Scientific Insights
IMPORTANT: WHY SHOULD VITAMIN D AND VITAMIN K BE TAKEN TOGETHER?
Regarding the claim that Vitamins D and K should be taken separately, please find hereafter the reasons why it is recommended, instead, that they be taken together.
Inside our bodies, Vitamins D and K take completely different metabolic pathways, and therefore, when taken together, they do not interfere with each other in any way. There is no validated scientific document that confirms a possible incompatibility.
Such claims may stem from “experimental” clinical protocols, which are not approved, and involve extremely high doses of Vitamin D—ranging from 40,000 IU to 320,000 IU per day!
Bear in mind that, according to Italian the Ministry of Health, the maximum daily intake of Vitamin D for supplements is 2,000 IU per day.
Dosages exceeding this limit should be taken only under strict medical supervision, as they are intended for pathological conditions and might carry significant side effects. Therefore, the combination of Vitamin D and Vitamin K in DKE + Magnesium formulation is completely legitimate and functional.
Supplementing with Vitamin D is important for maintaining bone strength and supporting the immune system.
Vitamin D deficiency and insufficiency are global health issues affecting more than one billion children and adults worldwide.
The consequences of vitamin D deficiency should not be underestimated. Vitamin D deficiency has been associated with a wide range of acute and chronic conditions, including preeclampsia, childhood dental caries, periodontitis, autoimmune diseases, infectious diseases, cardiovascular diseases, and more [8].
That’s why it is important to address this deficiency through supplementation.
The presence of vitamin D in the human body is primarily due to its synthesis in skin cells through sun exposure, and only to a small extent to the diet.
However, modern lifestyles limit our sun exposure, especially during the winter months, and nutrient-poor diets often fail to provide adequate amounts of vitamin D.
The effect of vitamin D supplementation has also been studied on the risk of acute respiratory tract infections.
One study, amongst the others, demonstrates that vitamin D supplementation can reduce the risk of acute respiratory infections. The greatest benefits are seen with daily or weekly supplementation, preferably not in large single doses (bolus) [9].
It is, therefore, important to supplement Vitamin D consistently to help maintain the normal function of the immune system and the strength of bones and teeth.
Checking whether your vitamin D levels are low is simple: you just need to request also the Vitamin D test as part of your routine blood test check-ups.
Vitamin E also supports the immune system and the combination with Vitamin K2 and Magnesium offers protection against cardiovascular calcification and supports overall bone strength.
VITAMIN D3
- Vanherwegen AS, Gysemans C, Mathieu C. Regulation of Immune Function by Vitamin D and Its Use in Diseases of Immunity. Endocrinol Metab Clin North Am. 2017 Dec;46(4):1061-1094. doi: 10.1016/j.ecl.2017.07.010. Epub 2017 Oct 6. PMID: 29080635.
Evidence exists for a role for vitamin D and its active metabolites in modulating immune functions. In humans, evidence exists on associations between vitamin D deficiency and impaired immune function, leading to autoimmunity in genetically predisposed people and increased risk for infections.
High doses of vitamin D can improve immune health, help prevent autoimmunity, and enhance the body’s defence against infections.
- Bischoff-Ferrari HA, Willett WC, Wong JB, Giovannucci E, Dietrich T, Dawson-Hughes B. Fracture prevention with vitamin D supplementation: a meta-analysis of randomized controlled trials. JAMA. 2005 May 11;293(18):2257-64. doi: 10.1001/jama.293.18.2257. PMID: 15886381.
This meta-analysis aimed to evaluate the effectiveness of vitamin D supplementation in preventing hip fractures and non-vertebral fractures in the elderly. All the studies used cholecalciferol (vitamin D3).
Oral vitamin D supplementation between 700 to 800 IU/d appears to reduce the risk of hip and any nonvertebral fractures in the elderly. An oral vitamin D dose of 400 IU/d is not sufficient for fracture prevention.
