Dina, Vitalady, anyone else - can we talk about K2?

I'll send it to you, of course, but I doubt it is anything that you haven't already considered.

Perhaps not, but better safe than sorry :)

I remembered Kimberly inquiring about vitamin K (Koagulation is what the K stands for) awhile back and I provided info regarding the difference between vitamin K1 and vitamin K2 with detailed reasoning between the two.

Getting to the point and to the best that I can explain that can be easily understood, Vitamin K2 activates osteocalcin and in the body's use of calcium that is controlled by an amino acid called gamma carboxyglutamic acid (Gla) in which vitamin K1 can't help out or benefit, at all. It is this Gla that is one of the amino acids that makes up the bone protein that controls calcium absorption, and the vitamin works through this amino acid in a process known as carboxylation. Through carboxylation, proteins are able to hold on to calcium and incorporate it into the structure of the bone. If the protein does not have enough vitamin K2, it cannot bond to the calcium and then leaves the bones and wanders off to enter the soft tissue that includes the arteries that can cause calcium to harden those arteries and even cause calcium to go to the heart and causes coronary heart disease and does lead to having a heart attack! This is very bad and we as DSers want to prevent this from ever happening, especially with the high amount of calcium we must intake daily and for life. Gla protein is responsible for moving calcium into our bones and also helps protects against developing osteoporosis. Calcium binding proteins that function in our bones bones and kidneys are VERY DEPENDENT of vitamin K2.  This is the purpose of vitamin K2.

Vitamin K1, on the other hand, main purpose is basically for blood clotting (coagulation) and that's it,. Nothing else to benefit from it, except that. You have bruising of your skin, vitamin K1 helps with this. You have dark under-eye circles, vitamin K1 helps with this, too. Blood clotting issues for a DSer is very rare to develop or occur. Regarding Vitamin K2, the MK-n, the "n" signifies the number of isoprenoids it has. Isoprenoid is an organic compound of living organism made of hydrocarbons that helps process the molecules to make certain functions of our metabolism work. Protein comes into play because it can't function without isoprenoid and hence the connection to all this and to calcium in which needs vitamin K2 to make it work properly and where it is suppose to directly to our bones and no where else.

A few other things, that I think is important to add here is that taking high doses of vitamin A (that some DSers are doing here), can interfere with the absorption of vitamin K and from it, cause low K reading blood result. Lastly, vitamin D3 and vitamin K2 are a tag team that work very well together and in harmony that links back to protein and how we process calcium in our system. As DSers that we are, we should be looking into vitamin K2 and from my explanation above should be part of our daily regime that helps with our calcium that is one of the major issues we have due to the absorption level we have with it. Vitamin K2 is what DSers should have as one of the important co-factors supplemental nutrient to help absorb calcium into our system and also help make it process correctly where it should, in our bones. Hope my interpretations helps you understand it better, for you to make an informed decision and research it further.

This does help tremendously and helps solidify what I've been reading.  Thank you so much.

So, to be clear - my low K1 on my first set of labs is absolutely no indication of what my k2 looks like - is this correct?  Supplementing my K1 (for coagulation/thinning issues) will not help any potential K2 issues, as I'm hearing it?

My A was normal on my labs and I'm taking one a day of 25000IU.  Is there a way to know if that much is interefering with K2?

What I'm hearing (correct me if I'm wrong) is that because of our shortened bowel it is most likely we will have K2 issues and should plan to supplement.  Does that sound right?

Thanks so much for your help.

So, to be clear - my low K1 on my first set of labs is absolutely no indication of what my k2 looks like - is this correct?

You have to discuss this further with your medical doctors to get clarification and your DS surgeon should review your bloodwork. One doctor is talking about K1 that you need to supplement for your low K or specifically K1? Yet, your surgeon is talking about supplementing with K2.  Unless you have blood clotting or some sort of bleeding issues and comparing the results with your liver panel blood results, vitamin K1 would have been recommended with/or another form of treatment. Your surgeon is correct when he said K1 doesn't matter (UNLESS you have beeding issues that is based on other levels of your blood results, such as I said, your liver). He is also correct to say that it is vitamin K2 that is important and he is also correct that vitamin K2 is produced in your gut. To be specific, vitamin K1 is used in your body to make blood clotting factors and that is done in your liver. Vitamin K2 is produced by BACTERIA that is in your gut. This is the difference between K1 and K2.  Also, vitamin K1 is found in plants and how you get it in your system that you eat, digest and absorb, and vitamin K2 is found in animals that you eat, digest and absorb and is produced in the form of good bacteria in your intestines (think how you get probiotic, this is how).

