D content present in the flesh of wild salmon" And everyone knows that a fish meal that size doesn't satisfy all the way to bed time. So you can imagine a hunter gatherer running around eating a ton of fish, berries etc. and how many IU's that would be
generalizations 3y ago
Eh. I know one of the researchers whose name is on one of those Vitamin D studies. Their recommendation to me was 5000IU daily. I think there's a lot of caveats to what you're saying, and the benefits outweigh the risks.
adrian_b 3y ago
Unfortunately I have not seen any study that has been conceived in such a way that could allow to determine whether supplements with vitamin K2 are useful or not. It is known with certainty that humans convert a part of the ingested vitamin K1 into vitamin K2. While there have been many studies that have shown beneficial effects of supplements with vitamin K2, none of them have used a correct control group. A deficiency in vitamin K2 can have two causes, either the capacity of a human body to produce vitamin K2 is not enough to cover the necessary amount of it, or the daily intake of vitamin K1 has been too low. In order to distinguish the two causes, the control group, which does not take vitamin K2 supplements, must have a much greater daily intake of vitamin K1, perhaps 10 times or 20 times greater. It is possible that the relationship between vitamin K1 and vitamin K2 is like between beta carotene and vitamin A, where, with a high enough daily intake of beta carotene, vitamin A is no longer needed, because the body can produce enough of it. Unlike for beta carotene, we do not know yet whether there is a threshold of daily intake of vitamin K1 above which there is no need of vitamin K2 supplements. It would be important to know this for sure, because vitamin K1 is extremely abundant in many green vegetables and it would be simple to reach very high daily intakes without any nutritional supplements.

cies 3y ago

I like to refer to Greger (a meta-study researcher in nutrition field): https://nutritionfacts.org/video/the-purported-benefits-of-vitamin-k2-should-you-take-supplements/ https://nutritionfacts.org/video/the-purported-benefits-of-v... His conclusion on VitK: eat your greens.

sBqQu3U0wH 3y ago

Recent studies suggest that taking vitamin K supplements does not help to prevent calcium build up in heart valve. https://www.heart.org/en/news/2022/04/25/despite-hopes-vitamin-k2-supplements-fail-to-slow-calcium-buildup-in-heart-valve https://www.heart.org/en/news/2022/04/25/despite-hopes-vitam...

snapplebobapple 3y ago
I don't believe they controlled for vitamin D status. The line has always been you need k and d in sufficient levels to get calcium to the right place so I'm not surprised that one or the other causes problems (although I do really want to see someone redo this with people with clinically validated moderate vitamin d levels).
- codersfocus 3y ago
  The linked article states they prescribed both vit d and k.
  - snapplebobapple 3y ago
    That's not the same as controlling for vitamin d because people's blood levels vary wildly even with supplementation. To control for vitamin d level you would need to blood test for it and supplement until the blood level is between 20 ng/ml and 50 ng/ml, ideally around 30. Depending on how they were supplementing blood levels could be way too low still (especially for obese people) or way too high with likely different effects on the outcome here.
raylad 3y ago
The dosage of vitamin K was probably much too low. In Japan K2 is dosed at 45mg (not mcg) per day, which was found to be the minimum effective dose for osteoporosis. A reasonable dose for coronary calcium is probably at least 5mg or more, a far higher dose than the 750mcg they used in the study. References: https://pubmed.ncbi.nlm.nih.gov/24841104/ https://pubmed.ncbi.nlm.nih.gov/24841104/ https://pubmed.ncbi.nlm.nih.gov/11886767/ https://pubmed.ncbi.nlm.nih.gov/11886767/

flenserboy 3y ago

Don't forget magnesium.

pazimzadeh 3y ago
but not the diuretic kind
1970-01-01 3y ago
Mg is better migraine medicine than actual headache medicine. Try it next time you feel one. :)
canucker2016 3y ago
from https://pubmed.ncbi.nlm.nih.gov/28471760/ https://pubmed.ncbi.nlm.nih.gov/28471760/: Background: ... Majority of the adults are deficient in both vitamin D and magnesium but continue to go unrecognized by many health care professionals. Conclusions: Vitamin D screening assay is readily available, but the reported lower limit of the normal range is totally inadequate for disease prevention. Based on the epidemiologic studies, ∼75% of all adults worldwide have serum 25(OH)D levels of <30 ng/mL. Because of the recent increase in global awareness, vitamin D supplementation has become a common practice, but Mg deficiency still remains unaddressed. Screening for chronic magnesium deficiency is difficult because a normal serum level may still be associated with moderate to severe deficiency. To date, there is no simple and accurate laboratory test to determine the total body magnesium status in humans. Mg is essential in the metabolism of vitamin D, and taking large doses of vitamin D can induce severe depletion of Mg. Adequate magnesium supplementation should be considered as an important aspect of vitamin D therapy.

mtalantikite 3y ago

What's considered excess for Vitamin D?

