Vitamin K1 and K2 Boost Bone Formation, Lessen Bone Breakdown

Thank you for this valuable information, also it is good that you have reminded all concern to take plenty of dark green vegetable which contains the vitamin K plus the useful minerals for their bodies.
Thank you Lara
Regards
Mohammad Ali Badran

Quite interesting useful information. Hope this’ll go a long way in treating bone wasting conditions.
I wonder if there is any role of fixed combination of vit D,vit -k and calcium combo treatment in osteoarthritis!
Thanks for the posting.

Hi Ashraf — what an interesting suggestion! And right on, as it turns out. Just a quick scan on PubMed turned up the following study (abstract below–this is a free access paper, so you can read the entire article by going on PubMed and clicking on the link provided with the abstract) that clearly indicates a relationship between vitamin K insufficiency and osteoarthritis (and this is surely K2, since it is this form that activates the proteins involved in regulation of calcium deposition).
Here is the abstract indicating a relationship between low vitamin K and osteoarthritis:

Arthritis Rheum. 2006 Apr;54(4):1255-61.
Low vitamin K status is associated with osteoarthritis in the hand and knee.
Neogi T, Booth SL, Zhang YQ, Jacques PF, Terkeltaub R, Aliabadi P, Felson DT.

Source: Boston University School of Medicine, and Brigham and Women’s Hospital, Boston, Massachusetts 02118, USA. [email protected]

Abstract
OBJECTIVE: Poor intake of vitamin K is common. Insufficient vitamin K can result in abnormal cartilage and bone mineralization. Furthermore, osteophyte growth, seen in osteoarthritis (OA), may be a vitamin K-dependent process. We undertook this study to determine whether vitamin K deficiency is associated with radiographic features of OA.

METHODS: We conducted an analysis among 672 participants (mean age 65.6 years, 358 women) in the Framingham Offspring Study, a population-based prospective observational cohort. Levels of plasma phylloquinone (the primary form of vitamin K) had previously been measured in these participants, for whom we also had bilateral hand and knee radiographs. The main outcomes were 1) prevalence ratios (PRs) of OA, osteophytes, and joint space narrowing (JSN) per quartile of plasma phylloquinone level for each joint, adjusting for correlated joints using generalized estimating equations, and 2) adjusted mean number of joints with each feature per quartile of plasma phylloquinone level. Analyses were conducted in hands and knees separately and adjusted for age, sex, body mass index, total energy intake, plasma vitamin D, and femoral neck bone mineral density.

RESULTS: The PRs for OA, osteophytes, and JSN and adjusted mean number of joints with all 3 features in the hand decreased significantly with increasing plasma phylloquinone levels (P<or=0.03 for all). For example, as plasma phylloquinone levels rose, the PR for hand OA decreased from 1.0 to 0.7 (P=0.005). For the knee, only the PR for osteophytes and the adjusted mean number of knee joints with osteophytes decreased significantly with increasing plasma phylloquinone levels (PR decreased from 1.0 to 0.6, P=0.01).

CONCLUSION: These observational data support the hypothesis of an association between low plasma levels of vitamin K and increased prevalence of OA manifestations in the hand and knee.

PMID: 16572460

You may also be interested in a 2 part review I wrote for Longevity Medicine Review (written for physicians, but you will understand it) discussing the interrelationships between vitamin D, vitamin K, osteoporosis and cardiovascular disease. Here is the abstract for this review and a link to Part I —
http://www.lmreview.com/articles/view/vitamin-d-and-vitamin-k-team-up-to-lower-cvd-risk-part-I/
I think you will find a link to Part II at the conclusion of Part I. If not, just go to the articles Archive on LMR (www.lmreview.com) and then page 3 of the list of articles for a link to this.
Here's the abstract for both Parts of this review:

"Strong correlations have been noted between cardiovascular diseases and low bone density / osteoporosis—connections so strong that the presence of one type of pathology is considered a likely predictor of the other. This potentially causal relationship has led to the hypothesis that these conditions share core mechanisms. Recent advances in our understanding of the complimentary roles played by vitamin D3 and vitamin K2 in vascular and bone health provide support for this hypothesis, along with insight into key metabolic dysfunctions underlying cardiovascular disease and osteoporosis.

Part I of this review summarizes current research linking vitamin D deficiency to cardiovascular disease, the physiological mechanisms underlying vitamin D's cardiovascular effects, and leading vitamin D researchers' recommendations for significantly higher supplemental doses of the pro-hormone. Part II reviews the vitamin K connection to cardiovascular disease; the ways in which vitamin D and vitamin K pair up to prevent inflammation, vascular calcification and osteoporosis; and the necessity of providing vitamin K along with vitamin D to preclude adverse effects associated with hypervitaminosis D, which include vascular and other soft tissue calcification.

