We got this question from a concerned customer:
"Hi,
In 'Death by Calcium' by Thomas E Levy MD, he recommends 45 mg (45,000 microgram or mcg) of Vitamin K2 to be taken in 3 separate 15 mg dosages.
Your Full Spectrum Vitamin K2 with MK4 + MK7 has 600 mcg in each capsule.
600 mcg is just 0.6 mg. Is that correct?
And is that sufficient?
On your website it says take 2 capsules for arterial health. Can you comment on the dosage?
Thank you!"
In a hurry? Here's the Summary:
The dose of 45 mg (or 45,000 mcg) refers only to the MK-4 form of K2. It does not refer to MK-7.
A daily dose this high, even though it appears safe, is astronomical. We do not recommend it. A daily dose of 500 to 1000 mcg of MK-4 is adequate and close to healthy ancestral consumption. Combine that with 100 to 200 mcg of MK-7. This will cover virtually everyone's needs.
You may wonder...
- Why this doctor is recommending a dosage that's so much higher than what's in InnovixLabs Vitamin K2 supplement? (Long answer below)
- And 'Death by Calcium'...what's with the book title? Calcium can kill me?! (No. Calcium is essential and will not kill you. But if you take calcium supplements while deficient in Vitamin K2, D3, and Magnesium, the calcium can get deposited in unlikely places and that can cause problems.)
45 grams or 45,000 micrograms Vitamin K2 dosage
First, yes, each pill of InnovixLabs Vitamin K2 has 600 mcg or 0.6 mg of Vitamin K2. That's a blend of 2 forms of Vitamin K2 - 500 mcg of MK-4 and 100 mcg of MK-7. And that is perfectly sufficient for most people.
Dr. Levy's dosage of 45 mg (45,000 mcg) of Vitamin K refers only to MK-4 and not MK-7.
Lumping all form of MKs together as 'Vitamin K' is a common source of confusion and misunderstanding.
This seemingly ultra-high dose is based on an old Japanese drug. MK-4 has been used in Japan for a long time as an osteoporosis drug.
Glakay Vitamin K2 (MK-4) Capsules 15 mg
Glakay is the trade name for the prescription Vitamin K2 (MK-4) in Japan, manufactured by Eisai Co. It's been on the market since 2005.
Glakay is 15 mg MK-4 taken 3 times per day. The combined dose is 45 mg of MK-4 per day.
However, the origin of the 45 mg dose precedes the osteoporosis drug. The original researchers' choice of the 45 mg dose was based on unpublished 1992 dose range study that sought to find the lowest dosage for improving bone mass.
They started at a dose that they felt would make a difference in bone mineral density. (In our opinion, they used the wrong MK at the wrong dose.)
And sure enough, 45 mg (or 45,000 mcg) improved bone density.
[Note: the InnovixLabs product is not a drug. It does not contain the same dose as the Japanese drug. We do not make the same disease claim as the drug because our product is a supplement and provides a fraction of the active ingredient as Glakay.]
What you need to keep in mind is that MK-4 is at best, mildly effective at strengthening bones.
MK-4 is not the 'bone K2.' For bone strength, you need MK-7.
But more on that later.
45,000 mcg and still no toxicity or overdose effects
There is little to no harm in taking that much MK-4. And that may be the best discovery: 45,000 mcg did not cause any serious side effects. Other than the contraindication for use with Warfarin.
MK-4 vs MK-7
Research on MK-4 has been done almost exclusively in Japan, reinforcing the 45 mg MK-4 dosage.
And research on MK-7 has been done almost exclusively in the Netherlands.
Until recently, there's been very little cross-talk among these two research groups. And so, no one has published a comparison study of, say, 45 mg (45,000 mcg) MK-4 versus 100 mcg MK-7.
Driven by both efficacy and financial interests, research on MK-7 is accelerating.
This does not mean that MK-7 is better. It simply means the volume of research behind MK-4 is less than for MK-7.
We also know that MK-7 seems more efficient than MK-4 at strengthening bones. Had the Japanese researchers known this 30 or 40 years ago, they might have focused on MK-7 instead of MK-4.
MK-7 'services' the liver and bones whereas MK-4 goes to work in other tissues and organs, like the brain.
Unlike MK-7, MK-4 has a strong role in gene expression relating to maintenance of healthy sex hormone levels.
There may be a higher need for MK-4 during pregnancy and breast-feeding because MK-7 does not seem to enter the placenta and is not found in breast milk - only MK-4 is.
Which MK for Stronger Bones?
The point we're making is that MK-4 may have been the wrong Vitamin K2 for studying bone strengthening.
Why? Because MK-4 appears to be a weak bone strengthener when compared to MK-7.
Even though there are no head-to-head bone strength comparisons, you may be able to accomplish with 100 or 200 mcg of MK-7 that you can with 45,000 mcg of MK-4.
But the reverse may not be true. MK-4 does things for you that no amount of MK-7 could, which suggests you need both.
As this paper argues, MK-4 and MK-7 are not interchangeable because they have 'distinct bioactivities, different intestinal absorption rates, and blood half-life, their physiological activities are also different.'
MK-7 is not a more bioavailable form of MK-4 as you may read on the internet.
Bottomline
No one needs 45 mg or 45,000 mcg of MK-4 per day. Period.
Still, if you wish to take high dose MK-4, we suggest brands like Thorne. They offer a liquid MK-4 item that works well.
100 mcg of MK-7 with 500 mcg of MK-4 will meet the needs of most people.
If you have kidney disease, if you are taking very high doses of Vitamin D3 or Vitamin A...or wish to be more aggressive in your approach, you may take 200 or 300 mcg of MK-7 - we cannot imagine a situation where you'd need more than that.
Our formula of 100 mcg MK-7 and 500 mcg of MK-4 is based on current understanding of science and ancestral nutrition.
Newer studies that use increasingly higher doses like 360 mcg plus of MK-7 daily are industry-funded, so there is self-interest in pursuing research that supports the use of higher and higher dosage.
We see no need for MK-7 doses higher than 200 mcg daily.
Stuff that must be said:
We sell Vitamin K2 supplements on this website. It goes without saying (but we’ll say it anyway) that we do not make claims that taking our K2 supplement will treat, cure or prevent osteoporosis or any disease.
People with kidney disease may need higher amounts of K2. And those taking anticoagulant medications should not change their Vitamin K intake (regardless of form) except under the strict supervision of the prescribing physician. Why? Because first-gen anticoagulants work by deactivating Vitamin K and maintaining the body in a constant state of K deficiency. Newer anticoagulant drugs do not induce Vitamin K deficiency. Talk to your doctor about it.
Supplements may help, but supplements alone will not restore you to complete health. We think supplements are a small piece of the health puzzle. You cannot outrun a bad diet and inactivity with pills. Most of the heavy lifting involved in restoring your health will have to come from you in the form of healthy eating and lifestyle corrections. In these articles, we are merely sharing our excitement about nutritional science and doing our best to translate dense science into easy-to-read English. We geek out on nutrition science and we think you will too. We hope it makes you a more informed consumer. Our Legal Dept says the same thing in Legalese at the bottom of this page. Enjoy.