12/21/2021 – 10:05 am
Dr. Jacobs Institute
Ingelheim (ots)
Optimizing vitamin K2 supplies could improve the course of COVID-19
It is generally accepted that the most important task of vitamin K is to promote blood clotting. But this is only half the story: Vitamin K not only activates coagulation-promoting, but also anti-coagulation factors such as proteins C and S. Vitamin K thus has a regulating effect on the coagulation function. New studies show that vitamin K thus plays an important role in COVID-19. Particularly in severe cases, there is a pronounced vitamin K deficiency, which disrupts calcium metabolism and promotes blood clotting.
The vitamin K triage: Vitamin K DEFICIENCY promotes blood clotting
If there is a vitamin K deficiency, the regulating function of the vitamin on blood coagulation is impaired: If there is not enough vitamin K, the liver primarily produces coagulant factors, since preventing bleeding is directly important for survival. However, this happens at the expense of other vitamin K-dependent proteins, which is also known as the triage thesis (Janssen et al., 2020). The vitamin K-dependent protein S, half of which is produced outside the liver in endothelial cells, falls short in the event of a vitamin K deficiency. Protein S inhibits blood coagulation and plays a role in the prevention of local thrombosis. In the case of a vitamin K deficiency, this important function of protein S is severely impaired, which, for example, explains the increased thrombus formation in COVID-19 (Janssen et al., 2020). Specifically, COVID-19 is virally triggered immunothrombosis, which is the most common cause of death in the disease.
Protein S plays a previously underestimated key role in the positive effects of vitamin K. It not only has an anti-coagulant effect, but also anti-inflammatory by reducing prostaglandin E2 (PGE2), cyclooxygenase-2 (COX-2) and interleukin-6 (Suleiman et al, 2013). The vitamin K-dependent protein C also has an anti-inflammatory effect.
The matrix-gla-protein (MGP) activated by vitamin K binds excess calcium (Schurgers et al., 2010). If too little vitamin K is available, less MGP is activated, so that more free calcium is available. Calcium is a key factor in blood clotting. In the blood it is normally 45% bound to protein and 50% in free, ionized form. In the event of shortness of breath in the context of COVID-19, acidosis ultimately occurs in the blood, which increases the release of bound calcium. Free calcium is the decisive factor in starting the coagulation cascade. Calcium ions are classified as coagulation factor IV and activate the other factors II, VII, IX, X and XIII. Excess free calcium can over-activate blood clotting, leading to potentially fatal blood clots. Vitamin K can counter-regulate here by activating MGP in the blood vessel walls.
Blood clots are a very common complication of COVID-19
Patients with severe COVID-19 disease show an incorrect and overreaction of the immune system, a so-called “cytokine storm”, which can be serious or even fatal. Cytokines activate blood clotting, which is why severe COVID-19 cases as a result of the cytokine storm often suffer from blood clotting disorders with the formation of blood clots (thrombus formation). Thromboembolism and microvascular thrombosis are the leading cause of death in COVID-19 (Janssen et al., 2020).
Virus infections are often associated with thrombus formation – but this effect seems to be particularly strong in the case of the coronavirus. While an average of 1.3% of seriously ill people without COVID-19 suffer a pulmonary embolism, it is a full 30% of seriously ill COVID-19 patients. In addition to pneumonia, clots are a key reason for damage to the lungs and fatal multiple organ failure. The sometimes rapid and severe deterioration in the patient’s condition can also be explained by the formation of clots.
Vitamin K supply poor in COVID-19 patients
More and more studies show that COVID-19 patients have a greatly reduced vitamin K status. The more severe the COVID-19 course, the greater the vitamin K deficiency (Dofferhoff et al., 2020; Linneberg et al., 2021). The cause of the severe vitamin K deficiency in COVID-19 patients is also an increased vitamin K consumption in the context of pneumonia, which depletes the vitamin K stores (Janssen et al., 2020).
In addition, many patients probably did not have enough vitamin K before they were infected. A poor supply of vitamin K is also linked to various health risk factors that increase the risk of developing severe disease in COVID-19.