What do you suggest for a -4 density bone patient. Not heavy, 5ft tall, 97pds. I believe also need to gain waight. I refuse to take sofomax and will stop calciun Citrate. What is the best alternative to bone density gain, to stop calcification.

thanks

Hi Jul,
Hi – I would very much like to be helpful to you, but I have insufficient information about you to be able to advise you well. How old are you? Are you Caucasian? African American? Asian? Are you postmenopausal? Where do you live? Have you had your vitamin D levels checked? What is your typical diet like? Are you vegetarian? Do you eat fish? Do you consume dairy products? Soy foods? Leafy greens? Do you exercise? If so, what type of exercise do you do? How is your digestion? Do you take any vitamins? I could go on and on and on here – and I do, in my book Your Bones – best recommendation I have for you is to get hold of a copy (your library should have it if you don’t want to spend $7 for the Kindle version or I think it’s around $9.50 or less for the paperback—it’s available on Amazon—here’s a link — http://www.amazon.com/Your-Bones-Prevent-Osteoporosis-Naturally/dp/1607660075/ref=sr_1_1?s=books&ie=UTF8&qid=1325291502&sr=1-1 And I see today the cost for the paperback is as little as $6.34 ).
Re preventing calcification – vitamin K2 is essential for this. It activates the proteins that put calcium into bone (called osteocalcin) and keep it out of arteries (called matrix Gla protein). In the research, the effective dose of K2 (as MK-7) is 100 micrograms daily. For K2 as MK-4, the effective dose in the studies is 15 milligrams taken 3 times a day for a total of 45 milligrams. It is very difficult to get sufficient K2 in our diet – unless you eat a fermented soy bean product called natto regularly, as this is the only concentrated food source of K2 (MK-7).
Since your T score is -4, which means you are at high risk for fracture, please consider reading Your Bones – it will give you a very good overview of everything you need to know regarding naturally restoring the health of your bones – and then get back to me with any questions you might have. You’ll be able to tell me what you think is going on with you – why YOU have lost so much bone – and then I hopefully can do a much better job of helping you create just the right bone building program that will meet YOUR needs.
Lara

Dear Lara

Thank you so much for responding. My health is most important for me, that is what I am taking my time to find a treatment that make sense to me. I had lost loved people out of ignorance, but at my age at least I have learned to be more consious.

I am taking Calcio Citrate an vitaming D3, as instructed. However as of today, after probably one or month and a half of taking these, I am stoping also the Calcio citrate. I don’t know how to continue and found that perhaps vitamin K2 can help me, (although I am afraid vitamin K, make your blood thicker), or concentrate in Algaes Calcium.

I just turned 68 years old. I have been healthy all my life, now I found I have pressure in my eyes, suffer very few cold, almost no allergies. I walk a-lot. Now I am excersising at home, every morning 1/2 hour. I had for over 20 years walk up 5 floors to my apartment. I am petit, Hispanic, live in NYC. I almost never gain weight. It fluctuates between 97 & 100 pds. I would like to find a way to increase at least 5 more pounds.

I have not checked my vitamin D level, for as I said, is just about 1 or 1 1/2 months since I started taking, both Calcium and D. My diet is better now, before due to my job I used to skip lunch or so. Eat not much meat, chicken or fish. I’m concentrating in eating more greens now, like spinachs, brocolies, squash, and others. I always have a strong breakfast, with fruit, eggs, vegetables, bread, cereal….no soy foods…

I don’t feel pain, Sometimes, when I excersise I am sure I get some discomfort in my back.

thanks so much for your interest.

Julia

Thanks again,

1) I’m afraid of the combination of strontium Citrate. When talking of a natural product as is AlgaeCal and then next to it something with Citrate, makes me wonder. On one side Calcio Carbonate or with Citrate may cause arteries blockage, why is Strontium Citrate which, I believe is same limestone, be different from Calcium Citrate?

2) Again, does vitamin K produces blocd to get thicker or not? Or there is a component on ViTamin K2 to avoid this? Am I missinformed?.

Sorry, but I need to be sure to take the next step and combine my medicine better.

Thanks

Hi Julia,
I’m guessing from the fact that your doctor wanted you to take a prescription bone drug that your bone density is low — that you are either osteopenic or have osteoporosis. It sounds like you are otherwise healthy and get regular exercise, also that your diet is pretty good — however, if you do not eat chicken, meat or fish and do not consume soy foods either, I am wondering if you are getting adequate protein. Eggs are good, but what else are you eating that is a rich source of protein — do you eat beans? Dairy foods like yogurt or cottage cheese or cheese?

I can suggest a free resource for healthy eating that I believe you will really enjoy, it’s called “The World’s Healthiest Foods” and is a website my husband (Dr. Joe Pizzorno), I and our medical team (about 20 naturopathic physicians & nutritionists) created for the George Mateljan Foundation about 10 years ago now. It is fully supported by the George Mateljan Foundation and is completely free, accepts no advertising, and all the information provided is based on the scientific research. We now get more than 1 million unique visitors to this website every month. Anything you want to know about healthy eating, you can find information about here. You can analyze your diet to see what nutrients it might be low in and then see what foods are rich in those nutrients, and get easy very delicious recipes that feature those foods. You can sign up for a free newsletter, and George also sends out a daily email with recipe suggestions. Here’s a link to this: http://www.whfoods.org
The palpitations you mention suggest you may need more magnesium — many people in the US do not get enough magnesium, and not having enough in your body will cause things like heart palpitations, muscle aches and cramps, restless legs, migraines, and many other things.
I am not sure why you have decided to stop taking calcium citrate? Are you getting enough calcium from your diet? Or what your blood levels of vitamin D3 are. Most doctors start people out with no more than 2,000 IU of D3 per day, so the fact that your doctor wanted you to begin with 5,000 IU per day suggests to me that your blood levels of vitamin D are quite low. Do you know what your blood levels of vitamin D are? The blood test for this measures the circulating form of vitamin D in our bloodstream — it’s called 25(OH)D — and optimal levels are 60 – 80 ng/mL.

