osteoporosis, calcium supplements and calcium paradox

@daisy17 Thanks so much for this info! The person who mentioned the higher dosage found in Osteo K said it was 45 mg and not 45 mcg. Yes, that's a big dose especially when compared to what is found here in similar products. I think that's the dosage used in Japan where MK4 is prescribed for osteoporosis. Because it was such a high dosage, I thought the capsule/pill might be huge.

I've ordered from Life Extension in the past so will take a look at their K2 products. Your descriptions are very helpful to me!

@prarysky Are you going to start taking the higher (45mg) dose of Vitamin K or MK-4?

I found this from AI Assist: "In Japan, high doses of MK-4 (menaquinone-4), a form of vitamin K2, have been prescribed for decades to treat osteoporosis, showing significant improvements in bone density and reduced fracture risk. Studies indicate that doses around 45 mg daily can effectively help build new bone and slow bone loss."

I also found this: ""MK4 (45 mg/day, given in divided doses and not all at once) has been so well researched that since 1995 it’s been approved by the Japanese Ministry of Health for the treatment of osteoporosis and bone pain caused by osteoporosis". I believe the divided dose is because the vitamin has a short half-life. I also found this review: "The only other bone therapy I find acceptable is vitamin K2 (MK4) at 45 mg/day (15 mg taken three times per day). MK4 at this dosage is given by prescription in Japan and other Asian countries for osteoporosis."

Attached is a link to one study I found. The dosages were: "Participants took low-dose MK-4 (0.5 mg) for 3 weeks (until the second visit), then medium-dose MK-4 (5 mg) for 3 weeks (until the third visit), then high-dose MK-4 (45 mg) for 3 weeks." Findings: " Compared to 5 mg/day, there was no additional benefit of 45 mg/day. There were no major side effects of MK-4 supplementation. In postmenopausal women with osteoporotic fractures, supplementation with either 5 or 45 mg/day of MK-4." So this study found 5mg/ adequate. https://pubmed.ncbi.nlm.nih.gov/30816822/

Another interesting articles: https://betterbones.com/bone-health-basics/vitamin-k2-mk7-vs-mk4/

This one says: "Low-dose (1.5-mg daily) vitamin K2 (MK-4) supplementation for 12 months improves bone metabolism and prevents forearm bone loss in postmenopausal Japanese women...without any substantial adverse effects." https://pubmed.ncbi.nlm.nih.gov/23702931/

I need to do some more research on this. I wonder why this isn't recommended in the U.S.?

@daisy17 You have found some very interesting info! That's the first time I've read about study participants starting MK-4 at a low dosage and then increasing it to the full 45 mg. We rarely see studies comparing different dosages. I am curious to know the Japanese Ministry of Health's response to this study. I would assume it has studied the MK-4 dosage over longer periods of time than this study. Still, it's an intriguing study.

I used to take both MK4 and MK7 but stopped taking both when I was diagnosed with afib and started Eliquis, and that was followed by a breast cancer diagnosis. I'm still on Eliquis but had a heart ablation in September. When I asked my electrophysiolgoist if I could resume MK-4, he didn't object.

My plan is to start MK4 but not MK7 which is sometimes linked to heart palpitations. I still need to get the okay from my cardiologist who specializes in cancer to be sure she's also okay with resuming Mk-4. She may tell me I can' take it while taking Eliquis. Have no idea.

So many doctors! It's a challenge juggling all the contraindications when you have multiple issues and medications.

As to your last question, though, yes...many of us wonder why more doctors are not aware of this Japanese approach to osteoporosis. It seems to fit the bill of "do not harm" better than many of the osteoporosis drugs they prescribe.

Daisy I wonder why vitamin K isn't recommended also. I have read about studies and its use in Japan too; when I asked my endo if I should take Vitamin K along with the 50,000 units of Vitamin D2 and the 1200 Calcium Citrate he has me on the answer was "no proven benefit" (his words). So I decided to take it anyway as I don't think I can get enough from food, and it sure sounds like there is a benefit. All I could find was MK4 however. Would be interesting to find how many of us are taking vitamin k, recommended by med pros or not. I wonder if a nutritionist would be of help. Sure seems like it!

