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I have a question about supplemental Vitamin K-2 (MK-7

Hi there,I have a question...
Hi there,I have a question about supplemental Vitamin K-2 (MK-7 derived from Natto) and blood clotting, though it requires some background info (sorry for the long-windedness).I'm a 37 year old male. Trying to lose weight and reduce blood pressure (not hypertensive yet, but trying to stay that way), but otherwise fairly healthy. My dad had a heart attack relatively young (53), so I'm trying to prevent that in my own life if possible.No prescription meds, but I take several supplements, including a whole food multivitamin, D3, fish oil, grape seed + resveratrol, pycnogenol, policosanol, aged garlic extract, fermented turmeric, cayenne, ginger, and a few others, but those are the majors, all with doctor and nutritionist approval.I recently added red yeast rice plus a bit extra K2 (from natto) and CoQ10. The totals are 1,200 mg red yeast rice; 100 mg natto w/ 100 mcg K2 (MK-7), and 160mg CoQ10 (a tiny bit more since my multi has some naturally).My question involves clotting. Given my family history, I'm aiming to keep my blood slightly thin. (Not too thin, of course, but I don't notice any unusual bruising or bleeding that won't stop, so I think I'm fine in that regard). The aged garlic, fish oil, pycnogenol, turmeric, cayenne, ginger, and natto itself, among others, should all help with that. Note that I do NOT take a baby aspirin as I'm taking these things essentially in place of that, as they should have similar blood thinning and anti-cancer effects.My doctor wanted me to try the red yeast rice to improve cholesterol numbers slightly (my numbers such as LDL and triglycerides are quite good, but HDL has always been low genetically, and my particle sizes are not ideal even though the number is *****). I've had some improvement as of my last blood test, so that's encouraging, but I've recently discovered vitamin K as well as CoQ10 can actually encourage clotting. What I want to know is, is this a concern?I know statins (and by extension, red yeast rice) can deplete both K2 and CoQ10, which is my rationale for supplementing them. I also know both are important, with K2 being considered especially so for preventing calcium buildup in arteries. I've also read that K1 is the main clotting version of K, but K2 can still promote some clotting factors, and that promotion of factors in itself should not be a problem unless your blood clotting is not working normally (which it is, as far as I know). I'm of course not on any prescription blood thinners, which I know can cause worries with K2.So, what I guess I'm trying to work out is if the combination I'm taking is working as intended. From my thought process, simply promoting proper clotting factors shouldn't reduce the anti-platelet activity of the other supplements I'm taking, and the added natto and lower cholesterol should actually improve things. Plus, the CoQ10 and K2 I'm taking should make up for any the red yeast rice depletes.I just want to make sure I'm not doing something to promote any extra clotting or make some sort of clot or ischemic issue more likely.Your thoughts and help are much appreciated, so thank you!
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Customer reply replied 1 month ago
Quick edit - I actually made an omission in my original post - my total CoQ10 intake is 280 mg, not 160 as stated.
Answered in 44 minutes by:
1/15/2018
Dr. Muneeb Ali
Dr. Muneeb Ali, Doctor (MD/DO)
Category: Health
Satisfied Customers: 8,630
Experience: MBBS, MD, ECFMG certified. 11 year experience in dealing with cases related to all fields of medicine
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Hi,

Welcome to JA and thanks for this question. First off, I'm glad to see that you have researched the supplements extensively and have taken charge of your own health, if more patients were this conscientious about their health, the epidemic of heart disease would be much better managed. Anyway coming to your question, Yes it is true that vitamin K does promote the production of certain clotting factors, primarily II, VII, IX, and X however as you already know the primary issue in the formation of blood clots in heart disease is the platelet activity. That is why the drugs which we use to PREVENT the further worsening or development of heart disease are antiplatelet drugs like aspirin or tigarcelor or clopidogrel.

The first step in the formation of the clots in the arteries of the heart is the aggregation of platelets and that is being well controlled by the supplements that you are using. Now the use of K2 or even natto (containing MK-7) will NOT cause a decrease in the antiplatelet effect of the other supplements. To date, there is no concrete evidence that using vitamin K would also have an effect on the platelets. Ill give you a practical clinical example, in a patient who is actively bleeding and has both a clotting factor issue and platelet problem, we have to replace BOTH to control the bleeding. Simply replenishing the clotting factors via vitamin K or via supplemental factors does NOT result in automatic control of the bleeding UNTIL the platelets are also replaced. If vitamin K affected the platelets as well, then using vitamin K (in any form) alone would be enough to control bleeding in these patients. This holds true even in those situations where there is a qualitative defect in the platelets (the number of platelets is normal but their function is not).

So in short, the simple answer to your question is that NO using these supplements (K2 and CoQ10 and even natto) would NOT lead to the promotion of clotting in your body/heart. I would suggest that you do continue with this plan of management.

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Customer reply replied 1 month ago
Thank you very much for the excellent and detailed response! I am really working with my health care providers to live as healthily as possible and hopefully avoid my father's fate. (I also omitted hibiscus/hawthorn in small doses.)So, just to sum up for peace of mind, the additional K2 (with the addition of natto, red yeast rice, and CoQ10) should not increase any types of dangerous clotting and should, in aggregate (with the keeping calcium out of where it shouldn't be, etc.), continue to benefit me along with my other supplements, and the other supplements will continue to do what they're meant to and keep my platelet activity down so my blood is thin (not too thin, but a bit like aspirin).A few followups as well:
- Do you agree that with the above supplements, additional aspirin is not necessary? My understanding is that they should have a similar antiplatelet activity and hopefully eliminate some of the more minor risks (stomach issues) while providing that protection.
- Is there anything you'd add or change, or do you think pending doctor/nutritionist approval, this is a solid regimen?Thanks so much for your help!

1) Yes, i believe that this combination should NOT increase the risk of any type of clotting and should, in theory, keep the calcium deposition controlled. This regimen should benefit you in terms of preventing heart disease etc

2) At the moment, yes I agree that aspirin is not really needed. At your age (37) I think you should be able to do without aspirin for the next few years however after the age of 45, I think we may need to re-evaluate the situation and see if aspirin is required at that time. But for now, i think you don't really need aspirin given the effects of these supplements

3) Actually no, this is an excellent regimen and you should continue with this.

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Customer reply replied 1 month ago
Great - thank you again. One last followup; you mention re-evaluating aspirin after age 45. What would be the determining factors assuming I'm still on this regimen or something similar?Thanks again - this has been very helpful!

The factors would be a change in the cholesterol levels or change in weight or basically development of any other risk factor for heart disease such as hypertension, diabetes etc. Basically after the age of 45, due to the natural changes which are occurring because of aging we would re evalute the situation based on a clinical examination, blood tests etc.

You're welcome, do remember to leave a POSITIVE rating by clicking on the stars above your screen as that is how we are compensated for helping you today. Any BONUSES would be well appreciated!

Dr. Muneeb Ali
Dr. Muneeb Ali, Doctor (MD/DO)
Category: Health
Satisfied Customers: 8,630
Experience: MBBS, MD, ECFMG certified. 11 year experience in dealing with cases related to all fields of medicine
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