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How Can I Avoid Arterial Calcium Deposits When Taking Coumadin?

Holly Hannula wrote me about being on Coumadin (warfarin) for 12 years because she has a mechanical heart valve. She’s alarmed by a recent scan of her artery walls showing dangerously high calcium deposits, i.e., the amount of hardening of the arteries (atherosclerosis).

Holly’s doctors recommended an angiogram (X-ray) and stents to be put in wherever needed and done very soon. She felt that was too drastic, that her quality of life was good and she was active and social. She and her husband declined those procedures.

Her emailed continued:

“The doctors won’t or can’t change me to a different blood thinner. If I have to take Coumadin for the rest of my life, can I reduce the calcification with vitamin K2 (MK-7)?”

Holly’s coronary artery calcium score is 800 which is dangerously high.

A score between 100 and 399 is classified as increased calcification, and any score over 400 signifies extensive calcium deposits. If your score is over 1,000, you have a 20 percent chance of having a serious or fatal cardiac episode within one year of testing.  (See table below for all scores.)

A score over 1,000 equals a 20% chance of a serious or fatal cardiac event within one year.

No wonder Holly is worried!

What are Her Options?

Because she has a mechanical heart valve, Holly doesn’t have a lot of options. Treatment Guidelines by the American College of Cardiology/American Heart Association (ACC/AHA) only include warfarin (Vitamin K Antagonist) therapy and perhaps aspirin. None of the newer anticoagulants are included.

One might think that a newer anticoagulant like Eliquis would work as well as Coumadin if one has a mechanical valve. But right now, this isn’t a recommended treatment. (For example, the maker of Eliquis states that it isn’t for patients with artificial heart valves.)

My Best Effort for Holly: In my return email, I promised Holly that I would get in touch with Bristol-Myers Squibb, the maker of Eliquis, to see if it could possibly be used in her case.

Tragic Dangers of Warfarin Not Recognized

It’s tragic that Holly has such extensive calcium deposits due to having to take warfarin (Coumadin) which works by blocking Vitamin K.

Vitamin K is essential for heart and bone health. Without enough K-2, osteocalcin, a protein that binds calcium to bone, doesn’t function. Instead the calcium ends up clogging arteries. See Arterial Calcification From Warfarin: Vitamin K May Reverse it.

What’s equally tragic is how few doctors and their patients are aware of this side effect of taking warfarin (Coumadin).

Vitamin K2 Reverses Arterial Calcification!

But, as Holly has already researched and as I described in my article, Arterial Calcification From Warfarin, high doses of Vitamin K2 MK-7 reversed arterial calcification in recent preliminary studies. (MK-7 means the Vitamin K2 also has a Natto component. Natto[kinase] is a known natural blood thinner.)

But what K2 MK-7 dosage should Holly consider? We don’t have enough human research yet to give a definitive answer, but we do have some indications.

Animal research: In an animal study, rats were initially fed a six-week diet of warfarin to induce calcium buildup in blood vessels. Some rats were then fed high dose Vitamin K1 or K2 (MK-4) for six weeks. They not only had no further arterial calcium accumulation but, more importantly, had a 37% reduction of previously accumulated arterial calcification. After 12 weeks, there was an astounding 53% reduction.

Doses: Note the distinction between mg and mcg. 1 mg = 1000 mcg

Mega dose or RDA? In the above study of rats, the human equivalent of the vitamin K2 dose is in the range of  52,000 mcg (52 mg) to 97,000 mcg (97 mg) per day.

Admittedly, these are high doses compared to the standard daily recommend dosages (90 mcg [0.09 mg] for females and 120 mcg [0.12 mg] for males).

Already approved: In Japan, a 45,000 mcg (45 mg) daily dose of the MK-4 form of vitamin K2 is approved as a drug to treat osteoporosis.

Vitamin K and Dosages

Forms of Vitamin K: Consider a high quality MK-7 form of Vitamin K2. Plus, as they are inexpensive, include vitamin K1 and MK-4 to help inhibit and possibly reverse vascular calcification.

Remember to always take your Vitamin K supplement with fatty foods since it is fat-soluble and won’t be absorbed without it.

to avoid arterial calcification

Although the exact dosage of Vitamin K is yet to be determined, one of the world’s top Vitamin K researchers, Dr. Cees Vermeer recommends between 45 mcg and 185 mcg daily for normally healthy adults. LifeExtension magazine recommends 180 mcg.

