Why should you take vitamin K2 with D3? (SQ-129)
When it comes to bone health, we all know what combination of supplements work best. You take vitamin D3 that helps you absorb calcium from your food and supplements. But did you know you should also take vitamin K2 with D3?
Nutrients do not work in isolation. They work together and this nutrient synergy is the foundation of a healthy diet. For example, you need vitamin C to absorb iron. Vitamins such as D, A and K need fat to be absorbed. Curcumin, one of the bioactive compounds in the spice turmeric, is absorbed better when you pair it up with black pepper. Vitamin B12 works best when combined with folate and B6. Similarly, you need magnesium so that your body is able to absorb and use vitamin D more effectively.
Why should I take vitamin K with vitamin D3? In this article, let’s explore the link between vitamin K2 with D3 and why should you absolutely take these two vitamins together.
Vitamin D3 and K2: What is the link?
Vitamin D helps absorb calcium, which you need to build strong bones and teeth. When your calcium intake is not sufficient, it can lead to reduced mineral density in bones, increasing the risk of osteoporosis and bone fractures.
In fact, calcium performs many other important functions in addition to maintaining a healthy skeleton. It helps the heart to beat regularly and maintain its rhythm. It is required for muscle contraction. Your nerve cells need calcium to send signals across the body. It is also required for blood clotting and secretion of hormones.
But you don’t want to end up with calcium in your soft tissues, where it can build up and cause calcification. Excessive accumulation of calcium in soft tissues like arteries can increase your risk of heart disease.
It is important to understand the risk of calcification does not occur because you are taking calcium supplements. It happens when calcium is not effectively absorbed, and when it is not shuttled to the places it belongs to. Your body maintains healthy calcium levels with the help of other nutrients such as vitamins D3 and K2, and of course magnesium.
Vitamin K is mostly known for its role in blood clotting. But it also plays an important role in bone and heart health. It is because vitamin K, more specifically vitamin K2, also activates other proteins that help in calcium metabolism.
“While vitamin D3 helps you absorb calcium, it is vitamin K2 that influences where this calcium goes. Low K2 status could mean calcium build-up in unwanted places.”
Vitamin K2 in bone health
Vitamin K2 activates osteocalcin, a protein that integrates calcium into bones and teeth.
Osteoblasts are cells that help in building of new bones. These cells secrete a protein called osteocalcin that bind to calcium in the bloodstream and deposit it in the bone, increasing mineral density. New research suggests that osteocalcin also works as a hormone that regulates glucose levels and may have a role to play in muscle health, brain development, cognition and even male fertility. 
Coming back to its role in building strong bones osteocalcin binds calcium to the bones. However, this protein needs vitamin K2 to be active and do its job. This is how vitamin K2 plays a key role in maintaining bone health and preventing the risk of fractures.
It is important to know that you need healthy levels of active osteocalcin in the blood. High levels don’t always indicate strong bones. Both too high and too low levels of osteocalcin can mean weak bones and a high risk of fractures.
Vitamin K2 in heart health
Since vitamin K2 regulates how your body uses calcium, its role in cardiovascular health can not be ignored. Let’s see how this works.
Vitamin K2 also activates Matrix Gla-protein (MGP), a protein that stops calcium from getting into soft tissues such as arteries, muscles, and kidneys. MGP is secreted by cartilage cells and cells of blood vessels. It is responsible for healthy contraction and dilation of blood vessels.
MGP has been recognized as one of the most important proteins that remove calcium from blood vessels and arteries. Calcification of blood vessels can give rise of a number of health complications, including heart disease and kidney disorders.
MGP cannot perform its function unless it is activated by vitamin K2. High levels of inactive MGP in the bloodstream is an indication of vitamin K deficiency.
Studies suggest that low levels of vitamin K is one of the risk factors for heart disease . Studies also indicate that vitamin K2 supplements may reduce this risk. For example, vitamin K2 can reduce the risk of calcification in the arteries and improve arterial stiffness in post-menopausal women.   