With vitamin K2 (all-trans MK-7) optimize the vitamin K status
A sufficient supply of vitamin K is of crucial importance for the regulation of blood clotting – not only with COVID-19. In addition, vitamin K has a variety of health effects that go beyond the regulation of blood clotting, especially for the bones and in the cardiovascular system. The supplementary intake is particularly useful for people over the age of 50, with previous illnesses such as osteoporosis, coronary heart disease, chronic kidney diseases, inflammatory and calcification processes of all kinds and when supplementing higher amounts of vitamin D, as all of this with an increased vitamin K requirement goes hand in hand.
Vitamin K2 has a significantly better stability in the body than vitamin K1, especially in the form of the all-trans menaquinone-7 (all-trans MK-7). With a half-life of around 3 days, it has a duration of action that is around 50 times longer and reaches every part of the body (Schurgers et al., 2007). Numerous clinical studies show that vitamin K2 (MK-7) is clearly superior to K1 and achieves effects that are associated with Vitamin K1 cannot be achieved (Halder et al., 2019).
As a preventive measure, dosages of around 100 µg vitamin K2 are sufficient. In the case of a COVID-19 illness, the dosage should be increased significantly, as the vitamin K consumption increases and the higher vitamin K amounts are important for the activation of protein S. There are no scientific data on this yet, but since vitamins K1 and K2 are non-toxic and there are therefore no intake restrictions, doses of 500 µg are advisable in the event of an infection. With K2 (MK-7), the dose is sufficient once a day, while K1 would have to be administered approximately every two hours. Vitamin K is fat-soluble and is therefore best absorbed in oil.
Take care when taking coumarin-type anticoagulants
Caution with vitamin K-containing food supplements is only advisable when taking anticoagulants of the coumarin type (e.g. Marcumar) at the same time, as these act as vitamin K antagonists (Vermeer, 2012). Vitamin K1 and K2 reduce their effect. A study shows that the daily intake of 10 µg vitamin K2 has a disruptive effect on the blood-thinning medication (Theuwissen et al., 2013).
People who take coumarins must clarify vitamin K supplementation with their doctor beforehand. When taking vitamin K2, the blood values (especially the coagulation values) must be checked closely at the beginning and the dosage of the blood thinner readjusted. The intake of vitamin K1 does not make sense due to its short half-life.
Coumarins cause atherosclerosis and have potentially other serious side effects. It therefore makes sense to switch to a modern anticoagulant with fewer side effects and without vitamin K interactions. However, such a change may only be made after prior clarification with the attending physician.
Vitamin K2 as an optimal supplement to the immune modulator vitamin D.
The crucial role of vitamin D in optimizing the immune system and alleviating the cytokine storm in COVID-19 has now been very well documented. Numerous studies show that vitamin D lowers the risk and mortality of acute respiratory diseases in general, and COVID-19 in particular. With a vitamin D deficiency, which affects most people in Germany, especially in winter, the risk of SARS-CoV-2 infection is increased. The lower the vitamin D value, the more severe the disease and the higher the death rate from COVID-19. The administration of vitamin D in COVID-19, on the other hand, lowers the risk of severe disease and death.
With COVID-19, most of the complications are due to the excessive immune response, which leads to a cytokine storm and organ damage. On the one hand, vitamin D strengthens the immune system and can counteract an infection; on the other hand, it can also inhibit an excessive immune reaction and have an anti-inflammatory effect (Musavi et al., 2020). Vitamin D has an immunomodulatory, i.e. regulating, effect (Siddiqui et al., 2020). The vitamin can prevent an excessive release of proinflammatory cytokines and chemokines and is also required to stabilize the mast cells.
Vitamin D contributes to the formation of proteins which vitamin K is necessary for activation (e.g. osteocalcin). With high vitamin D intake, the need for vitamin K increases. It is therefore recommended to combine a dietary supplement of vitamin D with vitamin K2. Especially with a high dose of vitamin D, the supplementary intake of vitamin K2 is important in order to improve the vitamin D effect and reduce the risk of potential side effects (Goddek, 2020). Very high doses of vitamin D alone increase the calcium values in the blood serum, which vitamin K2 can partially prevent by activating calcium-binding proteins.
The literature references for the press release can be found on www.drjacobsinstitut.de
The effects of vitamin D in COVID-19 and the synergistic effect with vitamin K have already been discussed in detail in previous press releases:
You can find more interesting, scientific information and articles on vitamins D and K2 at www.vitamind.science
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