Vitamin K2 and Osteoporosis: Everything You Need to Know

author avatar Dr. Eric Berg 11/02/2023

Vitamin K2 is a fat-soluble vitamin needed to maintain calcium balance and regulate bone metabolism, and vitamin K deficiency is associated with an increased risk of osteoporosis and bone fractures.


Discover the link between low levels of vitamin K2 and osteoporosis and learn how vitamin K supplements can improve bone strength and lower fracture risk. 

Osteoporosis illustration

What is osteoporosis?


Osteoporosis is an age-related skeletal condition characterized by weak, soft bones prone to fractures.  


Bone mass is regulated by continuous bone formation and bone resorption, a process that breaks down bone tissue to release minerals such as calcium and phosphorus into the circulation.


When blood calcium concentrations are imbalanced, the rate of bone resorption can exceed bone formation and result in porous and brittle bone tissue, the leading cause of osteoporosis.


Osteoporosis is a silent disease as it progresses without symptoms or pain, making it difficult to diagnose it without specialized techniques such as dual-energy X-ray absorptiometry, also known as DEXA scans. 


While excessive bone loss can develop in any part of the skeletal system, vertebral fractures and hip fractures are the most commonly associated with osteoporosis.


There are various risk factors for developing osteoporosis, including:

  • Aging

  • Family history

  • Low dietary intake of calcium 

  • Vitamin D and K deficiencies 

  • Sedentary lifestyle 

  • Smoking

  • Prolonged corticosteroid use


“Although osteoporosis can affect anyone, postmenopausal women are at greatest risk of poor bone health due to declining levels of estrogen, a critical hormone needed to regulate bone turnover,” explains Dr. Berg.   


Watch the video below to learn how vitamin K2 promotes calcium balance and bone health.   

What is vitamin K2?


Vitamin K is a fat-soluble vitamin that naturally occurs in two forms: vitamin K1 and vitamin K2.


Vitamins K1 and K2 are crucial for effective blood coagulation and wound healing and prevent excessive bleeding and other blood clotting disorders.


In addition to its role in blood clotting, vitamin K2 plays an essential role in regulating calcium balance and maintaining bone mass density, a marker of skeletal health.


Vitamin K2 redirects calcium from the blood into bone, which significantly lowers the risk of arterial calcification, atherosclerosis, and heart disease.


Vitamin K2 is naturally found in fermented foods such as natto, kimchi, and sauerkraut and certain animal products, including cheese, butter, egg yolks, oily fish and organ meat.

Vitamin K2 illustration

How does vitamin K2 affect bone health?


Vitamin K2 activates a group of vitamin K-dependent proteins, also known as matrix Gla protein (MGP), that bind to circulating calcium and transport it into bone tissue. 


This helps to regulate blood calcium levels and ensures the effective deposition of calcium into the bone matrix, the structural component that gives bones strength and rigidity.  


In addition, vitamin K2 activates osteocalcin, a protein that plays a crucial role in bone metabolism by binding calcium into the bone matrix, a critical step in the bone mineralization process. 


Many women are taking calcium supplementation to lower the risk of postmenopausal osteoporosis. However, without adequate vitamin K2 status, calcium won’t effectively be incorporated into bone, which explains why taking calcium may not prevent osteoporosis


A study published in Biomedicines confirms the effect of vitamin K on bone health and suggests that vitamin K supplementation with MK7, a highly effective and potent form of vitamin K2, can prevent and even reverse bone loss and lower the risk of fractures in later life.  

Senior man lying on the ground

Benefits of vitamin K2 for osteoporosis


Increasingly more research is being conducted to investigate the link between vitamin K status and osteoporosis, and evidence suggests that vitamin K2 treatment may be a feasible approach to prevent or slow down age-related bone loss.


A study published in the American Journal of Health-System Pharmacy found that healthy postmenopausal women with the highest vitamin K intake have a 30% lower risk of suffering a hip fracture compared to those with the lowest intake.  


It’s important to note that vitamin K2’s benefits for skeletal health require adequate levels of vitamin D, a fat-soluble vitamin that enhances the intestinal absorption of calcium.


Vitamin D3 and K2 work in synergy to regulate calcium levels, and vitamin D deficiency can result in low calcium levels and poor bone health despite adequate dietary intake of both vitamin K and calcium.


Evidence suggests that vitamin K2 and D3 play a more crucial role in osteoporosis prevention than previously thought and may be more beneficial than calcium in reducing fracture risk.


A randomized controlled trial published in the Journal of Orthopedic Science compared the effects of vitamin K2 and D3 supplementation with calcium supplementation on bone mineral density in women with osteoporosis.


The authors concluded, “Combined administration of vitamin D3 and vitamin K2, compared with calcium administration, appears to be useful in increasing lumbar bone mineral density in postmenopausal women with osteoporosis.” 

Bruised leg

Vitamin K2 deficiency signs


While severe vitamin K deficiency is rare, a study published in StatPearls found that around 30 percent of U.S. adults don’t consume enough vitamin K2, leaving many at risk of skeletal issues and osteoporosis. 


Because vitamin K2 plays a crucial role in blood clotting, symptoms such as poor wound healing, easy bruising, and bleeding gums are common warning signs of low vitamin K2 status.


Prolonged periods of vitamin K2 deficiency can cause excessive bleeding and result in bone-related problems, including soft and brittle bones, osteoporosis, and osteomalacia.


