This goes way back and is one of the themes that set me up strong for the Paleo / Primal journey right off. I didn't even blog about it for months, because it seemed too obvious. I had to read up, and I had to think.
And then I did my first post about it, way back three years ago, October of 2008: Doubling of Vitamin D for Children Is Urged; I Also “Urge” K2, Menatetrenone (MK-4).
Back then, I wrote:
Now, think about this from an evolutionary perspective, prior to modern mass migration. Northern latitude: white skin. As you proceeed south, toward the equator, increasingly dark skin on average. Vitamin D is fat soluable, which means, it can build up. At certain high levels it can produce a toxic effect. Final piece of the puzzle: white skin absorbes UV and synthesizes vitamin D way faster than increasingly dark skin. So, natural selection being what it was, those able to make use of the far shorter summers and lower angle of exposure to sunlight (white skin) fared better in the harshness of life; whereas, those in the south where the sun is year-round -- and very high in the sky for efficient exposure -- fared better by having protection against too much (dark skin), with consequent toxicity.
That was in reference to "Vitamin D," of course (it's actually a prohormone). My perspective has changed, but only qualitatively...in that I have come to believe that the root of the problem is collectivized, socialist thinking. People of white skin and brown skin really are different in profound ways, just not in the ways political opportunists would have you believe (one way or another). They are physically different, obviously, but it's owing to evolution and migration that made it so and, it's really such a shame that so much of what was right in front of our faces, all along, was instead relegated to the province of politics and domination (I repeat myself, redundantly) and of how to assuage the hand wringing and fear of white folk over "them brown skins."
And all the human capital that has been spent on it, over the years. ...As an aside, as a young white boy waking up to the wonder of the female form, I could not help but adore those with brown skin the most, and that is how I have spent 95% of my sexual life from day 1. ...So there you go.
But this post is about vitamin K2 (menaquinone), and to emphasize: no, you cannot get this but by eating animals and their parts. What's more, evolution dealt us an awful blow: inasmuch as hunting and gathering was far more arduous than snagging a ribeye at the local grass fed (clap clap) merchant, you're still SOL. See, actual hunting for food over the millions of years before Whole Foods, had an evolutionary effect. People ate the whole thing. And guess where the most nutrient dense parts are: organs, marrow, brain.
Cruel. Ribeys and Filets are so easy and tasty.
But if you're Paleo, doing meat, fish, fowl, veggies and fruit to the exclusion of crap that had to be "fortified" (that's a fraud word, in the context) by law to make it slightly less crappy (cereals, etc.), because it was taking up nutritional space in the diet and people were coming down with obvious and easily identifiable nutritional diseases way back, then you're many, many steps ahead.
I think vitamin K2 is a very special substance that more than any other, deserves consideration as a supplement, by which I mean, irrespective of diet and in super-normal quantity. I think this because I have seen enough evidence to make me suspect that it can undo damage, particularly in the realm of calcification, one of the major causes of early death (atherosclerosis) or debilitating later years (osteoporosis).
And what the fuck else? You know what? I feel a bit of shame that I accepted the utter bullsit as a kid that "cavities" in my teeth, causing enormous pain as they did, over days, were just another normal part of "growing up."
Do animals in the wild writhe in pain over teeth carries?
Well, the punchline here is that someone finally wrote a book on Vitamin K2 and she happens to be a well respected naturopath in Canada, Dr. Kate Rhéaume-Bleue, BSc, ND. Yea, the "naturopath" thing is troublesome. It's almost as bad as a blogger...
To the left: Vitamin K2 and the Calcium Paradox: How a Little-Known Vitamin Could Save Your Life. I Kindled (new verb) the book Monday morning and spent much of the day skimming over it.
She hits all the main points so far as I can tell by the quick-over I gave it. I'll also be reading it intensely and will report back with anything I think isn't quite right, but I doubt that will happen.
It is of intense interest to me that in low carb and Paleo circles over the last couple of years, there is no end of info on vitamin D; and yet, I almost never hear anything about K2.
Enough of that stupid shit. K2 has an important role to play in the following:
- Heart health
- Plaque accumulation
- Reversing calcification (generally)
- Bone health
- Varicose veins
- Neurological disorders
- Kidney disease
- Facial and jaw development in utero
- Birth canal development in utero for eventual easy, natural labor
- Dental health
Sounds like a "super food," don't it? ...Only it doesn't grow on some obscure tree in the rain forrest unavailable to the vast majority of people who evolved over the last 4 million years. Nope. It has been available to everyone throughout our evolution. But you have to eat animals, and you have to eat the "nasty bits" to really cash in. Don't want to? Fine, supplement.
