Vitamin K2 Deficiency Is a Significant Cause of Cardiovascular Disease

Heart Health

Story at-a-glance -

  • Warfarin and statins may reduce your absorption of vitamin K2, leading to an increased risk of heart disease, stroke, osteoporosis and cancer
  • Although necessary for your overall health, vitamin D without vitamin K2 may increase your risk of atherosclerosis, heart disease and stroke
  • Vitamin K2 is found in fermented foods, fermented cheeses and grass-fed meats and dairy products

By Dr. Mercola

Your body is a complex organism, dependent upon the interactions and interrelationships of organs, enzymes, vitamins and hormones. Anytime you take a nutritional supplement, especially at high doses, you affect the balance of others.

For instance, if you take a zinc supplement, you must be wary of a copper imbalance in your body. These two nutrients balance each other, meaning you may suffer from either zinc or copper toxicity if they get out of balance.

The same is true for vitamins K and D. When the ratio between these two is not balanced, it can increase your risk for cardiovascular disease (CVD), stroke and heart attacks.

But vitamin supplements are not the only thing that can cause an imbalance. In a recent review, researchers found a link between medications used to lower cholesterol levels and treat type 2 diabetes and an inhibition of absorption of vitamin K from food.1

The 2 Forms of Vitamin K

In this video, Dr. Kate Rhéaume-Bleue discusses the differences between vitamins K1 and K2 and how they interact with vitamin D, calcium and other nutrients.

Vitamin K was discovered in 1929 as part of an experiment and was associated with blood coagulation, or how your blood clots.2 There are two main forms of the vitamin. Phylloquinone (K1) is found in leafy green plants and menaquinone (K2) is found in animal meat and fermented foods. Your body can also synthesize K2 in your gut.

Vitamin K2 can be divided into subtypes. The two we understand to be important today are MK-4 (short-chain) and MK-7 (long-chain bacterial derived).

Both vitamins K1 and K2 have important functions in your body. K1 is an integral factor in blood clotting and K2 activates proteins that regulate where calcium ends up in your body.3

The importance of vitamin K2 relates to the interaction it has with calcium. How and where calcium is deposited and used by your body has an impact on your dental health, bone health, cardiovascular system and renal (kidney) health. Each of these bodily systems depend upon the correct balance of calcium.4

Your body has limited storage capacity for vitamin K2, but can recycle the vitamin so it can be used multiple times.5 The functions of the vitamin are unique and necessary throughout all your life stages.

Many Drugs Reduce Vitamin K2 Absorption

The review paper associated medications used to treat cardiovascular disease (CVD) and type 2 diabetes with an inhibition of vitamin K2 processes. These negative effects may increase your risk for CVD, diabetes, chronic kidney disease, bone loss and even mental disorders, as a result of poor K2 absorption.6

The research found a shared mechanism between the blood thinner warfarin, statin medications and vegetable oils in the inhibition of vitamin K dependent processes.7 The blood thinner warfarin works to reduce coagulation through an antagonistic effect on vitamin K.

This was the design of the drug. Even eating foods with vitamin K can reduce the effectiveness of warfarin. Research has also found that:

  • Anti-tuberculosis medications or anticonvulsant medications, taken when you are pregnant, may place your newborn at increased risk of vitamin K deficiency8
  • Use of broad-spectrum antibiotics may alter your gut microbiome and thus reduce the effectiveness of your gut to synthesize vitamin K2. Drug classes associated with this alteration include cephalosporins and salicylates9
  • Statin medications, developed to reduce cholesterol levels, also have a negative impact on your vitamin K2 absorption and inhibit CoQ10,10 both necessary for a healthy cardiovascular system.

Dr. Hogne Vik, chief medical officer with NattoPharma, a leader in vitamin K2 research and development, says:11

"We are not only finally seeing recognition that vitamin K2 is woefully insufficient in the diet, but there is a growing body of evidence that pharmaceuticals further exacerbate the problem of our limited vitamin K2 status, delivering potentially dangerous consequences for human health."

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Interaction Between K2 and Your Cardiovascular System

A significant risk factor in the development of CVD is calcium buildup in your arterial system.12,13 Plaque formation on the walls of your arteries may lead to small pieces breaking off, causing clot formation. This is one of the more common reasons for a heart attack or stroke.14

Calcification of these plaque formations occurs as atherosclerotic disease progresses, which may predict your risk for future cardiovascular events.

A meta-analysis of 30 studies, including over 218,000 participants, found calcification in the arteries was associated with a 300 to 400 percent increased risk of a cardiovascular event (such as a heart attack) or death.15

Vitamin K2 regulates arterial calcification through protein modulation. In one study, those who had the highest amount of vitamin K2 were 52 percent less likely to experience calcification in their arteries and 57 percent less likely to die from heart disease over a seven to 10 year period.16

Insufficient vitamin K2 in your diet may also lead to suboptimal carboxylation and biologically inactive matrix carboxylated glutamate protein (MGP), both leading to lower protection of your cardiovascular system from calcification of the arterial system.17

Vitamin D and Vitamin K2 Need Balance

Vitamin D influences or plays a significant role in dozens of conditions, including:

Eye health

Preventing macular degeneration

Preventing dry eye

Immune system health

Preventing bowel disease

Reducing effects of rheumatic diseases

Reducing effects of multiple sclerosis

Reducing effects of lupus

Fighting HIV/AIDS

Reducing depression

Reducing potential for childhood asthma

Reducing the risk of certain cancers

Reducing the signs of aging

Prevention of dementia

Prevention of heart disease

Deficiency in vitamin D may also contribute to a number of different health conditions, all of which increase your risk of heart disease. These conditions include high blood pressure, type 2 diabetes, atherosclerosis and increased inflammation in your body.18

However, like most other vitamins and nutrients, no one nutrient operates independently of others. For instance, most pasteurized milk is fortified with vitamin D. Manufacturers recognize they have effectively eradicated the natural vitamin D in the milk, necessary for absorption of calcium, and so they add it.

