Sponsored by Quicksilver Scientific
Vitamin D3 and K2 are two essential, fat-soluble vitamins that together have a broad and intertwined impact on health.1-3 We all know that vitamin D3 (cholecalciferol) is light transformed and that it is technically not a vitamin because the skin synthesizes it on exposure to UV light. Vitamin D3 is the precursor to a class of D3-related hormones that have many functions in the body beyond calcium homeostasis. Receptors for this vitamin are ubiquitous throughout the body as they are found in more than 36 cell types.4 Recent research has shown the action of vitamin D helps regulate Th1 and Th2 immune responses, even in utero.5 In 2012, extraordinary sequencing work revealed that the human genome literally has thousands of binding sites for vitamin D, an affirmation of how fundamental this vitamin is for immune function, as well as cellular growth and differentiation.6
And now we come to a quandary. Given the abundant evidence for widespread vitamin D deficiency—as many as a billion people worldwide according to a 2017 review—supplementation is extremely important and common.7 Yet a close look at scientific research, particularly regarding bone health and vascular calcification, shows that coadministration of vitamin K with vitamin D is equally as important.8-10 Well-known for its role in coagulation, vitamin K also plays an important role in arterial health and in helping vitamin D carry out many of its functions. Vitamin K plays a role in directing calcium deposition to the bone matrix, via activation of osteocalcin, and insufficiency may be associated with soft tissue calcification and lower bone mineral density.11,12 Some forms of vitamin K are more active in the body than others. Menaquinone-7, or MK-7, is a highly bioactive form of vitamin K2.13
A number of the proteins produced by the body in response to vitamin D are activated by vitamin K. These include osteocalcin and matrix Gla protein (MGP), which bind calcium into the bone matrix and inhibit the deposition of calcium into other soft tissues, like arteries, kidneys, and joint cartilage.14-16 Vascular calcification is regulated by a number of vitamin K dependent proteins.17,18 High artery calcium scores are correlated with adverse cardiovascular events, and can be linked to low vitamin K status.19 By supplementing vitamin D with vitamin K, arterial stiffness, which is associated with cardiovascular risk, morbidity, and mortality, can be reduced.20
Thus, vitamin D and vitamin K move in lockstep and ideally should be prescribed together in their active forms.
Of course, in all instances of supplementation, absorption is key, and liposomal technology can facilitate maximal absorption of these fat-soluble vitamins. Liposomal vesicle structure is dominated by phospholipids, the primary components of cell membranes. When liposomal bubbles reach the cell, the liposome phospholipids blend into the lipid membrane of the cell, facilitating maximal cellular delivery of the nutrients. This allows cellular nutrient levels to reach and even exceed those which, until recently, only intravenous therapies were capable of.22-23
The multi-targeted choreography of paired Vitamin D and K, delivered in liposomal format, is one more significant way that we can optimize our patient’s health.
- Gatti D, Idolazzi L, Fassio A. Vitamin D: not just bone, but also immunity. Minerva Med. 2016 Dec;107(6):452-460.
- Mayer O Jr, et al. Synergistic effect of low K and D vitamin status on arterial stiffness in a general population. J Nutr Biochem. 2017 Apr 22;46:83-89.
- Prietl B, et al. Vitamin D and immune function. Nutrients. 2013 Jul 5;5(7):2502-21.
- Norman AW. From vitamin D to hormone D: fundamentals of the vitamin D endocrine system essential for good health. Am J Clin Nutr. 2008 Aug;88(2):491S-499S.
- Akhtar E, Mily A, Haq A. Prenatal high-dose vitamin D3 supplementation has balanced effects on cord blood Th1 and Th2 responses. Nutr J. 2016 Aug 9;15(1):75
- Carlberg C, Seuter S, Heikkinen S. The first genome-wide view of vitamin D receptor locations and their mechanistic implications. Anticancer Res. 2012 Jan;32(1):271-82.
- Kim M. Pfotenhauer, Jay H. Shubrook. Vitamin D Deficiency, Its Role in Health and Disease, and Current Supplementation Recommendations. J Am Osteopath Assoc, 2017; 117 (5): 30
- Iwamoto J, et al. Treatment with vitamin D3 and/or vitamin K2 for postmenopausal osteoporosis. Keio J Med. 2003 Sep;52(3):147-50.
- Iwamoto J, et al. Effect of combined administration of vitamin D3 and vitamin K2 on bone mineral density of the lumbar spine in postmenopausal women with osteoporosis. J Orthop Sci. 2000;5(6):546-51.
- El Asmar MS, et al. Vitamin k dependent proteins and the role of vitamin k2 in the modulation of vascular calcification: a review. Oman Med J. 2014 May;29(3):172-7.
- Bügel S. Vitamin K and bone health in adult humans. Vitam Horm. 2008;78:393-416
- Inaba N, et al. Low-Dose Daily Intake of Vitamin K(2) (Menaquinone-7) Improves Osteocalcin γ-Carboxylation: A Double-Blind, Randomized Controlled Trials. J Nutr Sci Vitaminol (Tokyo). 2015;61(6):471-80.
- Inaba N, et al. Low-Dose Daily Intake of Vitamin K(2) (Menaquinone-7) Improves Osteocalcin γ-Carboxylation: A Double-Blind, Randomized Controlled Trials. J Nutr Sci Vitaminol (Tokyo). 2015;61(6):471-80
- Booth SL, et al. Relationships between dietary intakes and fasting plasma concentrations of fat-soluble vitamins in humans. J Nutr. 1997 Apr;127(4):587-92.
- Shea MK, et al. Vitamin K and vitamin D status: associations with inflammatory markers in the Framingham Offspring Study. Am J Epidemiol. 2008 Feb 1;167(3):313-20
- Wallin R, Schurgers L, Wajih N. Effects of the blood coagulation vitamin K as an inhibitor of arterial calcification.Thromb Res. 2008;122(3):411-7.
- Bostrom KI. Cell differentiation in vascular calcification. Z Kardiol. 2000;89:69-74.
- Schurgers LJ, Dissel PE, Spronk HM, et al. Role of vitamin K and vitamin K-dependent proteins in vascular calcification. Z Kardiol. 2001;90 Suppl 3:57-61.
- Nasir K, et al. Variation in atherosclerotic plaque composition according to increasing coronary artery calcium scores on computed tomography angiography. Int J Cardiovasc Imaging. 2010;26:923-32.
- Mozos I, Stoian D, Luca CT. Crosstalk between Vitamins A, B12, D, K, C, and E Status and Arterial Stiffness. Dis Markers. 2017;2017:8784971.
- Ahn H, Park JH. Liposomal delivery systems for intestinal lymphatic drug transport. Biomater Res. 2016 Nov 23;20:36
- Shade CW. Liposomes as Advanced Delivery Systems for Nutraceuticals Integr Med (Encinitas). 2016 Mar; 15(1): 33–36
- Hood RR, et al. Pharmacy-on-a-Chip: Microfluidic Synthesis of Pegylated and Folate Receptor-targeted Liposomes for Drug Delivery. 16th International Conference on Miniaturized Systems for Chemistry and Life Sciences October 28 - November 1, 2012, Okinawa, Japan