jodrellblank 3y ago
UK NHS page says: "If you choose to take vitamin D supplements, 10 micrograms a day will be enough for most people." "Do not take more than 100 micrograms (4,000 IU) of vitamin D a day as it could be harmful. This applies to adults, including pregnant and breastfeeding women and the elderly, and children aged 11 to 17 years." https://www.nhs.uk/conditions/vitamins-and-minerals/vitamin-d/ https://www.nhs.uk/conditions/vitamins-and-minerals/vitamin-...
- Aerroon 3y ago
  The problem with vitamin D is that there's a lot of wrong information. It's because of this[0]: >A statistical error in the estimation of the recommended dietary allowance (RDA) for vitamin D was recently discovered; in a correct analysis of the data used by the Institute of Medicine, it was found that 8895 IU/d was needed for 97.5% of individuals to achieve values ≥50 nmol/L. Another study confirmed that 6201 IU/d was needed to achieve 75 nmol/L and 9122 IU/d was needed to reach 100 nmol/L. >The largest meta-analysis ever conducted of studies published between 1966 and 2013 showed that 25-hydroxyvitamin D levels <75 nmol/L may be too low for safety and associated with higher all-cause mortality 10 mcg = 400 IU. It's based on the previous (erroneous) daily recommended intake of 20 mcg per day. Also, if you look at how much vitamin D you get from sunlight then [1]: >A minimum erythema dose (1 MED) amounts to about 30 minutes midsummer midday sun exposure in Oslo (=20 mJ/cm2). Such an exposure given to the whole skin surface is equivalent to taking between 10,000 and 20,000 IU vitamin D orally, i.e. as much as 250-500 μg vitamin D, a similar amount as that obtained when consuming 200-375 mL of cod liver oil It makes me wonder if health authorities use a dart board to set recommended amounts for vitamins. But hey, at least they're finally changing things and 4000 IU (100 mcg) seems reasonable. I'm just wondering how they justified keeping recommendations at 10-20 mcg a day when the sunlight study says you can get 250-500 mcg in 30 minutes. Edit: I believe it's 30 minutes of midday sun. You're going to get a lot less vitamin D at other times of the day. [0] https://pubmed.ncbi.nlm.nih.gov/28768407 https://pubmed.ncbi.nlm.nih.gov/28768407 [1] https://pubmed.ncbi.nlm.nih.gov/19667143/ https://pubmed.ncbi.nlm.nih.gov/19667143/

PragmaticPulp 3y ago

Fitness influencers and podcasters took the Vitamin D story and ran with it to extremes. The number of people who think more is better with vitamin D or assume that their levels are severely low without checking is scary. Taking a nominal amount of Vitamin D is probably a good idea for those of us who spend a lot of time indoors. Taking 10s of thousands of IUs every day for years is probably a bad idea for anyone who isn’t regularly checking their Vitamin D levels.

cmcaleer 3y ago
> Taking 10s of thousands of IUs every day for years is probably a bad idea for anyone who isn’t regularly checking their Vitamin D levels. This extreme is obviously bad but if you spend most of your time indoors and you're located somewhere that doesn't get much sun without government fortifying your food with vit D (like some Scandi countries do), I don't see the harm in taking somewhere around low 1000sIU per day.
- SOLAR_FIELDS 3y ago
  I’m indoors most of the time (previous skin cancer so I’m really careful about sun exposure these days) and I’ve been on 5000 IU daily for years and my levels show up basically perfect on the blood test every year
  - ikekkdcjkfke 3y ago
    "The average content of vitamin D 3 found in wild caught salmon was 988 ± 524 (mean ± SEM) IU of vitamin D 3 /3.5 oz which is a typical amount that is served for dinner (Table) In contrast, farmed salmon had approximately 25% of the vitamin D content present in the flesh of wild salmon" And everyone knows that a fish meal that size doesn't satisfy all the way to bed time. So you can imagine a hunter gatherer running around eating a ton of fish, berries etc. and how many IU's that would be

generalizations 3y ago

Eh. I know one of the researchers whose name is on one of those Vitamin D studies. Their recommendation to me was 5000IU daily. I think there's a lot of caveats to what you're saying, and the benefits outweigh the risks.

adrian_b 3y ago

Unfortunately I have not seen any study that has been conceived in such a way that could allow to determine whether supplements with vitamin K2 are useful or not. It is known with certainty that humans convert a part of the ingested vitamin K1 into vitamin K2. While there have been many studies that have shown beneficial effects of supplements with vitamin K2, none of them have used a correct control group. A deficiency in vitamin K2 can have two causes, either the capacity of a human body to produce vitamin K2 is not enough to cover the necessary amount of it, or the daily intake of vitamin K1 has been too low. In order to distinguish the two causes, the control group, which does not take vitamin K2 supplements, must have a much greater daily intake of vitamin K1, perhaps 10 times or 20 times greater. It is possible that the relationship between vitamin K1 and vitamin K2 is like between beta carotene and vitamin A, where, with a high enough daily intake of beta carotene, vitamin A is no longer needed, because the body can produce enough of it. Unlike for beta carotene, we do not know yet whether there is a threshold of daily intake of vitamin K1 above which there is no need of vitamin K2 supplements. It would be important to know this for sure, because vitamin K1 is extremely abundant in many green vegetables and it would be simple to reach very high daily intakes without any nutritional supplements.