Regarding vitamin K — vitamin K2, which is the form of this vitamin our bodies require to ensure that the calcium we consume goes into our bones and stays out of our arteries – has nothing to do with blood clotting and does not “thicken the blood.” Vitamin K1, which is found in leafy greens, is the version of vitamin K that activates clotting factors — and we really need this! Without enough vitamin K1, we would bleed to death from even a small scratch. I have written many articles about vitamin K — mostly for doctors, although recently I responded to concerns about vitamin K and blood clotting on the National Osteoporosis Forum — here is what I wrote there,, and it includes a link to one of the articles I wrote for doctors about vitamin K.

Vitamin K1 (which you will be getting in abundance if you eat leafy greens like any kind of lettuce, collards, Swiss chard, kale, broccoli, parsley) goes to the liver where it is used to produce the clotting factors that prevent us from bleeding out from even the tiniest cut. This is why newborns, who have not developed all this yet, are routinely given a shot of K1 in hospital. And also why people who are taking certain anticoagulants are told to be very consistent about the amount of leafy greens they eat. Vitamin K1 is so essential for our survival that our bodies have a special system to recycle it, so we can keep it around longer. It very effectively shuts down this system, so clotting factors cannot form from vitamin K1 (point here NOT vitamin K2).
Vitamin K2 has nothing to do with clotting factors. It is not in leafy greens, but is found in tiny amounts in eggs and certain cheeses (eg Emmenthaler, Jarlsberg) and in the greatest concentration in the fermented soy bean product called natto. Vitamin K2 activates the proteins that regulate what happens to calcium that you have consumed (whether from food or supplements). It does so by activating the proteins responsible for putting calcium into bone (called osteocalcin) and keeping it OUT of arteries (called matrix Gla protein). If you do not have enough vit K2 on board and you eat calcium rich foods or take a calcium supplement, especially if you are taking vitamin D, which significantly increases our body’s ability to absorb calcium, THEN you are going to increase your risk for stroke or heart attack. In other words, if you are taking vitamin D, you really need K2 to ensure the calcium you are absorbing is used beneficially for you.
As to the differences between the 2 available supplemental forms of K2 — MK-4 and MK-7. MK-4 is used and cleared from the body within about 6-8 hours, while MK-7 remains active in our systems for much longer — around 3 days. For most people, MK-7’s longer half life is a good thing — it results in our being able to take far less (just 100 micrograms per day is effective) and keeps K2 available 24 hours a day to activate osteocalcin and matrix Gla protein (plus K2 does many other helpful things for us which I wrote about in the review of K2 on Longevity Medicine Review — http://www.lmreview.com –if you would like to read more).

I hope this helps clear up some of the confusion about vitamin K. It distresses me greatly to think people are going to stop getting the calcium needed for healthy bones or the vitamin D to help absorb it effectively because they are afraid to take vitamin K2, which our bodies require to use calcium to build bone and to keep calcium out of our arteries. It is extremely important to recognize that nutrients do not work alone within our bodies! It’s absolutely a team effort. When team players are missing, our metabolism is very likely to drop the proverbial ball. When the team is fully present, our bodies will do what we are pre-programmed from birth to do — be gloriously healthy. Be well!

If you decide to try AlgaeCal Plus — it will give you the calcium and K2 you need, along with 1,000 IU of vitamin D3, magnesium and boron. Plus this calcium is in a matrix of all the minerals the sea-algae used to develop and maintain itself, so you get many nutrient “team players” that our bodies need. I started taking AlgaeCal last summer — June 2011 — and have had very good results with it! My bone density has gone up 6% in my spine and 3.2% in my hip/femur since I started taking AlgaeCal Plus. I’m 63 and had started losing lots of bone back in my mid-40s. Every woman in my family that I know about died from osteoporosis — my grandmother, mother, aunts — my family has several genetic issues that make us more at risk for bone loss (for example, my body has a very hard time absorbing vitamin D), so I am very happy to now have regained my healthy bones, and I know that if I could do it, so can you! I am just barely osteopenic now and expect by next year to be completely normal. My family does not eat meat or chicken either, but we do eat fish (salmon since we live in Seattle where it’s easy to get fresh fish); we eat eggs and beans (and I also eat soy foods like tofu) for protein.

Julia, I wish you would get a copy of my book Your Bones — your library should have it, so you won’t have to buy it — although I think it is being sold on Amazon now for only around $6.00 if you would like to get a copy to have on hand for yourself. Truly, your best defense is to become well informed about all this, so you can protect yourself.

Please don’t hesitate to ask if you have more questions. I wish you very well, Lara

Hi Jul,
Re your first question — our bodies do not put strontium into the vasculature — only calcium may be deposited in our arteries — but this only occurs when we have insufficient levels of vitamin K2. K2 is required to activate the proteins that keep calcium OUT of our arteries and put it into our bones.
No, vitamin K2 will not “thicken” the blood.
Here is a link to the review I wrote for physicians covering the latest research on vitamin K–and specifically K2.This article was written for doctors, but I am sure you will be able to understand it. I hope it will answer any concerns you have about vitamin K and will also explain why supplementing with K2 is vitally important for our health overall, not just the health of our bones:
http://www.lmreview.com/articles/view/Vitamin-K2-Essential-for-Prevention-of-Age-Associated-Chronic-Disease/

Re strontium citrate, please read the article I posted on AlgaeCal’s blog regarding strontium. I think it will provide answers to all your questions/concerns regarding strontium and specifically, the safety of strontium citrate. Re citrate, specifically, it is a natural and beneficial compound that plays many highly important roles in our bodies — it is used in energy production and promotes an alkaline pH in our bodies, which is protective for our bones.
Here is a link the article on strontium:
https://blog.algaecal.com/the-truth-about-strontium-supplements-side-effects-dexa-results-efficacy-and-more/
Hope this helps, Lara

Dear Ms. Pizzorno,

I am most grateful for your time and consideration of my case.