“Vitamin K2 tells your body where calcium goes. It activates proteins that not only ensure calcium is deposited in the bones where it is needed, but also prevents excessive calcium build-up in blood vessels and kidneys where it can cause damage.”
Why is vitamin D important?
What does vitamin D3 do? You need vitamin D to maintain healthy bones and prevent osteoporosis. But it is also important for your overall health. In fact, vitamin D plays a critical role in maintaining heart health and immunity.
Vitamin D regulates how your immune system works. On one hand, it boosts your natural immunity and helps the body fight bacterial and viral infections. On the other hand, it also prevents your immune system from becoming hyperactive and attacking the body’s own healthy cells – reducing the risk of auto-immune disorders.
Pregnant women need healthy vitamin D levels to support growth and development of the foetus. Vitamin D deficiency during pregnancy can increase the risk of asthma, allergies, and wheezing disorders in new-borns.
Health Benefits of Vitamin D3
- Supports formation of healthy bones and teeth
- Reduces risk of upper respiratory infections
- Reduces risk of autoimmune diseases
- Reduces risk and symptoms of asthma
- Reduces inflammation and protects heart health
- Maintains healthy pregnancy
- Supports fetal growth and development
Vitamin D3 Deficiency: Symptoms and Risk factors
Vitamin D deficiency is quite common. It is not easy to get your recommended dose of vitamin D3 through food alone. And while you can easily make enough vitamin D through sensible sun exposure, getting enough sun is a challenge.
Risk factors for developing vitamin D deficiency:
- Limited sun exposure
- Excessive use of sunscreen
- Dark skin
- Use of statins, drugs that lower cholesterol
- Liver and kidney disorders
- Strict vegetarian diet
- Magnesium deficiency
Signs of vitamin D deficiency
Achy joints, fatigue, and muscle pain are some of the most obvious signs of vitamin D deficiency.
Chronic long-term deficiency not only leads to weak bones that break easily but also increases your risk of developing several health conditions such as heart disease, dry eyes, asthma, allergies, respiratory infections, type 2 diabetes, depression, and autoimmune disorders.
Why do you need vitamin D3 supplements?
Fish, mushrooms, egg yolk and food products that are fortified with vitamin D3 are good dietary sources. But these foods do not provide enough vitamin D to maintain healthy levels. Your body can also make its own vitamin D when you expose your skin to sun, without sunscreen. Spending 15 to 20 minutes in the sun can help your body make a good amount of vitamin D. The best time is between 10.00 am to 3.00 pm as this is when the sun is high enough.
Your skin can make vitamin D only in the presence of UVB rays when the sun is higher than 45 degrees. A good rule of the thumb is: you are making vitamin D when your shadow is shorter than you are.
But if you can’t get enough sun, or if you take statins or have any condition that puts you at a risk of deficiency, a high quality vitamin D3 supplement is the best way to improve your levels and prevent deficiency and the associated risks.
“You need vitamin D3 for building strong bones and teeth. But it also plays a crucial role in maintaining overall health and most importantly in regulating immunity.”
Why is vitamin K important?
Vitamin K is a group of fat-soluble vitamins. Vitamin K1 (phylloquinone) and K2 (menaquinone) are two main vitamins in this group. So, what does vitamin K do for the body?
Both K vitamins are involved in activating proteins that help blood to clot. New-borns have extremely low levels of vitamin K in their body and this can lead to vitamin K deficiency bleeding or VKDB in new-borns. This life-threatening condition is prevented by giving new-borns a shot of vitamin K shortly after birth.
While both K1 and K2 help in blood clotting, these vitamins are absorbed differently and have different functions across the body. The vitamin K2 molecule is more stable than the K1 molecule and it stays in circulation longer. This gives tissues more time to absorb K2.
Over the years, scientists have uncovered the role of vitamin K2 in our overall health. It has been linked with many heath conditions such as osteoporosis, heart disease, rheumatoid arthritis, cancer and cognition. 
Health Benefits of Vitamin K2
Vitamin K2 is responsible for many important functions in the body.