While vitamin D helps you absorb calcium, vitamin K2 directs your body to deposit the calcium in the appropriate places. In other words, it's the vitamin K2 that tells your body to deposit calcium in your bones and teeth, and not in your organs, arteries, muscles or soft tissue.

An effective analogy is that vitamin D is your gatekeeper, allowing the admission of calcium, and vitamin K2 is the traffic cop, telling the calcium where to go. With vitamin D and calcium you'll have the traffic, but without vitamin K2 you'll have a traffic jam and calcium being deposited exactly where you don't want it — in your arteries.

With the push for vitamin D and calcium to "grow strong bones," you may be at risk for CVD if your diet isn't rich in sources of vitamin K2. As an added risk, you may be taking medication or have an altered gut microbiome, reducing the absorption of vitamin K2.

Role of K2 in Osteoporosis

Osteoporosis causes more than 8.9 million fractures worldwide. This means a fracture due to osteoporosis happens every three seconds.19 Worldwide, 1 in 3 women and 1 in 5 men over the age of 50 will experience a fracture related to osteoporosis.

The strength of your bones is related to several factors. Both the density of the bone and formation of the bone are related to the strength of the bone. When you have density without proper formation, your risk of fracture may actually increase. Your body needs several nutrients to build strong bones.20

Vitamin K2, working together with vitamin D, magnesium, phosphorus and calcium, helps your body develop strong bones and may reduce your risk of osteoporosis. This is because nutrients in your body are interconnected in the way they function.

Vitamin K is essential to the proper development of several bone-related proteins, including osteocalcin, MGP and periostin. Vitamin K is also a cofactor in the production of gamma-glutamyl carboxylase (GGCX). Recent research links low levels of GGCX and/or vitamin K2 to bone mineralization defects.21

This means that without vitamin K2 your body produces bone with defects, reducing the strength of the bone and increasing your risk of bone mineralization fractures.22,23

Vitamin K2 Is Also Important for Your Teeth and Cancer Prevention

Vitamin K2 also plays a significant role in the health of your teeth and in preventing cancer. You teeth, like your bones, are storehouses of calcium, which supports the structure and hardness of the teeth.24 The way calcium is deposited in your teeth will either increase the hardness of your tooth or make it more brittle.

Vitamin K2 once again acts like the traffic cop, telling calcium where and how to be used in your teeth. Working together with vitamin D, it also promotes a reduction in tooth decay or cavities.25 The process of depositing calcium in areas of the body where it is not normally found may act like sand in the gears of a machine. In fact, inappropriate calcium distribution may contribute to the development of:


Colon cancer

Liver cancer

Ovarian cysts

Bone cancer

Breast cancer

Prostate cancer

Lung cancer



Varicose veins

Macular degeneration

German doctors evaluating the effect of vitamins K1 and K2 on the development and treatment of prostate cancer found that those who consumed the greatest amount of K2 had a 63 percent reduced incidence of advanced prostate cancer.26,27

Vitamin K2 has demonstrated the ability to induce cell destruction in leukemia cells outside the body.28 The vitamin also demonstrated inhibitory effects on myeloma and lymphoma. Following treatment for liver cancer, those who took K2 supplements experienced a 13 percent relapse of the cancer while those who did not experienced a 55 percent relapse rate.29,30

Enjoy the Benefits of K2

How do you know if you're deficient in vitamin K2? According to Rhéaume-Bleue, there are several questions you can ask yourself, and depending upon the answers, you'll have a good idea if you are deficient. Estimates suggest up to 85 percent of Americans are vitamin K2 deficient.

Do you suffer from health conditions associated with vitamin K2 deficiency? Some of these conditions are listed above.

Do you eat meats, dairy or cheeses from grass-fed sources? Grass-fed beef and the dairy products from these animals are higher in vitamin K2 and healthier for you.

Do you eat fermented foods? The bacteria in the fermentation process produce vitamin K2 in the food. Natto (fermented soybeans), is one of the best sources of vitamin K2. I ate it for a while, but the flavor is a bit of a challenge and probably isn't well accepted by the Western palate.

Other fermented foods like kimchi also contain vitamin K2. My favorite way of getting K2 is to ferment my own vegetables using a special starter culture designed with bacteria that produce K2.

Do you eat Brie or Gouda cheeses or consistently eat liver pate? Fermentation in the cheese produces vitamin K2. Fermented dairy products will provide about one-third the amount per serving of natto. Ideally, I recommend fermented cheeses from raw milk. It is important to note that raw milk in and of itself does not contain K2. The vitamin is produced during the fermentation process.

If these foods aren't a regular part of your diet, then you are likely deficient in vitamin K2 and you may benefit from using a supplement. At this time, there are no reliable tests to determine your level of vitamin K2. However, while it is a fat-soluble vitamin, there is no known toxicity at any dose.

It is important to take your supplement with foods containing healthy fat to increase absorption. Of the two forms of vitamin K2, MK-4 and MK-7, the latter is the more effective supplement to use.

MK-4 is a synthetic product, having a very short biological half-life of about one hour, making it a poor candidate as a dietary supplement. After reaching your intestines, it remains mostly in your liver, where it is useful in synthesizing blood-clotting factors. MK-7 is a newer agent with more practical applications because it stays in your body longer. Its half-life is three days, meaning you have a better chance of building up a consistent blood level. MK-7 is extracted from the Japanese fermented soy product, natto.

+ Sources and References