Vitamin K tablets
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Agian
Well-known member
There was another thread on Vitamin K2; but I can't, for the life of me, find it.
pellicle
Professional Dingbat, Guru and Merkintologist
I'd hazzard a guess that there's been more than "another" on this topic ;-)
Hi Pellicle,
I tried to be very clear on this in my prior posts.
In my first post I indicated:
and when I referenced the journal article:
I certainly agree with your statement:
Even the authors of that paper I referenced say:
I wouldn't take that paper's results as gospel, but I personally found that the paper's approach was reasonably scientific, and the results were intriguing enough to prompt me to start my own experimental study on a population of one (myself). My INR results were highly volatile week-to-week, and I felt it couldn't hurt to give it a try - as long as I carefully began with a low dose, monitored weekly, and increased the K2 dose slowly. Again, this was done with the approval of the doctor monitoring my warfarin (although I'm really doing it on my own).
So far, I have about 4 months of data on my INR variability with no supplement, about 3 months with 45mcg/day of K2(as MK-7), about 3 months with 60mcg, and most recently about 4 months with 90mcg/day. My own personal results are that the standard deviation (the indicator of volatility in my INR) has just about halved with the 90mcg/day K2(MK-7) supplement, and my warfarin dose only increased modestly from about 12.0mg/day to about 12.5mg/day (with slight variations). So, I consider my own personal experiment on a sample of 1 to be successful so far.
I am interested to hear if others with highly volatile INR have seen similar success in reducing the variability of their INR with low-dose vitamin K supplements.
I know I found a few other papers on larger study populations when I first researched this, and I'll try to find those references again if I have time this weekend.
Is that perhaps the thread I linked to in my post above,
or are you referring to yet another, different thread? I know there are several.
I tried to be very clear on this in my prior posts.
In my first post I indicated:
and when I referenced the journal article:
I certainly agree with your statement:
Even the authors of that paper I referenced say:
I wouldn't take that paper's results as gospel, but I personally found that the paper's approach was reasonably scientific, and the results were intriguing enough to prompt me to start my own experimental study on a population of one (myself). My INR results were highly volatile week-to-week, and I felt it couldn't hurt to give it a try - as long as I carefully began with a low dose, monitored weekly, and increased the K2 dose slowly. Again, this was done with the approval of the doctor monitoring my warfarin (although I'm really doing it on my own).
So far, I have about 4 months of data on my INR variability with no supplement, about 3 months with 45mcg/day of K2(as MK-7), about 3 months with 60mcg, and most recently about 4 months with 90mcg/day. My own personal results are that the standard deviation (the indicator of volatility in my INR) has just about halved with the 90mcg/day K2(MK-7) supplement, and my warfarin dose only increased modestly from about 12.0mg/day to about 12.5mg/day (with slight variations). So, I consider my own personal experiment on a sample of 1 to be successful so far.
I am interested to hear if others with highly volatile INR have seen similar success in reducing the variability of their INR with low-dose vitamin K supplements.
I know I found a few other papers on larger study populations when I first researched this, and I'll try to find those references again if I have time this weekend.
Is that perhaps the thread I linked to in my post above,
or are you referring to yet another, different thread? I know there are several.
pellicle
Professional Dingbat, Guru and Merkintologist
Hi
just to be sure, I hope you aren't taking my questions as some sort of personal attack, because they are certainly not intended in that way
well and that's why I just wanted to clear it up. I thought that was the case. I also noticed that the K derivitatve that they synthesize is different to the Vit K we intake. So I wonder if the softgel tablets have a different effect ... which is why I dug out all that stuff.
its something I'm intending to give a go to, but it will be 'longer term' for me as I remain on antibiotics for at least the next 6 months ...
this quote:
is from Jarno ... just in case you thought it was me
just to be sure, I hope you aren't taking my questions as some sort of personal attack, because they are certainly not intended in that way
well and that's why I just wanted to clear it up. I thought that was the case. I also noticed that the K derivitatve that they synthesize is different to the Vit K we intake. So I wonder if the softgel tablets have a different effect ... which is why I dug out all that stuff.
its something I'm intending to give a go to, but it will be 'longer term' for me as I remain on antibiotics for at least the next 6 months ...
this quote:
is from Jarno ... just in case you thought it was me
Hi Pellicle,
Good heavens, of course not. That never entered my mind. It's just that I get the feeling, since my posts tend to be long and perhaps a bit rambling, that folks were not reading all of what I wrote.
