Vitamin K2 doseage?

[sarahsunshine]

Skyler’s been on Enoxaparin (think heparin) for the past several weeks because the antibiotics he’s on (Cefazolan and Rifampin) make Warfarin ineffective. He will be on Enox- for at lest another 3 weeks. They still kept him on a dose of 12mg/day.

At his last doctor’s appointment, we got the OK from his doctor to skip the warfarin altogether, and give him vitamin K2 supplementation until he gets of the antibiotics. We are doing this in the form of MK-7 drops. However, no one has given us a dose for such a short-term therapeutic use (long term use is on the bottle), and I haven’t been able to find any online.

Anyone have a suggestion of where to find doseage information?

 

[catwoman]

I'm not sure I understand why the need for vitamin K2...

 

[yotphix]

I don't understand either, but I'm curious where this is going. Do we understand correctly that you are supplementing vitamin k2 BECAUSE Skyler isn't taking Warfarin? Or are these two separate pieces of information?

 

[catwoman]

OK, I've found where vitamin K2 helps restore natural flora in the gut when taking broad-spectrum antibiotics. That makes sense.
I assume the enox is enoxaparin??

 

[Bill B]

Did your doctor come up with the vitmain K2? It's not obvious to me why Skyler should get this. The doctor should give you dose. K2 (or its subcomponent MK7) is a poorly understood supplement usually directed at bone health. (Ah, catwoman found a potential reason, but I can't find that - MK7 is produced by gut flora, but I don't see it helping to restore gut flora).

Rifampin has been documented to cause rather marked warfarin resistance, so that is operating here. I assume an infectious disease specialist recommended Rifampin in addition to cefazolin, as its use in staph infections is unusual.

Bill (retired pharmacist)

 

[Paleowoman]

Vitamin K2 is important for cardiovascular health: http://menaq7.com/?page=cardiovascular-health

I take vitamin K2 with my cardiologist's and endocrinologist's approval....but they wouldn't know what dosage I should take. If a doctor is recommending K2 they should say how much to take.

 

[Lynlw]

OK, I've found where vitamin K2 helps restore natural flora in the gut when taking broad-spectrum antibiotics. That makes sense.
I assume the enox is enoxaparin??

I've been trying to figure this out too. I know the bacteria in the gut make vitamen K2, but never heard it helps restore normal flora. I would think you would take Friendly flora or yougurt if you were trying to prevent problems from the antibiotics wiping out the normal flora tho. maybe the vit k2 is to make up for the vit k2 not being produced if the Normal flora is wiped out?

The only other thing I thought of was I know Coumadin blocks vit k from doing its various jobs, but some of the damage can be reversed when you stop coumadin and take vitamen K so "maybe" they are taking the opportunity during the short time Skyler is off Coumadin to get the benifits, like bone density especially since skyler is a child? But these are all just my rambling thoughts since I read her post so I could be completely off

But I do agree with everyone you would think the doctor would tell you the amount to take.

 

[lance]

For the past while my INR's have been unstable. So my manager recommended 100mcg (capsule) once per day. She also recommended brand name Coumadin. Between one and the other, I'm back in range. I've only seen VitK2 in this form.

 

[sarahsunshine]

Sorry I've left you to speculation. The biggest reasons for the Vit K2 are to possibly reverse the possible effects of coumadin for cardiovascular and bone health. Skyler has been on coumadin since he was 9 days old, and, like Lyn says, the effects of blocked vitamin K on bone density and cardiovascular system has the potential to be terrible on a growing body. We are taking this as a window of opportunity to possibly reverse some of those effects in this short window.

It could be debated that it may have no effect, and that we have no evidence of weak bones from Skyler's annual bone density test. However there is also very little (if any) literature on the effects of coumadin on a growing body. I've only found speculation based on issues adults have had.

So, this came about because we mentioned to the doctors that since Skyler would be off coumadin for several weeks that it may be an opportunity to supplement him with K2 during that time. Skyler's doctor thought it was a great idea, but did not have an idea of dosage. So we went out and bought some K2. The dose recommended for long term use by a healthy 9-13yo his size is 60mcg, but since this is for a short 3 week stint trying to potentially reverse some effects of long term warfarin use, I believe the dose should be much higher. If anyone else has used K2 for this reason, I would appreciate knowing what an adult dosage would be.

