Mk4 vs Mk7 for osteoporosis

@kathleen1314 Agree. Lots to consider and this community is very helpful. Ty

@oopsiedaisy Can you possibly share the link to this study? I'd like to learn more. I've been taking SynergyK by Pure Encapsulations, but it only has 1,000mcg MK4.

@solstice
I believe that these are the studies to which Dr. Neustadt refers:

1. The Cockayne Meta-Analysis (2006): Published in the Archives of Internal Medicine, this systematic review of 13 randomized controlled trials found that Vitamin K2 (MK4) reduced hip fractures by 77%, vertebral fractures by 60%, and all non-vertebral fractures by 81%.

2. The Huang Meta-Analysis (2015): This study, published in Osteoporosis International, evaluated 19 randomized controlled trials and confirmed that MK4 significantly improves lumbar spine bone mineral density and reduces fracture incidence in postmenopausal women.

3, The Ma Meta-Analysis (2022): Published in Frontiers in Public Health, this more recent review included dozens of studies and over 6,000 participants, reinforcing that MK4 effectively maintains bone strength and decreases fracture risk.

Interestingly, mk4 is used in prescription form in Japan as a treatment for osteoporosis.
The problem is that mk4 must be taken frequently while mk7 stays in the system longer and thus can be taken less often. But....there are no large scale tests that say that mk7 protects as well as mk4 in terms of fracture prevention.

Here is an educational article with some information and discussion involving Dr. Neustadt: https://www.nbihealth.com/mk4-or-mk7-which-is-better-for-bones/

His own specialized bone health supplements, such as NBI Osteo-K, are designed for this frequent schedule needed with mk4, with 2 capsules taken three times a day to reach the full 45 mg dose needed for mk4.

I know a well known strontium citrate user who has said that if for any reason she could not take strontium citrate that she would switch to using MK4. Mk4 and mk7 are easily found as supplements.

Posting which I have on this topic:
https://www.inspire.com/m/Kathleen1314/journal/7c2651-mk4-and-mk7-research-and-studies-affecting-bone-health-vitamin-k/

@kathleen1314
This is a recent Youtube conversation that seems to negate the benefit of taking strontium--

@shmbrd
How interesting and what a pretty video add! 🙂
I was just asked about this by a friend.

So I spent a day going over all that was being said and looked at all the research; I also plan on going over it some more and rechecking everything which I read and saw.
But this is what I saw with a day long check:
I will provide a link at the bottom to an ongoing post where I am hotlinking and discussing in more depth.

This seems based mainly on the good but old strontium ranelate studies done in the 1990s and used by the EMA to basically "black box" the use of strontium ranelate. Many of those studies in terms of heart attack concerns have been refuted by more recent population studies in Denmark and Uk. Part of the reason that the EMA "black boxed" strontium ranelate was because they had concerns that doctors were prescribing strontium ranelate to patients with
existing cardio and clot issues when the research at that time showed concerns in that area.

The most compelling argument, I felt, was that a blood clot issue found in the older research seemed to remain even with the new research.

Interestingly, a study on clots by UK found that the blood clot issue, at almost the same percentage, was found in women who had untreated osteoporosis, no strontium ranelate, no pharma drugs.

Why? Well.....
There have been several studies that have tied a much high risk of blood clots to patients with osteoporosis.

It is now believed that the blood clot issue found in the old research used by the EMA plus found in one subset of a newer population study in Denmark is actually picking up the elevated risk of blood clots which all osteoporosis patients suffer.

I think that another study would help nail this down BUT there will probably be no more studies....reason discussed below.

The information did not speak to the new research or the research on blood clots, just the 1990's studies upon which EMA based its concerns years ago.

Whether the EMA would now feel that this research is definitive enough to "black box" strontium ranelate is up for debate. This is because makers of strontium ranelate are not doing any more research and none will be presented to the EMA because they are no longer selling strontium ranelate in Uk or the European Union. The EMA ban used valid research but it does not extend to newer research or to larger better controlled population studies.

Research is a layered action and must be repeated and checked to be considered valid. This research was driven by a patented strontium product; that product has now effectively left the market and so the questions remain hanging without a satisfying solid resolution.

EMA will probably not revisit this concern based on the new evidence because strontium ranelate is no longer sold in the European Union (EU) and the United Kingdom (UK). So there is no need to revisit the situation with the EMA . There will be no counter research which is disheartening because much of the research for strontium has been driven by the patented strontium ranelate.

But to restate, newer research in population studies and on blood clots places doubt on the research used by the EMA to limit strontium ranelate. Research which the doctor is using in his video interview and in his new book.