In this case, I was very specific because all vitamin-K supplements are not the same, as you further noted. So, when specifying the vitamin-k supplement I was taking, I felt the need to be specific that it was the MK-7 version of K2 that has yielded the INR stabilization results I seem to be getting.
Actually, that quote was from myself in one of my earlier posts above. It was intended to be a response to "Agian", who said he could not find the prior K2 discussion thread.
Good heavens, of course not. That never entered my mind. It's just that I get the feeling, since my posts tend to be long and perhaps a bit rambling, that folks were not reading all of what I wrote.
In this case, I was very specific because all vitamin-K supplements are not the same, as you further noted. So, when specifying the vitamin-k supplement I was taking, I felt the need to be specific that it was the MK-7 version of K2 that has yielded the INR stabilization results I seem to be getting.
Actually, that quote was from myself in one of my earlier posts above. It was intended to be a response to "Agian", who said he could not find the prior K2 discussion thread.
jarno1973
Well-known member
This thread has become quite technical and some of it is above my head.
For me New Mitral is the living proof that the small dose of Vit K2 will not likely cause a dangerous drop in INR. I started the test yesterday with a "safe" 50 mcg dose. INR was 2.6 , today's test gave a 2.5 which is lower but its to early to conclude anything. Will keep testing regularly and posting my findings.
For me New Mitral is the living proof that the small dose of Vit K2 will not likely cause a dangerous drop in INR. I started the test yesterday with a "safe" 50 mcg dose. INR was 2.6 , today's test gave a 2.5 which is lower but its to early to conclude anything. Will keep testing regularly and posting my findings.
pellicle
Professional Dingbat, Guru and Merkintologist
Hi
personally I blame myself for being dyslexic (well, ok and either lazy or in a hurry) ... so correct me when I get thing wrong ;-)
phew (wipes brow) ... have that problem at work with some folks ... can't handle review. Also it should be mentioned that I got failed in 'tact' ... except in sailing.
personally I blame myself for being dyslexic (well, ok and either lazy or in a hurry) ... so correct me when I get thing wrong ;-)
pellicle
Professional Dingbat, Guru and Merkintologist
Jarno
well technical is what I do (so its my mistake to get technical when perhaps its not warranted), and beware of "living proof" as at one stage noone understood why some people require far less warfarin than others ... then we discovered a genetic basis for it.
so what I'm saying is "beware of transferring results"...
well technical is what I do (so its my mistake to get technical when perhaps its not warranted), and beware of "living proof" as at one stage noone understood why some people require far less warfarin than others ... then we discovered a genetic basis for it.
so what I'm saying is "beware of transferring results"...
Hi Jarno,
I also want to second Pellicle's warning to be careful. We are all different, and what works for some may not work, or may even be fatal for others.
It takes 12.5mg/day of warfarin to get my INR to its target 3.0 value. This is already a 3-sigma case on the high side of daily dose. That much warfarin would likely be fatal for someone who only needs 1 or 2 mg/day to hit their target range.
Also, the amount of volatility in my INR week to week is another indication that my particular case is not typical. So, the fact that 90mcg/day of K2 (MK-7) works for me doesn't mean it will be safe for everyone.
