Medical Chronicle May 2017 | Page 33

CLINICAL OSTEOPOROSIS CPD When taking vitamin D, the body creates more of the vitamin K2-dependent proteins, which move calcium around mutated in Parkinson's disease that affects mitochondrial function. We found that vitamin K(2) was necessary and sufficient to transfer electrons in Drosophila mitochondria. Heix mutants showed severe mitochondrial defects that were rescued by vitamin K(2), and, similar to ubiquinone, vitamin K(2) transferred electrons in Drosophila mitochondria, resulting in more efficient adenosine triphosphate (ATP) production. Thus, mitochondrial dysfunction was rescued by vitamin K(2) that serves as a mitochondrial electron carrier, helping to maintain normal ATP production." People diagnosed with osteoporosis tend to have lower blood levels of vitamin D than other healthy people of their age. The body needs vitamin D to fully absorb calcium. There is some evidence that getting enough vitamin D will help bones stay more dense compared to not getting enough vitamin D. The people most likely to benefit from taking vitamin D supplements to prevent a broken bone are frail, older people, living in institutions. Some researchers believe that to help treat and manage osteoporosis and prevent broken bones, it may be necessary to take both calcium and vitamin D supplements together. VITAMIN K2 DEFICIENCY There's no way to test for vitamin K2 deficiency. But by assessing diet and lifestyle, one can get an idea of whether or not patients may be lacking in this critical nutrient. If patients have any of the following health conditions, they’re likely deficient in vitamin K2 as they are all connected to K2: • Osteoporosis • Heart disease • Diabetes. If patients do not have any of those health conditions, but do not regularly eat high amounts of the following foods, then the likelihood of being vitamin K2 deficient is still very high: • Grass-fed organic animal products (i.e. eggs, butter, dairy) • Certain fermented foods such as natto, or vegetables fermented using a starter culture of vitamin K2- producing bacteria. Please note that most fermented vegetables are not really high in vitamin K2 and come in at about 50mcg per serving. However, if specific starter cultures are used they can have ten times as much, or 500 mcg per serving • Certain cheeses such as Brie and Gouda (these two are particularly high in K2) Note that not every strain of bacteria makes K2. For example, most yoghurts have almost no vitamin K2. Certain types of cheeses are very high in K2, and others are not. It really depends on the specific bacteria. THE INTERPLAY BETWEEN VITAMINS K2, D AND CALCIUM Vitamin D is a critical nutrient for optimal health and is best obtained from sun exposure. However, many are taking oral vitamin D, which may become problematic unless patients are also getting sufficient amounts of vitamin K2. When taking vitamin D, the body creates more of the vitamin K2-dependent proteins, which move calcium around. Until the K2 comes in to activate those proteins, the benefits aren't realised. Taking vitamin D creates an increased demand for K2. Vitamins D and K2 work together to strengthen bones and improve your heart health. More studies are coming out showing that increased calcium intake is causing more heart attacks and strokes. That created a lot of confusion around whether calcium is safe or not. But that's the wrong question to be asking, because we'll never properly understand the health benefits of calcium or vitamin D, unless we take into consideration K2, which keeps the calcium in its right place. Those taking oral vitamin D need to also consume in their food or take supplemental vitamin K2. While the ideal or optimal ratios between vitamin D and vitamin K2 have yet to be elucidated, 150-200 micrograms of K2 will meet the need for the average healthy person. No toxic effects of K2 have been demonstrated in the medical literature. Vitamin K2 activates K2 proteins. CALCIUM Calcium plays a crucial role in all kinds of biological processes. Many high calcium foods also contain naturally high amounts of vitamin K2. Nature cleverly gives us these two nutrients in combination, so they work optimally. Good sources of calcium include dairy, especially cheeses, and vegetables. Magnesium will help keep calcium in the cell to do its job far better. Those who choose to supplement with calcium, it’s important to maintain the proper balance between your intake of calcium and other nutrients such as: • Vitamin K2 • Vitamin D • Magnesium. References available on request. CPD questionnaire on pg 58. Complete online: www.medicalchronicle.co.za/the-right-vitamins-for-osteoporosis/ MEDICAL CHRONICLE | MAY 2017 33