Deficiency Symptoms: Excessive bleeding, a history of bruising, appearance of ruptured capillaries or menorrhagia (heavy periods) are the most common clinical symptoms of overt vitamin K deficiency, although subclinical deficiency may not affect clotting mechanisms. Due to its critical role in bone formation, long-term vitamin K deficiency may impair bone integrity and growth, eventually predisposing a person to osteoporosis. Antibiotic usage can induce vitamin K deficiency since it upsets the balance of normal intestinal flora. Anticoagulants such as Coumadin and warfarin can also deplete vitamin K by blocking the activation of prothrombin. However, patients on warfarin or other blood anticoagulants should not supplement with vitamin K unless specifically recommended and approved by their physician. Other causes of deficiency include celiac disease, liver disease, certain medications (i.e. aspirin, Dilantin), very high doses of vitamins A and E (over 600 IU) and gastrointestinal disorders associated with the malabsorption of fats, such as bile duct obstruction, pancreatitis or inflammatory bowel disease.
The RDA for vitamin K is 1 microgram (mcg) per 2.2 pounds of body weight, with 80 mcg per day (males) and 65 mcg per day (females) being the officially recognized amount, although therapeutic doses range from 100 to 500 mcg per day. No Tolerable Upper Intake Level for vitamin K has been established. The liver secures the amount of vitamin K required for the saturation of clotting factors. Excess vitamin K will not adversely affect clotting function.
Supplementation with vitamin K1 is recommended as it is the precursor of vitamin K2. As a result patient should receive benefits of both K1 and K2. Vitamin K is a fat soluble vitamin so ingestion with fats or oils significantly increases absorption. Since up to 50% of the vitamin is manufactured by bacteria in the gut, the balance of intestinal microflora is important in maintaining adequate endogenous production of vitamin K. Exogenous food sources of vitamin K include the following: Vitamin K content of various foods (mcg per 3½ oz) --
Green tea (712)
Turnip greens (650)
Whole wheat (17)
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