That said, you are approaching it the correct way. Start with a low dose first and check your INR frequently. The authors of the referenced paper say that 50mcg/day of K2 should be safe. Just please continue to go slowly. Per the referenced journal paper, it takes 2 weeks of taking the daily k2 pill before the concentration builds up to its high steady-state value in your blood. So, it is only after about 2 weeks of taking the same daily dose that you will know if there is a significant effect on your INR level from that dose. If you do increase the dose, do so slowly (10mcg or 15mcg increments) and wait at least another 2 or three weeks to see if the new accumulated concentration level is still safe for you.
I don't want to be a fear-monger, but just because these doses work for me doesn't mean the same doses will work for others. We all have different metabolisms.
You may have to adjust your warfarin dose a bit to compensate for the K2, which is why it is a good idea to consult with the doctor/clinic managing your warfarin dosing to let them know what you are doing as well.
I also want to second Pellicle's warning to be careful. We are all different, and what works for some may not work, or may even be fatal for others.
It takes 12.5mg/day of warfarin to get my INR to its target 3.0 value. This is already a 3-sigma case on the high side of daily dose. That much warfarin would likely be fatal for someone who only needs 1 or 2 mg/day to hit their target range.
Also, the amount of volatility in my INR week to week is another indication that my particular case is not typical. So, the fact that 90mcg/day of K2 (MK-7) works for me doesn't mean it will be safe for everyone.
That said, you are approaching it the correct way. Start with a low dose first and check your INR frequently. The authors of the referenced paper say that 50mcg/day of K2 should be safe. Just please continue to go slowly. Per the referenced journal paper, it takes 2 weeks of taking the daily k2 pill before the concentration builds up to its high steady-state value in your blood. So, it is only after about 2 weeks of taking the same daily dose that you will know if there is a significant effect on your INR level from that dose. If you do increase the dose, do so slowly (10mcg or 15mcg increments) and wait at least another 2 or three weeks to see if the new accumulated concentration level is still safe for you.
I don't want to be a fear-monger, but just because these doses work for me doesn't mean the same doses will work for others. We all have different metabolisms.
You may have to adjust your warfarin dose a bit to compensate for the K2, which is why it is a good idea to consult with the doctor/clinic managing your warfarin dosing to let them know what you are doing as well.
Agian
Well-known member
I have merrily been taking 200mcgs of MK-7 Vitamin K2. Last night I read on a post somewhere on the net, that a woman claimed to have had a TIA on this and another thrombosis in her legs. Neither were on Warfarin, nor am I. I'm just wondering whether there are risks of clots for those taking it, who are not on Warfarin. I'm eager to continue taking this stuff.
jarno1973
Well-known member
Jarno
well technical is what I do (so its my mistake to get technical when perhaps its not warranted), and beware of "living proof" as at one stage noone understood why some people require far less warfarin than others ... then we discovered a genetic basis for it.
so what I'm saying is "beware of transferring results"...
Nothing wrong with being technical and appreciate all the concern. The things is; going on opinions here, scientifc studies or what ever information is available, some of it seems to be contradicting so it will be very hard to draw conclusions. Most people and even scientific papers seem to be able to prove the point that they want to prove.
I will continue to go slow and may even keep on testing every day.
Further References:
Just to follow up on my prior promise to post the other relevant references I had found when I first started my experiment with taking low-dose vitamin K2 to help stabilize my highly varying INR, these are a few of the others listed below. Most of these indicate vitamin K1 in the studies, but after reading the other paper I referenced before, I decided to give it a go with vitamin K2(MK-7) instead. I sent these references to my doctor to get his opinion/approval before starting the experiment, and he was very supportive. If others are going to try it, I do highly recommend you coordinate with your own doctor as well.
----------------------------------------------
"Vitamin K supplementation can improve stability of anticoagulation for patients with unexplained variability in response to warfarin"
Sconce E, Avery P, Wynne H, Kamali F.
Source : School of Clinical and Laboratory Sciences, Newcastle University, Newcastle upon Tyne, United Kingdom
Blood. 2007 Mar 15;109(6):2419-23. Epub 2006 Nov 16.