I have read a lot of what you are suggesting, still much to read.

I haven’t heard or see my Dr. giving me any information on my Vitamin D3 levels-
Following is the report I got from him FYI:

BONE DENSITY AXIAL
——————————————————-
Baseline bone densitometry.
Dual Energy X-ray Absorptiometry (DXA) of the lumber spine, hip and forearm was performed using GE Lunar Prodigy fan beam densitometer.

DXA of the lumbar spine: Based on analysis of L1-4, bone mineral density is 0.657 g/cm2, and T score is -2.0,

DXA of the right proximal femur: Based on analysis of total, bone mineral density is 0.762 g/cm2, and T score is -2.0

DXA of the right forearm: Based on analysis of radius 33%, bone mineral density is 0.524 g/cm2, and T score is -4.1

IMPRESSION:
The lowest T score is in the lumbar spine. According to the World Health Organization criteria, the bone mass is osteoporotic.

I was prescribed 50000 of Vitamin D3 a week. Instead, I am taking, Calcium Citrate with Magnesium (by Bluebonnet) serving 4 caplets or 1000mg, plus Vitamin D3 liquid. (I was afraid of the Citrate that is why stop taking it.)

I stopped taking the Calcium Citrate for a week, but as per your question I started over again in addition of Vitaminin D3. I really don’t know if this is too much of a doses.

For a while I have reduced considerable the intake of meat and poultry. For a while, many times now, I skip lunch. I do eat fish, beans, yogurts, once in a while, but I will make sure I include all recommended food, at least once a week. Eventually I will also review your husband’s book. When it comes to my health, I don’t consider the taste as much as the benefits.

I will ask the doctor for a test to find out my vitamin D3 level.

Thanks for clarifying Vitamin K2 concern. I understand now. I got to you in my search for a more natural form of calcium. What I found that seemed to make more sense to me was AlgaCal. AlgaeCal Plus, makes even more sense, after all my concerns are explained. Yes I will change to that. Since with it I am also taking the magnesium, I will keep an eye in my palpitations, and yes, I was having some cramps, once in a while. My last question is, should I take Strontium Boost in addition to AlgaCal Plus? or is either one or the other, or can do that on other occasion.

I need really to be clear on these for I have a sister that I believe have the same problem. I don’t know what is she taking for she lives in South America. Also have a friend who can’t take calcium due to problems with her stomach, perhaps this form of calcium may help her.

Once again, thanks for your time and consideration. Wish you all the best and continued progress in your health.

Julia

Hi Julia,
Yes, the -2.0 T scores for both your spine and your hip/femur indicate osteoporosis. It’s not severe yet, but you do have osteoporosis. And you can certainly regain healthy bones by eating well, getting regular weight bearing exercise and taking supplements to ensure you are getting optimal amounts of the nutrients your bones require to rebuild. This is the natural program I explain in detail in Your Bones and it definitely works — I am living proof of this! Every woman in my family in all the generations I know about died from osteoporosis — but I will not. I was already losing lots of bone when I was just in my mid-40s, well before menopause. Now, my bones are barely osteopenic — I had been rebuilding bone for several years, but slowly. In the last 10 months (since I began using AlgaeCal Plus and Strontium Boost), I have gained 6% BMD in my spine and 3.2% BMD in my femur/hip. By this time next year, I expect to have completely normal BMD. You can too!
If your physician wanted you to take 5,000 IU of D3/day, your vitamin D levels are most likely quite low. I very much hope you will have the test run ( a blood draw to test for your levels of 25(OH) D–this is the form of vitamin D circulating in the bloodstream and the best indicator of body levels of vitamin D) to find out. Optimal levels of 25(OH)D are 60-80 ng/mL.
Please consider taking both AlgaeCal Plus and Strontium Boost — plus 2,000 IU per day of additional vitamin D3 if your vitamin D levels are quite low.
Strontium is used by our bones similarly to calcium, and is very helpful — it not only lessens the activity of osteoclasts (the cells that break down bone), but increases the actions of osteoblasts (the cells that build new bone); however, strontium is NOT a replacement for calcium — think of strontium as a very supportive friend, but one that should only be used in about half the amount that calcium is used by our bones. I take both AlgaeCal Plus and Strontium Boost — I want to give my bones all the natural support I can! Please read my blog post on strontium — lots of information in this post about why strontium citrate is helpful and how to best use it.
Back to diet — please be sure to eat LOTS of leafy greens to ensure you are getting plenty of vitamin K1. If you consume LOTS of K1 (and your digestion is good/intestinal health is good), healthy bacteria in your intestines will convert a small amount of K1 not used up in your liver to make clotting factors into K2 (the MK-4 form of K2). If you are also taking AlgaeCal Plus, you will be getting an effective dose of K2 as MK-7, but since you may be taking additional vitamin D3, you want to be sure your vitamin K2 levels are adequate, so I suggest you eat LOTS of leafy greens. K2 is also present in tiny amounts in eggs and some cheeses. Jarlsberg and Emmenthaler cheeses have the most K2 — again, not very much but at least a tiny amount, so please eat these if you like cheese. Re the eggs, try to get free range, omega-3-rich eggs. Omega-3 fatty acids are anti-inflammatory, and you really want to focus on avoiding things that promote inflammation and consuming things that lessen it! Inflammation activates osteoclasts — the cells that break down bone. (And vitamin K1 is also anti-inflammatory, another reason to eat plenty of leafy greens.)
Re palpitations and muscle cramps — I have one further suggestion for you that may be very helpful. About 25% of people in the Americas and Europe have inherited a very slow enzyme for the conversion of vitamin B6 into its active form, which is called pyridoxal-5-phosphate (P-5-P for short). P-5-P is what gets magnesium inside our cells where it does its work for us. So, people with a slow enzyme for converting B6 to P-5-P can have problems absorbing and utilizing magnesium well — even though they really need it! P-5-P is very inexpensive; if you simply try taking 25 mg of P-5-P along with magnesium (either in supplements or with foods rich in magnesium), then you may be able to utilize the magnesium more effectively. I wrote about this in my book, Your Bones, pgs. 177-178.
Since unlike calcium derived from rocks, the calcium in AlgaeCal Plus is plant (sea-algae) derived, and it is also in a matrix of all the other supportive nutrients that the sea-algae needed to build itself, it is much more likely to be able to be absorbed and well used by someone who cannnot tolerate just calcium derived from rock. Is your friend able to tolerate spinach? dairy foods? These foods provide calcium (although in much smaller amounts) than AlgaeCal Plus. So, if she can eat calcium-rich foods, she is likely to be able to use AlgaeCal.
You absolutely do not have to give up delicious meals to eat very healthfully — please check out The World’s Healthiest Foods website (it’s a nonprofit supported by the George Mateljan Foundation, all free, no advertising of any kind — my husband’s team –a whole group of doctors and nutritionists and me — helped create this website about 10 years ago now, and we continue to help maintain it. WHFoods gets more than 1 million visitors every month now. It’s a wonderful resource for healthy — and delicious–meals. Here’s a link: http://www.whfoods.org.
I hope you enjoy it!
Be well, Lara