Here is an summary of some research that I found that does include doses (http://www.springboard4health.com/notebook/v_k2.html). The nice thing is that it sites doses up to 1mg (not mcg)/day have shown no side effects. In fact in Japan they give people doses of 45-90 mg to treat osteoperosis.

 

[Paleowoman]

Hi Sarah,

I've not been on warfarin but I'm taking vitamin K2 to help my cardiovascular system and osteoporosis. I am taking 100mcg per day of vitamin K2 as MK-7 and 5mg of vitamin K2 as MK-4. The 45-90mg that the Japanese use is, I believe, MK-4. MK-4 does not last long so you have to take higher doses of it, it has a half life of only a few hours, whereas MK-7 lasts for days so a smaller dosage can be taken.

This website from Maastrict University (in English) where they are doing research into vitamin K2 has lots of useful info: http://www.vitak.com/

And this paper has more info than the springboard4health one: http://www.lmreview.com/articles/vi...Prevention-of-Age-Associated-Chronic-Disease/ They seem to recommend 200 mcg of MK-7 and they explain the difference between MK-7 and MK-4 very well.

 

[Duff Man]

Just my two cents, but I kind of feel like taking warfarin and vitamin k at the same time is analogous to taking acetaminophen for pain prevention and then intentionally smashing your hand with a hammer

 

[sarahsunshine]

Just my two cents, but I kind of feel like taking warfarin and vitamin k at the same time is analogous to taking acetaminophen for pain prevention and then intentionally smashing your hand with a hammer

I agree whole-heartedly in terms of high doses... right Skyler is not taking warfarin for 3 weeks, which is why we are trying to boost vitamin K for that time.

There is some research that shows that low doses do not seem to affect warfarin dose, but that is something that probably varies per person and by diet.


Incidentally, we've basically agreed to dose him 200mcg K@ a day for 2 weeks - 100mcg at breakfast, and 100 at dinner, in combination with a Cal-Mag, vit D supplement. The reason for this is that it's only short term (2 weeks), that you don't seem to be able to overdose, and that his body is likely low to begin with. His doctors are OK with this.

 

[Protimenow]

Other threads mention the possibility of adjusting warfarin dosage to accommodate for the Vitamin K dosages -- increase the vitamin K and you may have to increase the warfarin. BUT there are benefits of taking Vitamin K that may not be disabled by Warfarin, so it may be a good strategy to increase the Vitamin K, but be sure that you adjust the warfarin dose so that the INR stays within range.

 

[sarahsunshine]

Thanks Protime-

We will definitely consider that. I would be tons more amenable to trying to increase intake with diet... but with K2 that's really tough!

 

[Protimenow]

Current thinking is that you should take at least SOME K daily because it's supposed to make it EASIER to regulate your INR if you do. The old thinking that you should avoid anything with Vitamin K has given way to this probably more realistic thinking about K and warfarin. If you establish a baseline dosage for K, you may not have too much trouble setting warfarin dosage and keeping INRs consistent.

At least, this reflects some of the more recent writings on the matter.

 

[sarahsunshine]

I’m with you completely. We definitely do not try to remove vit K… Skyler has been on warfarin for 12 years already, and removing vit K in a growing body could have disasterous effects on bone growth.

We have never had much trouble with stable INR (unless related to accidental skipped doses or deliberate wrong doses by mom), even though he lives with dad one week, and mom another week. He takes a multivitamin that has K1 in it. It’s the K2 that we are currently focussing on. Also, we are definitely dosing the “diet”, as opposed to dieting the dose.

We definitely won’t keep this 200mcg daily dose full time. IF we do maintain a dose, it will likely be closer to 30-60mcg.

 

[drivetopless]

DOn't know about all that, but in my experience taking a daily vitamin with K2 in it has made my INR much more stable.

 

[sarahsunshine]

drivetopless - what daily vitamin do you take? I haven't seen any with K2 in them, only K1.