On that last point; that is: dental health, above...it was actually a dentist -- Weston A. Price (Nutrition and Physical Degeneration), back in the 20s & 30s -- who blazed the trail by traveling around the world to remote places out of contact with civilization, only to find generally pristine health and remarkably, a rate of tooth decay that was somewhere around one cavity or less per thousand teeth examined. This, in a time of his profession where dental carries were on the order of 1 in 3 teeth, and teenagers were being fitted for dentures.
And so don't you find it a bit interesting that prior to the 1920s, heart and cardiovascular disease were rare, almost unheard of? Was increasing alarm being sounded in the 1920s and 30s over tooth decay and heart attacks, with no one having a clue of the connection, and the trail went cold long ago?
What's the unifying mineral? Could it be calcium? Weak bones, insufficient facial and jaw development (causing breathing issues and teeth crowding), insufficient pelvic development in females (causing laborious childbirth)...while on the other hand, calcification of organs such as kidneys, and atherosclerosis, a huge killer.
It's a perfect storm and the only response has been the typical response. Somehow, we're different than all other animals on Earth and rather than stop for a second and realize that vital nutrition may be missing from our diet, we look to pharmaceutical companies to make...not billions, but trillions, over time...in a plethora of endeavors that never look to the root.
Let's take but one example from the book, heart disease.
Lots of lifestyle changes can help prevent heart disease (lose weight, cut your sugar intake, exercise), but can any substance remove calcium plaque once it has formed? Just one: vitamin K2. Studies show that adding menaquinone to the diet will activate MGP to reduce arterial calcium content by 50 percent over just a six-week period. This cardiovascular news just keeps getting better, since the same studies show that blood vessels are not irreparably damaged by the plaque, as you might expect. Apparently, vitamin K2 also helps restore arterial flexibility once the calcium has been removed (12). If you have a high coronary artery calcium score or elevated levels of inactive osteocalcin, take heart: vitamin K2 can help.
The coronary arteries aren't the only blood vessels in and around the heart that succumb to perilous calcification. Very seriously, plaque can build up in the aorta, the major blood vessel that carries fresh, oxygenated blood from the heart out to the body. This causes the aorta to become rigid and inflexible, increasing the risk for heart attack. Aortic stiffness also precedes kidney disease, an equally grave condition that is covered in the next chapter. Vitamin K2 is just as effective at removing calcium from the aorta as from the coronary arteries, as illustrated in the case of Sam K., a 69-year-old dentist with a heart murmur.
Sam's primary care physician detected the abnormal heart sound during a routine physical examination. He therefore had Sam undergo an echocardiogram, a simple test useful to evaluate disorders of the heart valves. The echocardiogram showed that Sam had aortic valve stenosis, a condition in which calcium and other material deposited on the aortic valve cause it to stiffen. A stiff aortic valve struggles to open with each heartbeat and can obstruct the blood output of the heart. This leads to chest pain, breathlessness, lightheadedness and heart failure. Although symptoms at first occur with vigorous physical activity, as the valve gets stiffer, symptoms occur with minimal physical provocation. The severity of aortic valve stenosis is gauged by measuring the effective area of the valve opening. Normal is 3.0 centimeters squared (about 1 1/2 inches squared); Sam's aortic valve area was reduced to 1.6 centimeters squared, about half of what is should have been.
Aortic valve stenosis is eventually fatal. For this reason, once it's identified, an echocardiogram is repeated every 6 to 12 months. When the valve opening is reduced to 1.0 centimeters squared or less and symptoms begin, aortic valve replacement is advised. This is an open-heart surgery, a major undertaking at any age. Because most people with aortic valve stenosis are in their 70s and 80s, an open-heart procedure carries substantial risk. Efforts have been made over the years to identify treatments that slow the progression of aortic valve disease. The only agent that has shown any effect in slowing aortic valve stenosis is high-dose Crestor, a potent cholesterol drug. The dose used in the study, 40 milligrams per day, carries crippling side effects for most people.
Sam had the good fortune of being referred to a forward-thinking cardiologist, Dr. William Davis, who, since 2006, had been advising patients to supplement vitamin D to prevent progression of aortic valve disease (13). Achieving a therapeutic blood level of vitamin D meant a dose of 8,000 international units per day for this average-sized man. The specialist found that high-dose vitamin D alone stopped the aortic valve area from shrinking in over 90 percent of his patients, although it did not reverse the existing disease.