Thanks so much Dr. Pizzorno,

I feel much better now, just reading your response.

What Dr. prescribe me of vitamin D is 50,000IU per week. I thought of taking Krill oil for the Omega 3 and perhaps as beneficial for my eyes. I haven’t done enough research to find out interference with this other medicines & conditions.

To make it short, I have a great felling for knowing that someone as important and as efficient as you, can take time to respond an stranger who is not paying for your advise.

Is beyond words what you do, to thank you, I only can wish you a long a healthy life, full of joy and accomplishments.

Julia Soledispa

Hi Julia,

Thanks so much for your very kind words!
I’m truly not anyone important — just like you, I’m trying to do my best to take care of my and my family’s health. Reading the breaking research is my work – and I’ve been fortunate enough to have this be my job for more than 25 years now. So, I am very lucky.

Also, I’ve been very blessed to have had access to cutting edge medical research (largely because I am married to one of the leading natural medicine physicians in the world (too much to try to summarize here about Joe but you can Google him if you would like–Dr. Joe Pizzorno, N.D.). Trying to share this information that can help others is the least I can do.

It seems to take so long – 10 years or more — for the research to get out to doctors and the rest of us – the studies get published but remain in the medical journals unread since by the end of their very long days in the office, few doctors have the time and energy to read them.

I just wish I had known all that I now know about bone health years earlier. I lost my mother to osteoporosis – almost 10 years ago now, but I miss her every single day. I cannot bring her back, but it is my hope that I can help others. Truly, YOU are the reason I wrote Your Bones and why I try my best to respond to questions both on AlgaeCal and the National Osteoporosis Forum.

Re krill oil – it is a good source of anti-inflammatory omega-3s, and the most current research suggests it may be better utilized by our bodies than fish oil, but it is more expensive.
(Here are a couple of recent papers on this: Schuchardt JP, Schneider I, Meyer H, et al. Incorporation of EPA and DHA into plasma phospholipids in response to different omega-3 fatty acid formulations–a comparative bioavailability study of fish oil vs. krill oil. Lipids Health Dis. 2011 Aug 22;10:145. PMID: 21854650; Ulven SM, Kirkhus B, Lamglait A, et al. Metabolic effects of krill oil are essentially similar to those of fish oil but at lower dose of EPA and DHA, in healthy volunteers. Lipids. 2011 Jan;46(1):37-46. Epub 2010 Nov 2. PMID: 21042875)

I know fish oil – especially in combination with bilberry (a European version of blueberry) and lutein (a carotenoid found in lots of leafy greens – here’s a link to the write up on WHFoods http://www.whfoods.org/genpage.php?tname=nutrient&dbid=126) has been shown to be helpful for dry eyes and eye strain. Fish oil has also been shown to be helpful in treating rheumatoid arthritis and asthma – other conditions in which excessive inflammation plays a major role.

And because fish oil is anti-inflammatory, it is also protective against osteoporosis. Another recent study published in the American Journal of Clinical Nutrition found that older people eating more than 3 servings of fish rich in omega-3s each week had higher BMD compared to those eating little fish. (Here’s the reference for this paper: Farina EK, Kiel DP, Roubenoff R, et al. Protective effects of fish intake and interactive effects of long-chain polyunsaturated fatty acid intakes on hip bone mineral density in older adults: the Framingham Osteoporosis Study. Am J Clin Nutr. 2011 May;93(5):1142-51. Epub 2011 Mar 2. PMID: 21367955)
Remember, anything that chronically increases inflammation will activate osteoclasts – the cells that break down bone – so the more you can do to lessen chronic inflammation, the better!