VITAMIN K2
- Rønn SH, Harsløf T, Pedersen SB, Langdahl BL. Vitamin K2 (menaquinone-7) prevents age-related deterioration of trabecular bone microarchitecture at the tibia in postmenopausal women. Eur J Endocrinol. 2016 Dec;175(6):541-549. doi: 10.1530/EJE-16-0498. Epub 2016 Sep 13. PMID: 27625301.
Clinical studies suggest that vitamin K2 protects against bone loss and fractures.
This study specifically analysed the effect of MK-7 on undercarboxylated osteocalcin (ucOC) and on bone mass and quality.
The effect of MK-7 on bone mineral density (BMD) and tibial bone microarchitecture was studied over a 12-month period.
One group of participants received a placebo, while the other received calcium and vitamin D supplementation.
The changes in bone microarchitecture in the placebo group are consistent with the age-related deterioration of trabecular structure, with a loss of trabeculae and a greater mean thickness of the remaining trabeculae.
Instead, in the group receiving Vit. D the bone structure remained unchanged.
This suggests that vitamin D (MK-7) preserves the trabecular bone structure of the tibia.
VITAMIN E
- Lewis ED, Meydani SN, Wu D. Regulatory role of vitamin E in the immune system and inflammation. IUBMB Life. 2019 Apr;71(4):487-494. doi: 10.1002/iub.1976. Epub 2018 Nov 30. PMID: 30501009; PMCID: PMC7011499.
Vitamin E deficiency has been demonstrated to impair normal functions of the immune system in animals and humans.
Although deficiency is rare, vitamin E supplementation above current dietary recommendations has been shown to enhance the function of the immune system and reduce risk of infection, particularly in older individuals. The mechanisms responsible for the effect of vitamin E on the immune system and inflammation have been explored in cell-based, pre-clinical and clinical intervention studies. Vitamin E modulates T cell function through directly impacting T cell membrane integrity, signal transduction, and cell division, and also indirectly by affecting inflammatory mediators generated from other immune cells.
Modulation of immune function by vitamin E has clinical relevance as it affects host susceptibility to infectious diseases such as respiratory infections, in addition to allergic diseases such as asthma.
Studies examining the role of vitamin E in the immune system have typically focused on α-tocopherol. However, emerging evidence suggests that other forms of vitamin E, including other tocopherols as well as tocotrienols, may also have potent immunomodulatory functions.
MAGNESIUM
- Yao Z, Xu Y, Ma W, Sun XY, Jia S, Zheng Y, Liu X, Fan Y, Wang C. Magnesium Citrate Protects Against Vascular Calcification in an Adenine-induced Chronic Renal Failure Rat Model. J Cardiovasc Pharmacol. 2018 Dec;72(6):270-276. doi: 10.1097/FJC.0000000000000590. PMID: 29738375.
Hypomagnesemia (low magnesium levels) was identified as a strong risk factor for cardiovascular disease in patients with chronic renal failure (CRF).
The main objective of this study was to determine the effects of magnesium citrate on vascular calcification in rats with chronic kidney disease.
The results showed that magnesium citrate plays a protective role against vascular calcification in rats with chronic kidney disease.
Therefore, it may be a potential aid in the prevention of vascular calcification.
- Aydin H, Deyneli O, Yavuz D, Gözü H, Mutlu N, Kaygusuz I, Akalin S. Short-term oral magnesium supplementation suppresses bone turnover in postmenopausal osteoporotic women. Biol Trace Elem Res. 2010 Feb;133(2):136-43. doi: 10.1007/s12011-009-8416-8. Epub 2009 Jun 2. PMID: 19488681.
Magnesium has been shown to increase bone mineral density when used in the treatment of osteoporosis, yet its mechanism of action is obscure.
In this study, the effects of daily oral magnesium supplementation on biochemical markers of bone turnover were investigated.
Twenty postmenopausal women have been divided into two groups.
