Vitamin K

Vitamin K is a fat-soluble quinone whose metabolic significance extends far beyond its classical role in blood clotting, functioning as a fundamental mitochondrial support agent and regulator of calcium homeostasis. 3 Ray Peat argued that both K1 and K2 have similar effects, though K1 is probably slightly less active, and he emphasized that adequate vitamin K can be obtained from dietary sources like cooked greens, milk, cheese, and eggs. 2 He cautioned that the modern vitamin K culture is largely a creation of marketing campaigns, and that the solvents and excipients used in extraction—particularly from natto—often cause the harmful reactions attributed to the vitamin itself. 2

The distinction between the menaquinone forms is a major point of divergence. Peat stated that all forms of vitamin K are good, and that taking the vitamin with a meal allows slow, steady absorption, making the difference between MK-4 and MK-7 negligible. 2 Georgi Dinkov has directly disagreed with this framing, arguing that only MK-4 has proven anti-osteoporosis and anti-calcification effects in human studies, while dismissing MK-7 as little more than a marketing ploy by the soy and cheese industries to monetize waste products. 2 Dinkov further notes that MK-4 is the actual form the body uses for osteocalcin carboxylation and electron transfer in the electron transport chain, and that only MK-4 is approved as an osteoporosis drug in countries like Japan. 2

Mechanistically, vitamin K acts as a cofactor for Complex III of the mitochondrial electron transport chain, speeding the flow of electrons through OXPHOS and thereby supporting energy production in every cell. 2 This bioenergetic function underpins its ability to activate Matrix Gla Protein (MGP), which prevents soft-tissue calcification by drawing calcium out of cells and into bones. 2 Dinkov has written that this decalcification is the main cause of vitamin K's hypotensive action at doses of 15 milligrams and up, and that the vitamin also exhibits direct anti-estrogenic activity, with MK-4 acting as a stronger estrogen receptor antagonist than K3. 2 Additionally, vitamin K synergizes with vitamin A to induce expression of microtubule-associated protein 2 (MAP2), a target also activated by neurosteroids like pregnenolone, suggesting a role in treating neurodegenerative conditions. 8

Dosing strategies vary significantly by goal. Dinkov notes that 2–3 milligrams per day can mimic the metabolic effects of high-dose coenzyme Q10, while 15 milligrams daily is effective for decalcifying soft tissues and lowering blood pressure over several months. 5 For therapeutic interventions like reversing arterial calcification or treating liver cancer and leukemias, doses of 30–90 milligrams per day have been used in clinical trials. 5 The Japanese osteoporosis studies used 45 milligrams daily, typically divided into three 15-milligram doses to maintain higher serum levels. 4 Dinkov has reported that topical application in DMSO can yield 3–10 times better bioavailability compared to oral pills, and that some users experience negative reactions like anxiety or chest tightness, possibly due to the vitamin's effects on lowering blood sugar or increasing GABA levels. 2 A human study also found that just 180 micrograms of MK-7 daily significantly reduced the frequency and severity of nocturnal leg cramps, an effect attributed to inhibiting calcium uptake into cells and improving mitochondrial energy production. 11