NIH abstract link: www.ncbi.nlm.nih.gov/pubmed/17110451
Link to full article :
bloodjournal.hematologylibrary.org/content/109/6/2419.full.html
---------------------------------------------------
"Low-dose vitamin K to augment anticoagulation control"
Reese AM, Farnett LE, Lyons RM, Patel B, Morgan L, Bussey HI.
Source: College of Pharmacy, University of Texas, Austin, and the Anticagulation Clinics of North America, San Antonio, Texas, USA
Pharmacotherapy. 2005 Dec;25(12):1746-51.
NIH abstract link: www.ncbi.nlm.nih.gov/pubmed/16305294
-------------------------------------------------------
"Prospective study of supplemental vitamin K therapy in patients on oral anticoagulants with unstable international normalized ratios"
Ford SK, Misita CP, Shilliday BB, Malone RM, Moore CG, Moll S.
Source : Department of Pharmacy, University of North Carolina Hospitals, Chapel Hill, NC 27599, USA.
NIH abstract link: www.ncbi.nlm.nih.gov/pubmed/17323135
--------------------------------------------------------
Just to follow up on my prior promise to post the other relevant references I had found when I first started my experiment with taking low-dose vitamin K2 to help stabilize my highly varying INR, these are a few of the others listed below. Most of these indicate vitamin K1 in the studies, but after reading the other paper I referenced before, I decided to give it a go with vitamin K2(MK-7) instead. I sent these references to my doctor to get his opinion/approval before starting the experiment, and he was very supportive. If others are going to try it, I do highly recommend you coordinate with your own doctor as well.
----------------------------------------------
"Vitamin K supplementation can improve stability of anticoagulation for patients with unexplained variability in response to warfarin"
Sconce E, Avery P, Wynne H, Kamali F.
Source : School of Clinical and Laboratory Sciences, Newcastle University, Newcastle upon Tyne, United Kingdom
Blood. 2007 Mar 15;109(6):2419-23. Epub 2006 Nov 16.
NIH abstract link: www.ncbi.nlm.nih.gov/pubmed/17110451
Link to full article :
bloodjournal.hematologylibrary.org/content/109/6/2419.full.html
---------------------------------------------------
"Low-dose vitamin K to augment anticoagulation control"
Reese AM, Farnett LE, Lyons RM, Patel B, Morgan L, Bussey HI.
Source: College of Pharmacy, University of Texas, Austin, and the Anticagulation Clinics of North America, San Antonio, Texas, USA
Pharmacotherapy. 2005 Dec;25(12):1746-51.
NIH abstract link: www.ncbi.nlm.nih.gov/pubmed/16305294
-------------------------------------------------------
"Prospective study of supplemental vitamin K therapy in patients on oral anticoagulants with unstable international normalized ratios"
Ford SK, Misita CP, Shilliday BB, Malone RM, Moore CG, Moll S.
Source : Department of Pharmacy, University of North Carolina Hospitals, Chapel Hill, NC 27599, USA.
NIH abstract link: www.ncbi.nlm.nih.gov/pubmed/17323135
--------------------------------------------------------
pellicle
Professional Dingbat, Guru and Merkintologist
well, perhaps this is insensitive of me, but
there is probably someone claiming that their employer is liable for them because they were having sex in a hotel on a work trip.
The thing is we know so little about the background and other issues the person may have had as for the information itself to be worthless.
just my opinion...
there is probably someone claiming that their employer is liable for them because they were having sex in a hotel on a work trip.
