For many years, calcium was the nutrient most emphasized when it came to supporting bone health. Over the past 10 years, we have learned about the amazing properties of vitamin D, and how in many ways, it is even more important than calcium for maintaining strong bones.
Now, vitamin K2 has emerged as a new player on the bone health research front, and the potential implications could be as revolutionary as the findings on vitamin D. But before we discuss the role of vitamin K2 in maintaining strong bones, I think it is important to review some facts regarding traditional approaches to bone health.
An Incomplete Approach to Bone Health
One important thing to take into consideration is how conditions such as osteopenia and osteoporosis are diagnosed. It is through the use of dual energy X-ray absorptiometry (better known as DXA, previously DEXA), which measures bone density. Bone density is a reflection of the amount of mineralization of the bone.
What is important to understand, however, is that mineralization is not the only factor that contributes to bone strength. Bone is also made up of a matrix of collagen. The collagen gives the bone some flexibility, while the mineral matrix gives the bone rigidity. To focus only on the aspect of mineralization would be to overlook the importance of the collagen network, which plays a very important role in reducing fracture risk because it gives the bone its flexibility.
When we look at how traditional bisphosphonate drugs work, we see a prime example of this incomplete approach to supporting bone health. These are the drugs most commonly prescribed to support bone density. Bisphosphonates work by inhibiting the cells that break bone down. Sounds great right?
The problem is that bone is under a constant state of remodeling, which entails both the building up and breaking down of bone. This process of remodeling is absolutely essential to creating bone strength.
An example of why inhibiting bone breakdown and remodeling might be bad can be seen in the rare cases when people who are on bisphosphonate drugs suffer major fractures to extremely dense bone. This most commonly happens at the site of the femur. The drugs have worked to build up a lot of minerals and make the bone look very dense, but it is extremely brittle and susceptible to fracture.
In fact, researchers found that as many as 1 in 50 women will suffer an atypical fracture of the hip after being on bisphosphonate therapy for more than five years. The bone appears to be old brittle bone, rather than the young resilient bone associated with proper bone metabolism and turnover.
The Missing Ingredient: Vitamin K2
Unlike bisphosphonates, the right vitamins and minerals will strengthen bone properly — in a fashion that does not inhibit the natural process of remodeling. Also, nutritional therapies can be used in combination with pharmaceutical approaches for better gains.
Vitamin K2 is the hottest new player on the bone-building front. Like vitamin D, it is a fat soluble vitamin that most Americans get too little of.
What I mean by this is that although we get enough to prevent major disease related to deficiency, we don’t get enough to support optimal health. This was the story with vitamin D, and why many experts are now suggesting we take doses five times what we used to think was adequate.
Vitamin K2 is important to bone because it activates a protein hormone called osteocalcin. Osteocalcin is needed in order to bind calcium to the matrix of bone. So what we understand now is that we need to get enough calcium to support bone health from food and supplements; we need enough vitamin D to be able to absorb the calcium we consume; and we need enough vitamin K2 to make sure that the calcium gets bound to our bones.
Another interesting fact about vitaminK2 is that is also seems to reduce risk for heart disease by reversing and preventing plaque formation. This is no surprise, considering that plaques have a high concentration of calcium. Vitamin K2 activates osteocalcin, which prompts the removal of calcium from arterial plaques, and then ensures that it is deposited into the bones.
I would argue that anyone taking calcium and vitamin D needs to be on vitamin K2 as well. If you are ingesting large amounts of calcium and using vitamin D to improve its absorption, it is imperative that your body be able to deposit the calcium in the right place. Without enough vitamin K2 and activated osteocalcin, there is a greater chance that all of that calcium could end up in your organs or arteries.
Note: People taking blood-thinning medication need to be careful about taking vitamin K2 because it is involved in blood clotting. If you are taking a blood-thinning medication, you must discuss the possibility of taking vitamin K2 with your doctor first. There is a certain type of vitamin K2 (called MK-7) derived from fermented soy that has been shown to not affect blood clotting for those on anti-coagulants when given in a dose of 45 micrograms (mcg) or less.
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