To Reverse Arterial calcification

To reverse or reduce calcium plaque, you might consider the ultra high doses of 45-50 mg (45,000 mcg) daily, which is based on the research with rats. But only under your doctor’s supervision!

It’s most important that Holly should NOT make any changes to her treatment plan without consulting withher  doctor first.

No Overdosing on Vitamin K

You need not worry about overdosing on K2—people who have been given a thousand-fold increase over the recommended dose over the course of three years have shown no adverse reactions (i.e., no increased clotting tendencies).

Advice for Warfarin Users

If you are taking warfarin, your goal should be to maintain the highest healthy levels of Vitamin K to counteract the effects of warfarin on your arterial and bone health.

If you change from warfarin to a NOAC, your goal should be to restore your arterial and bone health from the effects of warfarin by maintaining the highest healthy levels of Vitamin K.

Additional reading about Vitamin K To learn more about the types of Vitamin K, see our article, Vitamin K―Protection Against Arterial Calcification & Cardiovascular Disease

On a personal note: I’ve had a CT scan which revealed calcium deposits in my heart’s arteries, especially in the “widow maker”, the Left Anterior Descending artery (LAD).
After writing this article, I’ve decided to take 45 mg (45,000 mcg) of Vitamin K2 daily.
Coronary Artery Calcium Score  Interpretation
 0 No identifiable plaque. Risk of coronary artery disease very low (<5%)
 1-10 Mild identifiable plaque. Risk of coronary artery disease low (<10%)
 11-100 Definite, at least mild atherosclerotic plaque. Mild or minimal coronary narrowings likely.
 101-400 Definite, at least moderate atherosclerotic plaque. Mild coronary artery disease highly likely. Significant narrowings possible
 > 400 Extensive atherosclerotic plaque. High likelihood of at least one significant coronary narrowing.

Back to Top

Resources for this article
• Goodman, Denonis. The New Nutrient Fix. Bottom Line/Health. July, 2015, p. 3.

• Faloon, William. Turning To Stone. Life Extension Magazine, July 2015, pp. 7-16. Last accessed Aug 10, 2015. URL: http://atlaschiropractichealthcenter.com/blog/wp-content/uploads/2015/06/Vitamin-K-LE1.pdf

• Tantisattamo E et al. Increased vascular calcification in patients receiving warfarin. Arterioscler Throm Ib Vasc Biol. 2015 Jan;35(1): 237-42. doi: 10.1161/ATVBAHA.114.304392

• Pilkey, RM, et al. Subclinical vitamin K deficiency in hemodialysis patients. Am J Kidney Dis. 2007 Mar;49(3):432-9. Last accessed Aug 10, 2015. URL: http://www.ncbi.nlm.nih.gov/pubmed/17336705

• Schurgers, LJ, et al. Regression of warfarin induced medial elastocalcinosis by high intake of vitamin K in rats. Blood. 2007 Apr 1;109(7):2823-31. Last accessed Aug 10, 2015. URL: http://www.bloodjournal.org/content/109/7/2823.full?sso-checked=true

• Westenfeld, R, et al. Effect of vitamin K2 supplementation on fictional vitamin K deficiency in hemodialysis patients: a randomized trial. Am J Kidney Dis. 2012 Feb;59(2):186-95. Last accessed Aug 10, 2015. URL: http://www.ajkd.org/article/S0272-6386(11)01570-8/abstract

• Geleijnse, JM et al. Dietary Intake of Menaquinone Is Associated with a Reduced Risk of Coronary Heart Disease: The Rotterdam Study. The Journal of Nutrition, November 1, 2004, Vol. 134, no. 11. 3100-3105. http://jn.nutrition.org/content/134/11/3100.full Last accessed 6/19/2015.

• Vitamin K: How much is too much? Alere/PTINR.com. April 1, 2013. Last accessed Aug. 10, 2015. URL: http://ptinr.com/warfarin-you/dietary-food-beverage/vitamin-k-how-much-too-much

• Mercola, J. 10 Important Facts About Vitamin K That You Need to Know. Mercola.com, March 24, 2004 Last accessed Aug 10, 2015. URL: http://articles.mercola.com/sites/articles/archive/2004/03/24/vitamin-k-part-two.aspx

• Mercola, J. New Study Shows Evidence That Vitamin K2 Positively Impacts Inflammation. Mercola.com. October 12, 2013. https://articles.mercola.com/sites/articles/archive/2013/10/12/vitamin-k2-benefits.aspx

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