Vitamin K2 for Cardio Health

Vitamin K2 for Cardio Health

A little known vitamin can save your life…

“Vitamin K2 has promising potential to be used as treatment or prevention for the development of vascular calcification.”[1]

Needless to say, calcification in your arteries is not good. It is one of the leading causes of cardiovascular morbidity and disease. Pretty much, your body is building bone where it shouldn’t be. It is one of the many factors that makes up arterial plaque. It is also strongly associated with myocardial infarction (heart attacks).[2] Do you then think it might be important to talk about how to prevent or reverse calcification?

In the picture below you can see the 3 forms of vitamin K (1, 2, & 3). But there is really only one that we are concerned about today. That is vitamin K2 – he is the one responsible for making sure our vascular system doesn’t become clogged. It is a fat soluble vitamin that we used to get from our diet. I say “used to” because fat has been demonized for so long that we no longer have it in our food supply.


Different families of vitamin K

Last week, we reviewed an article about atherosclerosis (check it out here). It talked about the importance vitamin C has in heart health. And indeed, it is very important. But there is another side to the heart story – one that isn’t often talked about a whole lot. But is so important nonetheless. Maybe even more so because of the lack of attention it gets. Yes, today is going to be all about Vitamin K2 and its role in maintaining cardiovascular health.

I don’t know about you, but if there was a simple vitamin I could take to reduce my risk of heart disease and heart attack, I would certainly take it. Who wouldn’t? The science is all there.


Okay, so we are always told to take our vitamins, right? But have you heard of how important K2 is? Because our society has tended to low-fat foods, vitamin K2 no longer exists in our food supply. We used to get it all the time from grass-fed meats, butter, and eggs. But now, everything has switched to grain-fed. Go ahead. Check out the animal products next time you go shopping. That means less K2 to go around. Maybe this is one of the reasons heart disease is so prevalent…

We are discussing the physiology of how vitamin K2 can prevent / reverse vascular calcification. This article is a quick overview of the roles K2 plays. [Click here for the file.]

El Asmar MS, Naoum JJ, Arbid EJ. (2014). Vitamin K Dependent Proteins and the Role of Vitamin K2 in the Modulation of Vascular Calcification: A Review. Oman Medical Journal 29(3): 172-177.

  • Vitamin K2 is a fat soluble vitamin – long gone from our food supply. It “activates” several important proteins to function properly through carboxylation. Namely, osteocalcin and matrix gla protein (MGP) are the most important involving calcification.
  • MGP makes sure your arterial cells do not turn into osteocytes – the building blocks of bones. Osteocalcin makes sure the calcium you have in your blood properly deposit in normal bones.
  • Diabetic patients are especially prone to calcification due to advanced glycation end-products, inflammation, and foam cell proliferation.
  • Take your vitamin K2! It is more important than you think.

Vitamin K Dependent Proteins (VKDPs)

Okay, so this is what all the hubbub is about. There are certain proteins in your body that vitamin K needs to activate – meaning to make them fully functional. Just like there are different kinds of vitamin Ks, there are different kinds of proteins that need activation. These proteins go through a process called “carboxylation.” In essence, that means there is a CO2 group added onto the protein to make it a carboxylic acid. In this form, the proteins can work their magic and stimulate other processes. Doctors will actually measure the amount of “uncarboxylated” proteins you have in your blood as a measure for vitamin K deficiency. Pretty neat stuff.


Vitamin K activates proteins through "carboxylation"

Now, there are lots of proteins that depend on vitamin K for functionality. We mentioned that some proteins work in the calcification network. Yet, there are even more function of these VKDPs: blood coagulation and nervous system regulation.[1] I think it goes without saying that these guys are pretty important. There are tons of them. But there are only a couple that we will focus on today.

Vitamin K1 mainly activates proteins for blood coagulation, and we are not going to spend time talking about it.[3] The really juicy stuff for today’s topic are the calcification proteins, osteocalcin and matrix gla protein (MGP). It is these proteins that vitamin K2 activates – that’s the real point of interest.