In terms of safety – fish oils have been shown to be very safe. There was some concern that fish oil might increase bleeding risk, but this has not been found to be a problem, even in people also taking certain anticoagulants or aspirin. The only concern is with the purity of the fish oil – could it contain mercury? Krill oil is highly unlikely to be contaminated with mercury, and there are a number of excellent fish oil supplements made with very high quality control standards, so they are checked for mercury and are safe as well. Just be sure any fish oil product you purchase shows on the label that it has been tested for mercury and is pure. I’m copying in the full abstract for this recent paper in the American Journal of Cardiology discussing that fish oil (omega-3s) are safe, so you can see all of it.

Am J Cardiol. 2007 Mar 19;99(6A):35C-43C. Epub 2006 Nov 28.

Safety considerations with omega-3 fatty acid therapy.

Bays HE.

Source
Louisville Metabolic and Atherosclerosis Research Center, Louisville, Kentucky 40213, USA. [email protected]

Abstract
It has been suggested that the potential antithrombotic effect of fish oils may theoretically increase the risk for bleeding, which may be a safety concern for individual patients. However, clinical trial evidence has not supported increased bleeding with omega-3 fatty acid intake, even when combined with other agents that might also increase bleeding (such as aspirin and certain anticoagulants). Another potential safety concern is the susceptibility of omega-3 fatty acid preparations to undergo oxidation, which contributes to patient intolerance and potential toxicity. Finally, large amounts of fish consumption may result in adverse experiences due to the potential presence of environmental toxins such as mercury, polychlorinated biphenyls, dioxins, and other contaminants. The risks of exposure to environmental toxins and hypervitaminosis with fish consumption are substantially reduced through purification processes used to develop selected concentrated fish oil supplements and prescription preparations. Thus, in choosing which fish oil therapies to recommend, clinicians should be aware of available information to best assess their relative safety, which includes the US Food and Drug Administration (FDA) and Environmental Protection Agency (EPA) advisory statement regarding fish consumption, the meaning of certain labeling (such as “verification” through the US Pharmacopeia) and the differences in FDA regulatory requirements between nonprescription fish oil supplements and prescription fish oil preparations, and how all of this is important to the optimal treatment of patients.

PMID: 17368277

Be well! Lara

Dear Dr. Pizzorno

I feel so fortunate and very happy that I reached you. You are ‘THE BEST”, and sincerely pray God to help you and your husband in all your endeavours and needs and give you health to continue such a great job. People like you make a better world for all, specially for people like me.

I too lost my mother to bone problem. I wish, like you, I new better then, but that is something that can not be. I have already spoken to couple of my closest friends about my and their bones problem and complications, and new alternatives. Best of all, of how lucky I am to be able get the advise of someone like you, the best doctor. I am reading your book.

Regarding the krill oil, I bought it actually because of my eyes. My Eye Dr. found that I have elevated pressure , and I am committed to do the best also. I found out that the billberry is very good, and I will try to find the European version with bilberry. I am also taking for my eyes the Eye Bright, and was told drops are also very good.

I will call my sisters, this week to talk about your advise, and also regarding “Your Bones”. Is there an Spanish version?

I am so grateful for all your help, I will also follows your husband’s diet’s advise.

All the best,

Julia Soledispa

P.S. May I ask where are you from?

Hi Julia, thanks so much for your very kind words. I so hope the information will be helpful to you!
Re your eyes — please check in with your eye doctor — it is important to get the pressure down quickly. You might consider using medication short-term to get the pressure down while also using krill oil, Billberry, your eye drops and lastly –Ginkgo biloba. I am copying in for you here the abstracts from several recent papers on PubMed discussing the use of Ginkgo for elevated pressure in the eyes. You could share these with your doctor and discuss this option:

Mol Vis. 2012;18:390-402. Epub 2012 Feb 9.
Ginkgo biloba: an adjuvant therapy for progressive normal and high tension glaucoma.
Cybulska-Heinrich AK, Mozaffarieh M, Flammer J.
Source: Department of Ophthalmology, University of Basel, Basel, Switzerland.
Abstract
Gingko biloba has been used for hundreds of years to treat various disorders such as asthma, vertigo, fatigue and, tinnitus or circulatory problems. Two of the main extracts are EGb761 and LI 1370. Most pharmacological, toxicological and clinical studies have focused on the neuroprotective value of these two main extracts. Neuroprotection is a rapidly expanding area of research. This area is of particular interest due to the fact that it represents a new avenue of therapy for a frustrating disease that may progress despite optimal treatment. One such disease is glaucoma.Glaucoma leads to the loss of retinal ganglion cells and their axons but also to tissue remodelling which involves both the optic nerve head and the retina. In the retina the astrocytes get activated. In addition, the optic nerve gets thinner and the cells of the lateral geniculate ganglion disappear partially. On average, ocular blood flow (OBF) is reduced in glaucoma patients in various tissues of the eye. Increased intraocular pressure (IOP) is a major risk factor for glaucomatous damage. Nevertheless, there is little doubt that other risk factors besides IOP are involved. One such risk factor is a primary vascular dysregulation (PVD) occurring in patients with a disturbed autoregulation, another risk factor is oxidative stress.
PMID: 22355250