Sam is a nutritional supplement enthusiast, so when his doctor told him about the benefits of vitamin D to aortic valve disease, he jumped on the idea. At the time, Sam's cardiologist also suspected that vitamin K2 supplementation would add an additional advantage. Among the observations that pointed toward vitamin K2 as a factor in aortic valve disease was that people who take the blood-thinning drug warfarin, or Coumadin — which induces both vitamin K1 (associated with blood thinning) and K2 (associated with calcium metabolism) deficiencies — experience gradual calcification and narrowing (stenosis) of their aortic valves. Because he loved the idea of applying nutritional supplements in a rational, targeted way, Sam added to his vitamin D supplementation 900 micrograms of the short-acting MK-4 form of K2 and 100 micrograms of the long-acting MK-7 form, along with 1,000 micrograms of K1, to cover all his vitamin K bases. In reality, the dose of MK-4 was not likely therapeutic and the K1 wasn't really necessary, but the 100 micrograms of MK-7 provided effective treatment.
Ten months later, another echocardiogram showed an aortic valve area of 2.9 centimeters squared—nearly doubling the valve area. The finding was so remarkable that Sam's doctor asked the echocardiography technician to confirm precisely what he had found. Yes indeed, by using a combination of vitamins D and K, Sam had managed to open up his valve to essentially a normal, healthy size.
12. Schurgers L. Regression of warfarin-induced medial elastocalcinosis by high intake of vitamin K in rats. Blood 2007 Apr, 109(7): 2823–31.
13. Clinical case courtesy of William Davis, MD, author of WheatBelly: Lose the Wheat, Lose the Weight and Find Your Path Back to Health, (New York: Rodale, 2011) and Track Your Plaque, 2nd ed. (New York: iUniverse, 2011).
As to reference 12, Dr. Stephan Guyenet blogged about that way back here, about three years ago. And I will respectfully dispute the idea that the MK-4 was not likely therapeutic. And for a simple reason: that's the subform you get from animal products. The MK-7 subform comes from bacterial fermentation in things like high quality cheeses and natto. Those were not available generally to evolutionary man. On the other hand, the MK-7 form has been shown beneficial, as I totally rant about in this post from early 2009. I think you try to get both; but if I had to choose, it would be the animal form, made by ruhminats for benefit of those who consume them.
I should draw this to a close, so let me begin that with another quote from the book:
Calcium is abundant in nature. It is the primary mineral in the sedimentary rock that covers up to 80 percent of the earth's surface, the rock that is the parent material to soil. Bones and teeth are our bodies' reservoir for calcium, holding up to 99 percent of the mineral in the human organism. Although bones have been likened to rock, really they are dynamic, living tissue that is capable of gaining and losing mineral density throughout life. Losing calcium from the skeleton compromises our health because it leads to bone fractures and opens an access route for bacteria in the mouth to reach the bloodstream. Calcium also paradoxically finds its way to places in the body that further endanger our health. In recent years, calcium has been added to everything from multivitamins to orange juice to pasta in an effort to stave off the massive trend toward osteoporosis. Controversial research shows that this practice is, in fact, condemning calcium-takers to death from heart attack as that added calcium lodges itself in our blood vessels instead of building our bones. Simply giving up added calcium isn't the answer. Whether or not you take calcium supplements and calcium-fortified foods, it's statistically likely that hardening of the arteries, porous bones or both will affect you. That's because the problem of calcium leaching from your skeleton and gathering in your arteries is not about calcium. It is about the fat-soluble vitamins that create and activate biological proteins that guide calcium into, around and out of the body. Even though all the fat-soluble vitamins have been known to scientists for more than 70 years, we have learned little about them until very recently. According to respected fat-soluble-vitamin researchers, this is at least partly due to financial incentive that diverts the focus of investigators toward proprietary analogs — artificial forms of vitamins that can be patented (1). K2 research in particular lagged behind because its sister molecule, K1, hogged the spotlight. The fascinating menaquinone discoveries made by Dr. Weston Price remained in obscurity for decades, since K2 goes by a pseudonym in his work. Whatever the reasons, we've got a lot of catching up to do. [Emphasis added]
1. Vieth R. The pharmacology of vitamin D, including fortification strategies. In Vitamin D, 2nd ed., Feldman D and Glorieux F (San Diego: Elsevier Academic Press, 2005) 995–1018.
Regarding the emphatic I added to that quote, it is a long time now I have been saying about k2: makes calcium go everyplace it should, i.e., bones and teeth, and no place it shouldn't, i.e., your arteries. You'll also want to be getting your vitamin A and D, as they all work in synergy, importantly.
And of course, I love all this because it makes total sense in an evolutionary context. Moreover, it makes vegetarians look shortsighted...and vegans look like absolute morons...and that's always a good thing.
Here's a search link to all of my Vitamin K2 posts over the years, emphasizing the MK-4 subform, menatetrenone.
In terms of when, what and how much supplementation? Participate in the comments.
Update: You might want to check out this recent post by Dr. Jack Kruse, a neurosurgeon, "OSTEOPOROSIS TWO: THE VITAMIN K2 STORY"