Because of what vitamin K1 supplement is and how it works in my DS system, I do not touch it as a needed daily supplement. I do get my vitamin K1 directly from food source that I eat and as a DSer, I can absorb it because these type of high source of vitamin K1 food are not fat soluble. These are dark green leafy greens such as spinach, romain lettuce, watercress, green peas, asparagus, celery, cabbage (this is also a probiotic), to mention a few. Using just 2 tsp of dried parsley, dried  oregano, dried basil, dried thyme, black pepper or ground cloves will provide a high source of vitamin K1 that I can benefit from. I use a lot of the mentioned, especially dried herbs in my food and using only 2 tsp of any of these dried herbs will provide a high source of vitamin K1 that again, we are able to absorb without the need for me to use vitamin K1 supplements. Even tomato is high in vitamin K1, if you can tolerate it. That is how I rememeber vitamin K1, that I can obtain it from the plant food and are not even fat soluble type, so no worry about if I will malabsorb what I digest. Look into food that are high in vitamin K1. At the same time, there is what is known as salicylates (excuse me if I am not spelling it correctly), that can cause issues with vitamin k. You need to reseatch that one to see which type of salicylate food causing this interference to cause issues with vitamin K.  

Supplementing my K1 (for coagulation/thinning issues) will not help any potential K2 issues, as I'm hearing it?

Yes, vitamin K1 and K2 work differently. I take vitamin K2 and that is specificaly to enhance the absorption of calcium to work properly to go directly into my bones and to not allow my calcium intake to leak out and take residence in my arteries, liver, kidneys or elsewhere that is not my bones matrix in which without vitamin K2 may cause calcification and that is very bad, especially with the amount of calcium we take.

My A was normal on my labs and I'm taking one a day of 25000IU.  Is there a way to know if that much is interefering with K2?

Your daily vitamin A intake is acceptable. It is when you go above a certain dosage that is considered megadoses when you do not need that it may cause what is known as masked deficiencies which means it causes other blood level to drop to low range and even deficiency level. You have to watch your vitamin A blood results to make sure it is within normal ranges for your system and understand if you intake more vitamin A than your body needs, it can cause an imbalance to your other blood level results. Supplementation is strongly and directly based on your bloodwork, not just megadosing without reference.  You want to keep it all balance and you do this with taking the correct amount of supplement dosage that is right for you and understand how each works and process and how it affect other nutrients, especially when use as co-factors. I do know that taking megadoses of vitamin A does cause issues to vitamin K. You can look into that to research. Just be aware and I am sure your doctor can explain this, if he reviews your daily supplementation with you and cross reference it with your bloodwork to pinpoint and if not, an endocrinologist or hemotologist can if you PCP confuses you.  

What I'm hearing (correct me if I'm wrong) is that because of our shortened bowel it is most likely we will have K2 issues and should plan to supplement.  Does that sound right?
To a certain extent, yes and no. Vitamin K starts metabolizing in the liver and from there is where vitamin K1 and vitamin K2 differs. Vitamin K2 issues can be caused by having gluten sensitivity issues that needs to be ruled out, bleeding issues that need to be ruled out, bacterial overgrowth that needs to be ruled out, and then there is dietary issues not intaking enough vitamin K from food that needs to be ruled out. Certain medications such as antibiotics and even aspirins, can cause vitamin K issues, and as you are becoming aware of certain vitamin can inhibit vitamin K, such as high dosage amount of vitamin A.

Malabsorption has to be carefully evaluated if this is the cause triggering your vitamin K to trend downward and go into low levels and has a lot to do with the gamma glutamyl carboyxlase enzyme. Without this enzyme, the amino acid protein will not function and from it have issue trying to regulate calcium that can lead to osteopenia and even osteoporosis. So, make sure you discuss this and your bloodwork levels and it result, throughly with your doctor.