Ophthalmol Clin North Am. 2005 Dec;18(4):597-609.
Complementary therapy for the treatment of glaucoma: a perspective.
Ritch R.
Source: Glaucoma Associates of New York, The New York Eye and Ear Infirmary, 310 East 14th Street, Suite 304, New York, NY 10003, USA. [email protected]

Abstract
Although neuroprotective strategies and pharmaceutical agents have been initiated in the treatment of numerous disorders of the central and peripheral nervous systems, including trauma, epilepsy, stroke, Huntington disease, amyotrophic lateral sclerosis,and AIDS dementia, none have yet been applied to the treatment of glaucoma. A prospective, placebo-controlled, multi-institutional trial of memantine is underway. One would not expect the treatment modalities that form the bases of nonpharmaceutical, traditional medical systems to be used to lower IOP. Glaucoma was unknown when these medicinal treatments were developed over the centuries. Their primary use is in improving the cardiovascular and immune systems and in what is now called neuro-protection. Rather than single compounds that target a specific receptor and have demarcated side effects in other systems, plant products are a blend of many compounds and, according to those most versed in them, they achieve a balanced therapy, helping in specific symptomatic complexes while reducing side effects through ameliorating effects in other areas. It is not insignificant that, now that the rain forests are rapidly dwindling, together with their inhabitants and the knowledge of medicinal plants (especially in South America), the pharmaceutical companies are spending large amounts of money in a sudden, almost frantic attempt to gather the knowledge about rainforest plants before all has been completely lost. Proof of effects clinically in a chronic disease such as glaucoma remains largely lacking, and controlled trials are unlikely to be initiated, except perhaps through the National Institutes of Health, because these compounds have been in the public domain for many years. Perhaps those as yet unknown or un-recorded are patentable and perhaps these include drugs known only to small surviving communities of hunter-gatherers, which explains the pharmaceutical interest in these areas. When more accurate and rapid means of assessment of progression of glaucomatous damage than perimetry and optic nerve head photography are eventually developed and trials can be reduced in time, number of subjects, or even the use of nonhuman subjects for the bulk of studies, studies could be done for verification of effect of various compounds and also comparative studies. At the present time, GBE is the best documented of all the complementary medicinal agents and seems to have the greatest potential value. Ginkgo biloba extract has numerous properties that theoretically should be beneficial in treating non-IOP-dependent mechanisms in glaucoma. Its multi-ple beneficial actions, including increased ocular blood flow, antioxidant activity, platelet activating factor inhibitory activity, nitric oxide inhibition, and neuroprotective activity, combine to suggest that GBE could prove to be of major therapeutic value in the treatment of glaucoma.
PMID: 16314222

Med Hypotheses. 2000 Feb;54(2):221-35.
Potential role for Ginkgo biloba extract in the treatment of glaucoma.
Ritch R.
Source: Department of Ophthalmology, The New York Eye and Ear Infirmary, New York 10003, USA. [email protected]

Abstract
Glaucoma is becoming recognized as a condition for which not only elevated intraocular pressure, but also non-pressure-dependent risk factors are responsible. New avenues of treatment into which investigations are being initiated include agents which could possibly improve blood flow to the eye and neuroprotective drugs. Only calcium channel blockers are presently available for such treatment in glaucoma, and these have not been widely adopted, in contrast to clinical trials involving a number of neuroprotectants in other neurologic disorders. Ginkgo biloba extract is freely available and has several biological actions which combine to make it a potentially important agent in the treatment of glaucoma: improvement of central and peripheral blood flow, reduction of vasospasm, reduction of serum viscosity, antioxidant activity, platelet activating factor inhibitory activity, inhibition of apoptosis, and inhibition of excitotoxicity. The effect of Ginkgo biloba extract as a potential antiglaucoma therapy deserves intensive scrutiny.
PMID: 10790757

FYI–I am not a doctor; I have 2 master’s degrees — one from Yale Divinity School in New Haven, CT, and the other from the University of Washington here in Seattle, that one is in English literature and writing. I have been a medical writer for almost 30 years now, attended hundreds of medical conferences, have helped my husband, who is a doctor, with the Textbook of Natural Medicine and others of his books, have co-authored a number of medical books myself as well, written both for doctors and for the public — and I am the editor of a medical journal focusing on healthy aging called Longevity Medicine Review, which is written for physicians. I spend 3-4 hours every day reading the breaking medical research and have done so for many years now. So, I am very well informed — but I am not a doctor.

I happened onto your blog via the AlgaeCal Website. Very fascinating information!
I am 79 years old and in fair health. I do have oseopenia at the cusp of being ostoporosis, which has been at that level pretty much for 20 years. I faithfully take 600 mg. calcium citrate/day plus a bone builder with 300 mg. of calcium and eat a pretty healthy diet. AlgaeCal seems like a much better option, but I have a few questions. 42 years ago I had a Vagotomy and only have a portion of my stomach which produces little acid (I had ulcers).
1. Would I be able to absorb the AlgaeCal?
2. How much K2 is too much? I presently take a supplement that produces:
1000mcg of K1
1000mcg of K2 as MK-4
100 mcg of K2 as MK-7
I like this supplement as it provides many of the nutrients that I think necessary, but would be willing to give it up if AlgaeCal would be a better option for my calcium needs.
I do have high blood pressure and diagnosed heart disease with plaque in my carotids, so found your writings on K2 very interesting regarding cardiovascular disease. I would be very appreciative of any comment you might have regarding the above.

