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Vitamin K, Phylloquinone, Menaquinone


Chemistry
Vitamin K1 (Phylloquinone) - natural derivative from fish or plants
Vitamin K2 (Menaquinone) - made by intestinal bacteria
Vitamin K3 - synthetic form

Metabolism
Vitamin K is absorbed in the upper GI tract, and requires bile for absorption

Functions
cofactor in synthesis of proteins with a modified glutamic acid residue
binds to calcium ions in bone causing calcification
binds calcium in blood vessels, an integral part of blood clotting
synthesis of osteocalcin
allows calcium ions to bind, resulting in bone calcification
synthesis of kidney protein
that inhibits calcium oxylate stone formation
synthesis of proteins C and S
which promote fibrinolysis and anti-coagulation
inhibits platelet aggregration

Requirements
no RDA established
optimal daily intake - 750 mcg (dose 1-10 mg per day)
long-term oral antibiotics may eliminate intestinal bacteria as a source
Newborn infants tend to be deficient in vitamin K

Sources
turnip greens, broccoli

Toxicity
most toxicity is associated with IV use

Interactions
Dilantin interferes with vitamin K function
Vitamin K may interfere with warfarin and coumadin

Deficiency
Obstetrics
hemorrhagic disease of the newborn, especially premature infants
easy bleeding in children, spontaneous nosebeeds
Musculoskeletal
osteoporosis

Therapeutics
EENT
floaters
Musculoskeletal
osteoporosis, fractures - aids in calcification of bone
rheumatoid arthritis - large doses stabilize inflammatory lysosomes
chronic pain
Hematology
blood clotting disorders
Obstetrics
nausea and vomiting of pregnancy - 5 mg K with 25 mg C
Urology
prevention of calcium oxylate stones - synthesis of kidney protein

Those with an unusual metabolic condition called Glucose-6-phosphate dehydrogenase (G6PD) deficiency should avoid vitamin K. Those with G6PD deficiency experience a serious breakdown of red blood cells (called hemolysis) when exposed to certain infections or medications, including vitamin K.

 

 

 

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