The thing is we know so little about the background and other issues the person may have had as for the information itself to be worthless.
just my opinion...
pellicle
Professional Dingbat, Guru and Merkintologist
thanks ... will see if I've got any of these in my 'cache' yet
pellicle
Professional Dingbat, Guru and Merkintologist
Hi
in case Jarno doesn't follow these up, this one had an interesting point in the abstract:
So definitely do monitor your INR carefully and if your warfarin dose rises by 95% then be sure to not stop taking your K once you start it.
and thanks again Newmitral for the refs.
in case Jarno doesn't follow these up, this one had an interesting point in the abstract:
So definitely do monitor your INR carefully and if your warfarin dose rises by 95% then be sure to not stop taking your K once you start it.
and thanks again Newmitral for the refs.
pellicle
Professional Dingbat, Guru and Merkintologist
while we're trading stamps ...
Effect of vitamin K intake on the stability of oral anticoagulant treatment: dose-response relationships in healthy subjects
Oral anticoagulants exert their effect by blocking the utilization of
vitamin K, yet little is known about competitive aspects of their
interaction with dietary vitamin K. We carried out systematic dose-
response studies in healthy volunteers who had been stably anticoagulated
and maintained on their individualized doses for 13 weeks. First, we
studied the response to weekly incremental doses (50 µg~500 µg) of vitamin
K1 supplements (K1) taken daily for 7 days. The threshold K1 dose causing
a statistically significant lowering of the INR was 150 µg/day. In 25% of
the participants the INR change was regarded as clinically relevant at a
vitamin K intake of 150 µg/day. Circulating undercarboxylated osteocalcin
did not decrease until 300 µg K1/day compared with 100 µg K1/day for
undercarboxylated FII, suggesting differential antidotal effects on bone
and hepatic -carboxylation. Next, we tested the response to vitamin
K~rich food items. The short-lived response after meals of spinach and
broccoli suggested an inefficient bioavailability from these 2 sources. We
conclude that shortterm variability in intake of K1 is less important to
fluctuations in the international normalized ratio (INR) than has been
commonly assumed and that food supplements providing 100 µg/day of vitamin
K1 do not significantly interfere with oral anticoagulant therapy. (Blood.
2004; 104:2682-2689)
Effect of vitamin K intake on the stability of oral anticoagulant treatment: dose-response relationships in healthy subjects
Oral anticoagulants exert their effect by blocking the utilization of
vitamin K, yet little is known about competitive aspects of their
interaction with dietary vitamin K. We carried out systematic dose-
response studies in healthy volunteers who had been stably anticoagulated
and maintained on their individualized doses for 13 weeks. First, we
studied the response to weekly incremental doses (50 µg~500 µg) of vitamin
K1 supplements (K1) taken daily for 7 days. The threshold K1 dose causing
a statistically significant lowering of the INR was 150 µg/day. In 25% of
the participants the INR change was regarded as clinically relevant at a
vitamin K intake of 150 µg/day. Circulating undercarboxylated osteocalcin
did not decrease until 300 µg K1/day compared with 100 µg K1/day for
undercarboxylated FII, suggesting differential antidotal effects on bone
and hepatic -carboxylation. Next, we tested the response to vitamin
K~rich food items. The short-lived response after meals of spinach and
broccoli suggested an inefficient bioavailability from these 2 sources. We
conclude that shortterm variability in intake of K1 is less important to
fluctuations in the international normalized ratio (INR) than has been
commonly assumed and that food supplements providing 100 µg/day of vitamin
K1 do not significantly interfere with oral anticoagulant therapy. (Blood.
2004; 104:2682-2689)
pellicle
Professional Dingbat, Guru and Merkintologist
Hi
definitely ....
well this is how it is with many people, most news papers and frequently magazines. But the purpose of a "peer review" in a journal is to force the person / group publishing to support their arguments with evidence and to follow accepted guidelines on how that evidence can be collected and presented. This drastically reduces the amount of personal bias and outright BS that flows in (say) newspapers and magazines.
which is why I lean towards peer reviewed journals. Also I'm trained as a researcher so that's what we see to be the right way.
but I think you're on the right path ... carefully and with testing
best wishes
well, sadly that's how it is when we don't have conclusive evidence. ...
definitely ....