- Regulates calcium metabolism
- Supports bone health, reduces risk of osteoporosis
- Supports heart health, reduces risk of heart disease
- Regulates sex hormones
- Regulates sugar and insulin levels
- Works as an anti-oxidant
Vitamin K2 Deficiency: Risk factors and Symptoms
Vitamin K1 is found in green leafy vegetables, fruits and grains; whereas vitamin K2 is found in fermented foods such as natto and sauerkraut.
In fact, natto – a Japanese dish made of fermented soyabeans – is one of the richest sources of vitamin k2. Specialty cheese like Gouda and Brie, and animal-based foods such as goose liver, eggs and dairy also contain a good amount of K2.
Vitamin K2 is also produced by gut bacteria. Some of the vitamin K1 is converted into K2 but this conversion is not considered to be very effective.
Risk factors for developing vitamin K2 deficiency:
- Poor intake of foods that contain vitamin K2
- Excessive use of blood-thinning drugs
- Frequent use of antibiotics that kill healthy bacteria, required for K2 production and absorption
- Absorption issues caused by health conditions such as celiac disease, Crohn’s disease, ulcerative colitis, and abdominal surgeries.
- Liver disease
- Use of statins, as these drugs block the production of vitamin K2 (and also other compounds such as CoQ10, vitamin D, and bile).
- Low fat diet
Signs of vitamin K2 deficiency
Unlike iron, B12 or D3 deficiency, vitamin K2 deficiency is not easy to pin down as it does not cause clear symptoms in the short-term. However, if left untreated, chronic deficiency can be detrimental to your health.
Low levels of vitamin K2 can lead to poor bone health, increasing the risk of osteoporosis and fractures. Low vitamin K2 status also affects heart health as it can lead to excessive calcification in the arteries. Studies show that vitamin K2 may help in reducing the risk of type 2 diabetes. It may also help in reducing the risk of complications that are commonly linked with diabetes such as heart disease, stiffness in arteries and weak bones.
Why do you need vitamin K2 supplements?
It is not difficult to get vitamin K1 through diet. It is commonly found in green leafy vegetables such as spinach, mustard greens, kale, broccoli and Brussel sprouts. But the modern diet typically lacks foods that are rich in vitamin K2, making vitamin K2 deficiency quite common. So, unless your diet contains fermented foods, chances are you will need vitamin K2 supplements to ward off deficiency.
Calcium, Vitamin D3 and Vitamin K2: Recipe for bone and heart health
If you are taking calcium and vitamin D3 supplements, make sure you are also taking vitamin K2. By maintaining a correct balance between calcium, vitamin D3 and K2, it is possible to reduce the risk of osteoporosis as well as prevent calcification and hardening of arteries.
Taking a high-quality liposomal vitamin D3+K2 supplement is a good option that enables your body to optimize how it uses calcium. And don’t forget your magnesium, as the mineral is required for absorbing and using vitamin D3.
Liposomal supplements increase the amount of nutrients that are available for cells to use. This technology prevents the loss and degradation of nutrients during digestion, leading to better bio-availability and absorption. So, it is a good idea to replace traditional supplements with the ones that use liposomal technology to deliver nutrients.
- Sarah C. Moser and Bram C. J. van der Eerden. Osteocalcin—A Versatile Bone-Derived Hormone. Front. Endocrinol., 10 January 2019
- Riphagen et al. Prevalence and Effects of Functional Vitamin K Insufficiency: The PREVEND Study. Nutrients 2017.
- Beulens et al. High dietary menaquinone intake is associated with reduced coronary calcification. Atherosclerosis. 2009
- Knapen et al. Menaquinone-7 supplementation improves arterial stiffness in healthy postmenopausal women. A double-blind randomised clinical trial. Thromb Haemost. 2015
- Mansour et al. Vitamin K2 supplementation and arterial stiffness among renal transplant recipients-a single-arm, single-center clinical trial. J Am Soc Hypertens. 2017
- Gerry Kurt Schwalfenberg. Vitamins K1 and K2: The Emerging Group of Vitamins Required for Human Health. J Nutr Metab. 2017