Vitamin K2 metabolism and storage is regulated in the liver, and individuals with poor liver health, fatty liver disease, and cirrhosis are at increased risk of vitamin K deficiency.


If you have developed signs of vitamin K2 deficiency or are concerned about your skeletal health, it’s crucial to consult a healthcare provider for an evaluation of your symptoms and assessment of your bone mineral density. 

Vitamin K2 supplement container

Vitamin K2 dosage for osteoporosis


Most healthcare providers recommend a daily vitamin K intake of 120 mcg for men and 90 mcg for women. 


However, research published in Nutrients suggests that these intake recommendations are not adequate to promote bone health and that significantly larger daily vitamin K2 doses of up to 45 mg may be needed for the management and prevention of osteoporosis.


In addition, it’s recommended to opt for a vitamin K2 supplement that contains vitamin D3 for optimal calcium balance. 


Taking vitamins K2 and D3 is an effective strategy to promote bone health and improve bone density and may be especially beneficial for individuals with low bone mass or those at risk of osteoporosis due to menopause, liver problems, or prolonged steroid drug use.


While vitamin K2 is generally considered safe, vitamin K supplementation can interfere with blood thinners and hormonal treatments, and it’s recommended to discuss the use of vitamin K2 with a healthcare provider to minimize the risk of side effects.

Human skeletal system

Key takeaways


Vitamin K2 regulates calcium deposition into the bone matrix, which promotes bone formation and skeletal health. This also may explain why osteoporosis and vitamin K2 deficiency are closely linked.


Evidence suggests that taking vitamin K2 in combination with vitamin D3 can prevent excessive loss of bone tissue and may restore bone density in individuals with osteoporosis. 



Additional resources



FAQ


1. How much vitamin K2 should I take for osteoporosis?

Evidence suggests that vitamin K2 doses of around 45 mg daily are associated with a significant improvement in bone mass density and reduced fracture risk in individuals with osteoporosis. 


2. Does vitamin K2 rebuild bone?

Yes, vitamin K2 helps to rebuild bone by stimulating the deposition of calcium into bones and activating proteins that form bone matrix. This promotes bone formation and lowers the rate of bone resorption, which is linked to improved bone health.  


3. Should I take D3 and K2 at the same time?

Yes. It’s recommended to take vitamin D3 at the same time as vitamin K2 as these two fat-soluble vitamins work in synergy to regulate calcium balance and maintain skeletal health.


4. Who should not take K2 supplements?

Vitamin K has been found to interfere with blood thinners and hormonal treatments, and people with blood clotting disorders and those taking blood thinning medication or hormone replacement drugs should discuss vitamin K supplementation with a healthcare provider.


5. What are the best supplements to take for osteoporosis?

While it’s commonly believed that calcium is the best supplement for osteoporosis, evidence suggests that taking vitamins K2 and D3 is more beneficial for improving bone mineral density compared to calcium supplements. 


However, individuals with a low dietary calcium intake should consider combining vitamins K2 and D3 with a high-quality calcium supplement.


6. Which is better for osteoporosis: vitamin D2 or vitamin D3?

Vitamin D3 is the same potent form of vitamin D that’s produced in the body in response to sunlight, making it the best choice for osteoporosis.


Vitamin D2 is a synthetic form of vitamin D that isn’t well absorbed and is less effective at promoting calcium balance and skeletal health compared to vitamin D3. 


7. How can I fix osteoporosis naturally?

Taking vitamin K2 in combination with vitamin D3 has been found to improve bone mass density in postmenopausal women with osteoporosis.


In addition, it’s essential to prevent further bone loss by avoiding smoking and excessive alcohol intake and engaging in regular physical exercise. 


8. Is vitamin K2 good for bones?

Yes, vitamin K2 is good for bones as it regulates calcium metabolism, supports effective bone mineralization, and may help reduce the risk of osteoporosis and fractures.


9. Is K2 good for bone density?

Vitamin K2 stimulates the transport of calcium into the bones and activates proteins that produce and deposit bone matrix, which supports optimal bone density and skeletal health. 


10. How much K2 should I take for bone health?

General recommendations suggest a daily vitamin K2 intake of 120 mcg for men and 90 mcg for women to support a healthy vitamin K status and promote bone health. 


However, individuals at risk of low vitamin K levels, such as people with poor liver function, postmenopausal women, and those who regularly take corticosteroid medications, may benefit from larger doses up to 180 mcg per day to promote bone health. 


11. Is calcium or vitamin K better for bones?

While both calcium and vitamin K are needed to support healthy bones, evidence suggests that vitamin K is more effective in improving and maintaining bone mass density compared to calcium. 


12. Which form of vitamin K is best for your bones? 

Vitamin K2 is the best form of vitamin K to promote skeletal health due to its role in calcium balance and bone tissue formation linked to improved bone mineral density and lower fracture risk.  


In contrast, vitamin K1 doesn’t play an important role in calcium metabolism and bone mineralization and isn’t associated with a reduced risk of osteoporosis.  



Sources


  1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9138595/

  2. https://www.medscape.com/viewarticle/509074_4?form=fpf

  3. https://www.sciencedirect.com/science/article/abs/pii/S0949265815334114?via%3Dihub

  4. https://www.ncbi.nlm.nih.gov/books/NBK536983/

  5. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4042573/


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