MGP & Calcification

Osteocalcin is a protein heavily involved in bringing calcium into the bones. Remember how you were told to drink milk (i.e. calcium) for strong bones? Well, it is osteocalcin that actually puts it where it needs to go. And new research is showing that osteocalcin is heavily involved in overall body metabolism. It helps with glucose homeostasis.[4] Osteocalcin is very important for many things, but that idea of putting calcium where it needs to go is of most interest. However, it turns out osteocalcin doesn’t directly affect vascular calcification. Its role is to put calcium in bones – not to prevent calcium deposits in the arteries.

That is matrix gla protein’s job (MGP). MGP is a very complex thing, and honestly, I still do not fully understand it. But, nonetheless, I will do my best to explain its role in calcification. MGP is an extracellular protein – its specialty is to watch what is going on the outside of a cell. If the extracellular matrix of vascular smooth muscle cells (VSMCs) is getting mineralized, there is an up-regulation of MGP. Vitamin K2 still needs to activate it if it is going to help the MGP reverse the calcification. If there is not enough vitamin K around, then MGP can’t do anything and the calcium starts to build up.

So that means we need Vitamin K2. But where do we get it?

Sources of Vitamin K2

That vitamin K2 can come from diet or supplements. We pretty much get all our vitamin K2 (if any at all) from grass-fed animal products. Bacteria in their stomachs synthesize K2, which then the animals take into their body and store it in fat.[1] It is almost impossible for us to get enough K2 without eating everything that is grass-fed. Thus it is much easier to take a K2 supplement to make sure you are getting the right amounts (~100 micrograms per day).

Implication for Diabetes

There are certain kinds of people that are especially prone to calcification. It is very sad… but true. And people with diabetes are one of those kinds of people. Earlier I said that bone building is a very important part of metabolism? Well, that might be why diabetics are prone to the wrong kind of bone building – arterial bone building. The researchers suggest that it might be due to the advanced glycation end-products (AGEs).

These AGEs can manipulate proteins and lipids in the blood, which then affects extracellular functions. This can lead to inflammation, foam cell proliferation, and calcification.[5] You can think about it like actual sugar – it sticks to everything. When it sticks to a protein, it can shift its shape. That protein won’t be able to function the same way. All the sugar in your blood is going around and messing everything up. But even the top researchers still don’t understand it all. It makes sense to me, but we will have to see where the literature leads us next.


Calcification in the middle layer: tunica media

One important note: diabetics usually get calcification in the tunica media (very specifically). That is the middle part of you arterial wall. That is where your vascular smooth muscle cells (VSMCs) reside. It is those cells that MGP works with to make sure its extracellular matrix is not “too mineralized.” Vitamin K2 is what activates the MGP to do its job. You need to have vitamin K2 so your VSMCs don’t become osteogenic. So I have one last question for you then:

Do you think it is important for people with diabetes to take vitamin K2?


[1] El Asmar MS, Naoum JJ, Arbid EJ. (2014). Vitamin K Dependent Proteins and the Role of Vitamin K2 in the Modulation of Vascular Calcification: A Review. Oman Medical Journal 29(3): 172-177.

[2] Ehara S, Kobayashi Y, Yoshiyama M, et al. (2004). Spotty Clacification Typifies the Culprit Plaque in Patients With Acute Myocardial Infarction. Circulation 110(22): 3424-3429.

[3] “Vitamin K”. Colorado State University. Vivo Pathophysiology. [Online]. Available: http://www.vivo.colostate.edu/hbooks/pathphys/topics/vitamink.html. Accessed: 24 May 2018.

[4] Wei J, Karsenty G. (2015). An overview of the metabolic functions of osteocalcin. Reviews in Endocrine and Metabolic Disorders 16(2): 93-98.

[5] Goldin A, Beckman JA, Schmidt AM, Creager MA. (2006). Advanced Glycation End Products: Sparking the Development of Diabetic Vascular Injury. Circulation 114(6): 597-605.

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