Hi Sharon,
If you are able to absorb calcium citrate, then you should have no difficulty absorbing AlgaeCal. Do you currently take any betaine HCL and pancreatic enzymes with your meals? If not, you might want to discuss doing so with your doctor since if your production of hydrochloric acid is compromised, this will lessen your ability to absorb not only calcium, but virtually all vitamins and minerals, also your ability to digest protein. When we are unable to fully digest proteins, larger protein fragments are likely to be absorbed and pass into the systemic circulation — where they are seen as potential threats / invaders — and this triggers an immune response and may result in food allergies. Such reactions to food proteins promote inflammation — and the chronic low level inflammation that may be caused will activate osteoclasts, the cells that break down bone. To safeguard and promote the health of your bones, you want to be minimizing inflammation from any and all causes!
Regarding taking more than 100 micrograms of K2 per day (i.e., you would be taking 200 micrograms/day if you continue to take your current vitamin K supplement and add the 100 mcg of K2 in AlgaeCal Plus): this should be very safe and should be beneficial. Many studies have been done using MK-7 in amounts greater than 450 micrograms per day with no adverse effects seen. A cup of natto, an amount typically consumed by people in Japan, contains more than 400 micrograms. Again, no adverse effects have been seen. In animal studies, doses of 10 milligrams (each milligram = 1,000 micrograms, so this is 10,000 micrograms per day) have produced no adverse effects. (Here’s the PubMed reference for this study: Pucaj K, Rasmussen H, Møller M, et al. Safety and toxicological evaluation of a synthetic vitamin K2, menaquinone-7.Toxicol Mech Methods. 2011 Sep;21(7):520-32. Epub 2011 Jul 25.PMID: 21781006) I have read literally hundreds of studies now discussing vitamin K (as K1, and K2, both MK-4 and MK-7) and have summarized these in several review articles — the most current one is available on Longevity Medicine Review (this is a free access journal written for doctors, but you will understand the discussion, and as you will learn if you have a few moments to scan this paper, vitamin K2 does way more for us than promote the health of our bones! It is a key nutrient required for healthy aging, and may be especially helpful for you given your diagnosed arterial plaque issues.) I think you will find my review of the vitamin K research very interesting! Here’s a link to this article:
http://www.lmreview.com/articles/view/Vitamin-K2-Essential-for-Prevention-of-Age-Associated-Chronic-Disease/

I, myself, take AlgaeCal Plus + an additional vitamin K supplement providing 100 mcg of MK-7, and my multiple vitamin and mineral supplement also gives me an additional 100 mcg of MK-7 — I have been following this regimen for more than a year now with not only no adverse effects, but extremely positive effects on my BMD — since I began using AlgaeCal Plus last summer (July 2011), my BMD is up 6% in my spine and 3.2% in my hip/femur according to my most recent DXA, which was run May 1, 2012. Since switching to AlgaeCal Plus as my source of supplemental calcium was the only change I made to my bone building regimen (I had been taking 200 mcg of K2 in my additional Vitamin K supplement, taking it twice daily, and cut back to once a day when I began using AlgaeCal Plus), I am sure the sea-alage-derived calcium (which is provided in the full matrix of all the trace minerals the sea-alage utilized to build itself, so you receive the synergistic benefits of all of these, in their natural balance) is a key factor in my improvement. I am now just barely osteopenic. I encourage you to consider giving AlgaeCal Plus a try.
I also realize I should publicly state here that I make no money from the sales of AlgaeCal — I recommend it because I know it is both safe (very high quality control standards) and highly effective. My personal experience simply confirms research studies that have been conducted comparing AlgaeCal to calcium citrate — both lab studies and human trials. All have demonstrated that AlgaeCal is significantly more effective in building bone than calcium citrate.
Hope this helps. Be well! Lara

Where can I find medical doctors/practitioners who will work with me prescribing AlgaeCal and supplements? A subscribing medical authority is needed. I am in Virginia Beach, VA .
Thank you!

Hi Laura,
I enjoy reading your health advice very much. I recently went to the doctor with low back pain. I am now in physical therapy for pain. However the doctor advises me no exercise at this time. My back has discs that are pressing on nerves. He has me in traction to pull the vertebrae apart to decrease some pain. I have always exercised now I cannot until further notice. Will this have an effect on my bones health. I do have low one density. I take AlgaeeCal. I would love to know what you think. Thank you so much for your good advice to every women that needs to know the truth. Audrey

Hi Audrey,
Sorry to hear your low back is giving you pain. Very glad to hear you are working with a physical therapist to help correct the alignment problem.
Be sure you are eating a very healthy diet now as well as taking your supplements. Avoid processed foods (high in sugars, salt, and pro-inflammatory fats–trans fats and omega-6s). You really want to cut down on all sources of inflammation as your body tries to heal — and frankly, long term, for your overall and bone health.
If you are unable to exercise for a short time, but you are at least walking around and getting some movement to stimulate your bones, you should be fine short-term. You might talk with your PT about Pilates. A very supportive piece of equipment, called a Reformer, is used for Pilates exercises. A good STOTT Pilates instructor would actually be able to provide exercises for you that would be safe for you and would further improve your PT regimen. Often, STOTT Pilates instructors work in PT offices as part of the staff. A good Pilates instructor could work with your PT to help your low back pain improve more quickly.

I am struggling to find a calcium free “snack” which you say you have with your Strontium Citrate and have taken it alone and well away from AlgaeCal. Any suggestions please?