Ten patients were given magnesium citrate orally for 30 days. Ten postmenopausal women of matching age, menopause duration, and BMI were recruited as the control group and followed without any medication.
Fasting blood and first-void urine samples were collected on days 0, 1, 5, 10, 20, and 30, respectively. Total magnesium, calcium, phosphorus, iPTH and osteocalcin were determined in blood samples.
This study has demonstrated that oral magnesium supplementation in postmenopausal osteoporotic women suppresses bone turnover thus allowing for the bone tissue to be preserved.
Bibliography
[1] Gatti D, Idolazzi L, Fassio A. Vitamin D: not just bone, but also immunity. Minerva Med. 2016 Dec;107(6):452-460. Epub 2016 Jul 21. PMID: 27441391.
[2] Carlberg C. Nutrigenomics of Vitamin D. Nutrients. 2019 Mar 21;11(3):676. doi: 10.3390/nu11030676. PMID: 30901909; PMCID: PMC6470874.
[3] Villa JKD, Diaz MAN, Pizziolo VR, Martino HSD. Effect of vitamin K in bone metabolism and vascular calcification: A review of mechanisms of action and evidences. Crit Rev Food Sci Nutr. 2017 Dec 12;57(18):3959-3970. doi: 10.1080/10408398.2016.1211616. PMID: 27437760.
[4] Maresz K. Proper Calcium Use: Vitamin K2 as a Promoter of Bone and Cardiovascular Health. Integr Med (Encinitas). 2015 Feb;14(1):34-9. PMID: 26770129; PMCID: PMC4566462.
[5] Lewis ED, Meydani SN, Wu D. Regulatory role of vitamin E in the immune system and inflammation. IUBMB Life. 2019 Apr;71(4):487-494. doi: 10.1002/iub.1976. Epub 2018 Nov 30. PMID: 30501009; PMCID: PMC7011499.
[6] Mata-Granados JM, Cuenca-Acebedo R, Luque de Castro MD, Quesada Gómez JM. Lower vitamin E serum levels are associated with osteoporosis in early postmenopausal women: a cross-sectional study. J Bone Miner Metab. 2013 Jul;31(4):455-60. doi: 10.1007/s00774-013-0432-2. Epub 2013 Mar 28. PMID: 23536191.
[7] Yao Z, Xu Y, Ma W, Sun XY, Jia S, Zheng Y, Liu X, Fan Y, Wang C. Magnesium Citrate Protects Against Vascular Calcification in an Adenine-induced Chronic Renal Failure Rat Model. J Cardiovasc Pharmacol. 2018 Dec;72(6):270-276. doi: 10.1097/FJC.0000000000000590. PMID: 29738375.
[8] Holick MF. The vitamin D deficiency pandemic: Approaches for diagnosis, treatment and prevention. Rev Endocr Metab Disord. 2017 Jun;18(2):153-165. doi: 10.1007/s11154-017-9424-1. PMID: 28516265.
[9] Martineau AR, Jolliffe DA, Hooper RL, Greenberg L, Aloia JF, Bergman P, Dubnov-Raz G, Esposito S, Ganmaa D, Ginde AA, Goodall EC, Grant CC, Griffiths CJ, Janssens W, Laaksi I, Manaseki-Holland S, Mauger D, Murdoch DR, Neale R, Rees JR, Simpson S Jr, Stelmach I, Kumar GT, Urashima M, Camargo CA Jr. Vitamin D supplementation to prevent acute respiratory tract infections: systematic review and meta-analysis of individual participant data. BMJ. 2017 Feb 15;356:i6583. doi: 10.1136/bmj.i6583. PMID: 28202713; PMCID: PMC5310969.
Disclaimer
The content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding your medical condition.
I nostri testi hanno scopo divulgativo, non vanno intesi come indicazione di diagnosi e cura di stati patologici e non vogliono sostituirsi in alcun modo al parere del Medico.