There are several strontium citrate studies, none of them show a concern with cardio events or clots. Link to another journal where I am placing strontium citrate studies:
https://www.inspire.com/m/Kathleen1314/journal/f1a7d7-strontium-citrate-studies-research/
Inspire post about this question:
https://www.inspire.com/m/Kathleen1314/journal/117867-strontium-research/
We do need more research , and I would welcome it. I want to know more; I am not wedded to strontium citrate; I am wedded to good bone health!

@kathleen1314
please make note that “Cockayne(sic)” data likely refers to Cochrane Meta analysis.
Cochrane reviews are the most rigorous reviews of research data and highly respected in scientific community to establish the basis for clinical decision making. Please correct the spelling. This is where you go when search literature for valid conclusions. Thanks!!!

@kathleen1314 Awesome. Thank you. Are you a person with diagnosed osteoporosis who is refusing the prescribed medications? I'm 82, have osteoporosis according to DEXA scans, and have not used any pharmaceuticals. Now I have a new doctor who wants to change that, and what I've read about Reclast (because my insurance company doesn't cover any of the other options) is disheartening. I've only recently found this forum. thank you!

@daylemaples
Thanks for the spell check. I would love to fix it but if Mayo allows that ability I cannot find it. I can't even see where I can delete the post and repost without going thru the Mayo report system.
We'll have to rely on your great reply for others to know what the spelling should be.
Mayo, suggestion: it would be very helpful for us to have the ability to delete and then repost when we find errors past the time given to edit.

@shmbrd
I can't say that I "refused" medications; I think that they refused me. ha

I tried Boniva years ago, and was not able to live with the side effects. My endo had talked about a new drug in Europe that contained strontium, so I began to research the mineral strontium.

I stopped the Boniva, which had never helped my dexa but was free with its side effects.

I started strontium citrate, plus I was already taking BHRT.
At my next appointment with the endocrinologist, he almost skipped into the room. Large gain in my dexa. I confessed that I was not taking the Boniva but had begun strontium citrate. He spent some time looking up information and called another expert. He told me to change nothing.

Time passed my dexa continued to increase, no side effects, no fractures. The endocrinologist told me that I did not need him any more and released me. He told me to change nothing.

Years passed still no fractures, no side effects, but steady dexa gains until I was in normal bone territory and as of 2025 a TBS report of normal bone quality.

I do not know what your medical history is or what your doctor is seeing in your history. I do know that it never hurts to consider and research and decide what is best for yourself.

Here are some strontium citrate stories from strontium users:
https://www.inspire.com/m/Kathleen1314/journal/d69831-strontium-users-stories-3-alternative-to-pharma-meds/
And
A compilation of strontium research and posts:
https://www.inspire.com/groups/bone-health-and-osteoporosis/discussion/dd823b-strontium-a-compilation-of-research-and-information/

@kathleen1314 I am 75 with osteoporosis, severe in my spine (-4.1) with no fractures and have refused any bone drugs (Tymlos and Forteo are not an option for me due to parathyroid issues).

What are your DEXA scores and have you had anything fractures? If I were considering a bisphosphonate, I would start with Fosamax over Reclast due to the serious long-term side effects I've heard about Reclast. At least with Fosamax, you can stop taking it if you have side effects. My Dr said he'd prescribe Fosamax at 1/2 strength to ease my fears, and said studies have shown it's effective at that dose. However, I still refused because I've read studies that show bisphosphonates offer minimal benefits at fracture prevention, and isn't that the point of taking any bone drugs?

Here are a couple studies on the "absolute risk" vs benefit of bisphosphonates: https://www.amjmed.com/article/S0002-9343(24)00101-3/fulltext
From that study: "When the baseline risk is low, use of relative risk alone is likely misleading. According to the review conducted by the ACP, the relative risk reduction of hip fractures with bisphosphonate treatment for at least 3 years is 36%; however, the absolute risk reduction is only 0.6%. Framed as number needed to treat, 167 patients need to be treated for 3 years to prevent one hip fracture."
"The benefits of treatment in older or less functional adults are less certain, as clinical trials mostly excluded adults over age 80 and residents of long-term care facilities; limited data in both subgroups does not support a fracture risk reduction. In addition, the long-term benefits of fracture risk reduction must be considered in the context of functionality and life expectancy. The time to benefit for bisphosphonates is estimated to be 1-2 years for important clinical outcomes like hip fracture and vertebral fractures."

Another study:
https://www.consumerreports.org/cro/2012/04/popular-osteoporosis-drugs-come-with-mounting-concerns/index.htm
"Bottom line. Bisphosphonates offer only modest benefits in building bone and preventing fractures, and that should be considered along with the risks."