The Bone—Vasculature Axis: Calcium Supplementation and the Role of Vitamin K
Grzegorz B. Wasilewski1,2, Marc G. Vervloet3 and Leon J. Schurgers1*
Front. Cardiovasc. Med., 05 February 2019 | https://doi.org/10.3389/fcvm.2019.00006
1 Department of Biochemistry, Cardiovascular Research Institute Maastricht, Maastricht University, Maastricht, Netherlands
2 Nattopharma ASA, Hovik, Norway
3 Dept of Nephrology and Amsterdam Cardiovascular Sciences, Amsterdam University Medical Centers, Amsterdam, Netherlands
- Calcium hazards and bioavailability
- Overview Vitamin K and Vitamin D
- Interview of Vitamin K2 and Calcium Paradox author by Dr. Mercola – Dec 2012
- Vitamin K2 and the Calcium Paradox – 2012 book
- Controversy: Too much Calcium if increase Vitamin D
Items in BOTH categories Calcium and Vitamin K are listed here:
- Which supplements are often taken for healing hairline bone fractures
- Calcium and Vitamin K2 - many studies
- Excellent reviews of supplements at ConsumerLab
- Lowering Calcium Risk when having High Dose Vitamin D3 – Cawley Dec 2019
- Hypercalcemia in critically ill patients taking 10,000 IU of vitamin D (many solutions) – Oct 2019
- Calcium Supplementation is OK provided you also take Vitamin K – Feb 2019
- Calcium supplements go to muscle, not bone, unless have enough Vitamin K – Feb 2019
- Drugs which create deficiencies in Vitamin D, Vitamin K, Magnesium, Zinc, Iron, etc. – Sept 2017
- Vitamin D Cofactors in a nutshell
- Vascular calcification greatly reduced by 3 per week 1000 ug of Vitamin K2 MK-7 – Dec 2013
- Increased Vitamin K2 reduces the problems of excess Calcium – Nov 2013
- Review of Micronutrients such as vitamin D for women and childhood – Aug 2013
- Healthy bones need Ca, Silicon, Vitamins B, C, D, and K – Dec 2012
- Interview of Vitamin K2 and Calcium Paradox author by Dr. Mercola – Dec 2012
- Vitamin K2 and the Calcium Paradox – 2012 book
- Low cost cofactors for vitamin D
- Postmenopausal women should supplement vitamins C D K and Calcium – June 2010
Pages listed in BOTH the categories Cardiovascular and Calcium
- Should not add rock Calcium to Vitamin D (after 20 year followup: 6% increase in heart problems – no surprise) – RCT May 2024
- Calcium Supplementation is OK provided you also take Vitamin K – Feb 2019
- Less than 900 IU of Vitamin D and Calcium do not cause cardiovascular problems – Dec 2016
- 800 IU of vitamin D is not enough to help Cardiovascular Disease (found again) – Oct 2016
- Calcium supplementation associated with 3.9X increase risk of atrial fibrillation – June 2015
- Adding Calcium does NOT cause cardiovascular problems (reverses their meta-analysis) – Dec 2014
- Increased Vitamin K2 reduces the problems of excess Calcium – Nov 2013
- More than 400 mg of Calcium supplements caused cardiovascular deaths in men - Feb 2013
- Stiff arteries in seniors associated with low vitamin D levels – July 2012
- Aortic Calcification 85 percent more likely if vitamin D level lower than 29 ng – June 2012
- More than 800 mg of Calcium increases Cardiovascular events by 85 percent– Nov 2011
- Is excess calcium harmful to health - 2010
- Review of Calcium – Vitamin D - Cardiovascular Disease – June 2011
- Calcium without vitamin D increased heart risk by 30 percent - Jan 2011
- Heart attacks increased by 30% in those taking 500 mg of Calcium without vitamin D – July 2010
 Download the PDF from VitaminDWiki
Calcium supplements are broadly prescribed to treat osteoporosis either as monotherapy or together with vitamin D to enhance calcium absorption. It is still unclear whether calcium supplementation significantly contributes to the reduction of bone fragility and fracture risk.
Data suggest that supplementing post-menopausal women with high doses of calcium has a detrimental impact on cardiovascular morbidity and mortality. Chronic kidney disease (CKD) patients are prone to vascular calcification in part due to impaired phosphate excretion. Calcium-based phosphate binders further increase risk of vascular calcification progression.
In both bone and vascular tissue, vitamin K-dependent processes play an important role in calcium homeostasis and it is tempting to speculate that vitamin K supplementation might protect from the potentially untoward effects of calcium supplementation.
This review provides an update on current literature on calcium supplementation among post-menopausal women and CKD patients and discusses underlying molecular mechanisms of vascular calcification.
We propose therapeutic strategies with vitamin K2 treatment to prevent or hold progression of vascular calcification as a consequence of excessive calcium intake.
Conclusions
To date, calcium supplements are the most commonly used non-prescription drug to treat age-related bone loss. Also, in patients suffering from chronic kidney disease, calcium-based phosphate binders are commonly prescribed.
However, the rising concern of side-effects from calcium supplementation illustrates a clinical dilemma: supplementation of calcium—either with or without vitamin D—comes at the price of increased risk of vascular calcification.
Clinical studies demonstrate that increased intake of vitamin K could be a promising complementary nutrient in supporting both bone health and protecting vascular calcification.
Thereby it can increase safety of current treatments of osteoporosis and provide an escape from the calcium paradox.
Future clinical trials should be carried out to confirm the feasibility of such combination.