@daisy17 You have found some very interesting info! That's the first time I've read about study participants starting MK-4 at a low dosage and then increasing it to the full 45 mg. We rarely see studies comparing different dosages. I am curious to know the Japanese Ministry of Health's response to this study. I would assume it has studied the MK-4 dosage over longer periods of time than this study. Still, it's an intriguing study.

I used to take both MK4 and MK7 but stopped taking both when I was diagnosed with afib and started Eliquis, and that was followed by a breast cancer diagnosis. I'm still on Eliquis but had a heart ablation in September. When I asked my electrophysiolgoist if I could resume MK-4, he didn't object.

My plan is to start MK4 but not MK7 which is sometimes linked to heart palpitations. I still need to get the okay from my cardiologist who specializes in cancer to be sure she's also okay with resuming Mk-4. She may tell me I can' take it while taking Eliquis. Have no idea.

So many doctors! It's a challenge juggling all the contraindications when you have multiple issues and medications.

As to your last question, though, yes...many of us wonder why more doctors are not aware of this Japanese approach to osteoporosis. It seems to fit the bill of "do not harm" better than many of the osteoporosis drugs they prescribe.

@prarysky
I am not sure that electrophysiologist is the one who has a knowledge if any form of vitamin K should be taken together with Eliquis. On my opinion when one takes Eliquis it is better to be cautious with vit. K that doing exactly opposite to what you want to reach taking Eliquis.

@daisy17 You have found some very interesting info! That's the first time I've read about study participants starting MK-4 at a low dosage and then increasing it to the full 45 mg. We rarely see studies comparing different dosages. I am curious to know the Japanese Ministry of Health's response to this study. I would assume it has studied the MK-4 dosage over longer periods of time than this study. Still, it's an intriguing study.

I used to take both MK4 and MK7 but stopped taking both when I was diagnosed with afib and started Eliquis, and that was followed by a breast cancer diagnosis. I'm still on Eliquis but had a heart ablation in September. When I asked my electrophysiolgoist if I could resume MK-4, he didn't object.

My plan is to start MK4 but not MK7 which is sometimes linked to heart palpitations. I still need to get the okay from my cardiologist who specializes in cancer to be sure she's also okay with resuming Mk-4. She may tell me I can' take it while taking Eliquis. Have no idea.

So many doctors! It's a challenge juggling all the contraindications when you have multiple issues and medications.

As to your last question, though, yes...many of us wonder why more doctors are not aware of this Japanese approach to osteoporosis. It seems to fit the bill of "do not harm" better than many of the osteoporosis drugs they prescribe.

@prarysky hi. I am curious if you have started taking the higher dose of mk4 45 mg? If so, what brand and how is it going? I have read that you can still do the mk7 100 mcg along with the higher mk4. Would love to hear your experience.

@crbarefoot I have not started the MK4 at any dosage yet. I plan to discuss this with my cardiologists later this month and early April. Yes, you read that correctly. I see more than one cardiologist. One of them specializes in oncology and I was referred to her with my breast cancer diagnosis.

I have a feeling neither of these doctors will have an informed opinion on MK4 but still want to see what they might say. If they have no opinion about it, I will add MK4 but probably start at a lower dose.

I'd taken both MK4 and MK7 in the past but stopped when I developed afib first followed by breast cancer. People sometimes experience heart palpitations with MK7 so that was a no-no for me. During breast cancer treatment, I was advised to stop most supplements so just now figuring out what I can safely add.

Sorry I don't have any experience with high dose MK4, but there is another Mayo discussion on MK4 and MK7 dosages that may be helpful to you.
https://connect.mayoclinic.org/discussion/mk4-vs-mk7-for-osteoporosis/