well this is how it is with many people, most news papers and frequently magazines. But the purpose of a "peer review" in a journal is to force the person / group publishing to support their arguments with evidence and to follow accepted guidelines on how that evidence can be collected and presented. This drastically reduces the amount of personal bias and outright BS that flows in (say) newspapers and magazines.
which is why I lean towards peer reviewed journals. Also I'm trained as a researcher so that's what we see to be the right way.
but I think you're on the right path ... carefully and with testing
best wishes
Hi Pellicle,
Thanks for the additional article reference:
I don't think this particular paper is one I had found before. Interestingly, and somewhat serendipitously, it does seem to confirm the findings in the first Blood Journal paper I referenced. Specifically, the two quotes below from the paper you cited:
along with:
These findings do confirm the basic underlying reasons I elected to do my INR stabilization experiment using low-dose K2(MK-7) instead of K1.
(1): The K2(MK-7) does counteract the INR effect of the warfarin and can lower INR
and
(2): it lasts much longer in the body than K1 - making the level of concentration in the blood more steady over time.
In my own opinion, this greater blood-level concentration stability over time should make it the better choice for seeking INR stability than K1. I reiterate that this is only my personal opinion.
Again, it should be emphasized for others that might want to experiment with INR stabilization that the "safe" levels of K1 (around 100-150ug/day) in other studies should not be assumed to apply to the K2(MK-7) ("safe" levels only 50ug/day) before these supplements seem to have clinically significant effects on lowering INR in the small study groups. The two forms of vitamin-K behave quite differently.
Thanks for the additional article reference:
I don't think this particular paper is one I had found before. Interestingly, and somewhat serendipitously, it does seem to confirm the findings in the first Blood Journal paper I referenced. Specifically, the two quotes below from the paper you cited:
along with:
These findings do confirm the basic underlying reasons I elected to do my INR stabilization experiment using low-dose K2(MK-7) instead of K1.
(1): The K2(MK-7) does counteract the INR effect of the warfarin and can lower INR
and
(2): it lasts much longer in the body than K1 - making the level of concentration in the blood more steady over time.
In my own opinion, this greater blood-level concentration stability over time should make it the better choice for seeking INR stability than K1. I reiterate that this is only my personal opinion.
Again, it should be emphasized for others that might want to experiment with INR stabilization that the "safe" levels of K1 (around 100-150ug/day) in other studies should not be assumed to apply to the K2(MK-7) ("safe" levels only 50ug/day) before these supplements seem to have clinically significant effects on lowering INR in the small study groups. The two forms of vitamin-K behave quite differently.
jarno1973
Well-known member
A bit of an update:
I am about 10 days in and still testing everyday. There seems to be a slow decrease of my INR but the actual effect will be hard to tell with several other factor influencing my INR. I started at INR 2.5 and was at 1.7 two days ago. The day after, the INR was already on its way back up..with a 1.9 yesterday and a 2.1 just now...I dont want to fall below 2.0 so I increased my warfarin intake slightly. It is quite long time ago but at my standard 8 mg of warfarin per day I had earlier been at a 1.7 so it remains hard to say if this is due to the effect of the vit K. Looking at the overal trend I feel that the INR has dropped around 0.2-0.3 points because of the Vit. K. Tests will however need to run quite a bit longer before I can draw any real conclusions.
I am about 10 days in and still testing everyday. There seems to be a slow decrease of my INR but the actual effect will be hard to tell with several other factor influencing my INR. I started at INR 2.5 and was at 1.7 two days ago. The day after, the INR was already on its way back up..with a 1.9 yesterday and a 2.1 just now...I dont want to fall below 2.0 so I increased my warfarin intake slightly. It is quite long time ago but at my standard 8 mg of warfarin per day I had earlier been at a 1.7 so it remains hard to say if this is due to the effect of the vit K. Looking at the overal trend I feel that the INR has dropped around 0.2-0.3 points because of the Vit. K. Tests will however need to run quite a bit longer before I can draw any real conclusions.
