Vitamin K is a fat-soluble micronutrient that is essential for making proteins for healthy bones and tissues. It synthesises the protein responsible for blood clotting and protects against severe bleeding. The proper functioning of vitamin K in the human body depends upon the adequacy of vitamin E in our system which regulates the uses of vitamin K. Small quantity of vitamin K is also formed by bacteria in the small intestine however, a major source of vitamin K are green leafy vegetables and animal-derived products (1, 2).
Types of Vitamin K
There are 2 types of Vitamin K (2, 3):
- Vitamin K1: It is known and phylloquinone and is easily obtained from green leafy vegetables.
- Vitamin K2: It is called menaquinone and can be obtained from animal-derived food products like meat, cheese, and eggs.
What is Vitamin K Deficiency?
Vitamin K deficiency is the health condition caused by prolonged deprivation of Vitamin K. It may be caused by inadequate intake of Vitamin K-rich diet, rapid metabolism, excessive excretion, and malabsorption due to preexisting health conditions like gastrointestinal disorders. GI disorders affect the presence and reproduction of good bacteria which are responsible for the internal production of vitamin K (2).
Functions of Vitamin K
Vitamin K functions as coenzymes for vitamin K dependent carboxylase and enzymes responsible for the formation of protein which helps in haemostasis (blood clotting), bone metabolism, and other necessary functions. The vitamin K-based protein responsible for blood clotting is known as prothrombin (2).
Causes of Vitamin K Deficiency
The condition of Vitamin K deficiency can be developed due to various factors. Some of the major cause has been illustrated below:
- Inadequate Diet: The most common cause of Vitamin K deficiency is a vitamin deficit diet. We often end up consuming foods that are poor in essential vitamins and minerals such as Vitamin K. Green leafy vegetables and animal-derived food products are a rich source of Vitamin K however, these food items are not adequately available to the lower-income group.
- GI Disorders: Vitamin K is soluble in fat; hence it gets stored in the liver for future use. The presence of gastrointestinal disorders interferes with the absorption of Vitamin K and unfavorable conditions for the vitamin K generating bacteria reside in the small intestine. These factors will lead to prolonged vitamin C deficiency.
- Vitamin E Deficiency: Vitamin E regulates the utilisation of vitamin K; its deficiency may lead to malabsorption and imbalance of vitamin K in our body.
- Newborn Babies: Babies are born with vitamin K deficiency, within few weeks of born they need to be treated with vitamin K supplements otherwise it may cause bleeding in the umbilicus, gastrointestinal tract, skin, nose, or other sites (4).
Symptoms of Vitamin K Deficiency
The common symptoms of Vitamin K deficiency include (5):
- Easy bruising
- Oozing from nose or gums
- Excessive bleeding from wounds, punctures, and injection or surgical sites
- Heavy menstrual periods
- Bleeding from the gastrointestinal (GI) tract
- Blood in the urine and/or stool.
Health Risks due to Vitamin K Deficiency
Vitamin K deficiency poses several health risks. Some of the health risks are illustrated below (4):
- Cardiovascular Diseases (CVD): Vascular calcification is the major cause of heart disease. Matrix Gla-protein (MGP) which is vitamin-K based protein plays a vital role in the prevention of calcification. Vitamin K deficiency may lead to improper regulation of MGP and results in coronary heart disease.
- Osteoporosis: It is mainly caused by the deficiency of calcium and vitamin D in the body however, vitamin K acts as a cofactor for the protein osteocalcin which is responsible for the bone mineral density. Vitamin K deficiency may lead to the fragile and porous bone.
- Internal Bleeding: Vitamin K deficiency may result in bleeding from gastrointestinal tracts, eyes, gums, heavy menstruation period. It is primarily caused by the inadequacy of vitamin K-based protein prothrombin.
Tests for Vitamin K Deficiency
The test for vitamin K deficiency is very rarely used. It’s often identified due to heavy bleeding in GI tracts, nose, gums, and urine, and stool. In general, there would be any preventive measure required for the test however, individual should stop taking medications which might interfere with test results.
- Prothrombin Time (PT): The primarily used test for the identification of vitamin K is prothrombin time. If the result of the test is prolonged, then vitamin K supplements are provided, and if the condition of the patient improves it may indicate the condition of vitamin K deficiency.
Remedies of Vitamin K Deficiency
- Vitamin K Supplements: If you are diagnosed with severe Vitamin K deficiency, you should consider medical supplements under the supervision of doctors. As higher Vitamin K may lead to a deadly health condition.
- Vitamin K Rich Diet: Vitamin K-rich food items will help in minimising the Vitamin K deficiency. Some of the Vitamin K-rich food items are like include leafy veggies, fish, liver, meat, eggs, cheese, dairy products, soybean, pumpkin, brussels sprout, broccoli, cabbage, cauliflower.
- Vitamin E Rich Diet: Vitamin E is responsible for the utilisation of Vitamin K. Some of the Vitamin E rich food items are like includes Wheat germ oil, sunflower, safflower, soybean oil, sunflower seeds, almonds, peanuts, peanut butter, spinach, pumpkin, red bell pepper, asparagus, mango, avocado.
- Fortified Food Items: Rich sources of Vitamin K are green leafy vegetables and animal-derived products. Agricultural lands that lack Vitamin K concentration will produce feet with a relatively low concentration of phylloquinone. Such a situation can be overcome by providing fortified seeds.
Prevention of Vitamin K Deficiency
It is often said that “Prevention is better than Cure” and indeed this is very much true about micronutrient deficiencies. Vitamin K deficiency can be prevented through the consumption of a Vitamin K-rich diet.
Food items rich in Vitamin K (4):
- Collards
- Turnip
- Spinach
- Broccoli
- Soybeans
- Carrot juice
- Soybean oil
- Pumpkin
- Pomegranate
- Okra
- Blueberries
- Chicken
- Grapes
- Olive oil
- Figs
- Chicken
- Cheese
- Milk
- Salmon
- Shrimp
Ideally, we should consume an adequate quantity of vegetable fruits and animal-derived products which are the major source of Vitamin K in our diet.
Adequate Intake (>19 yrs.):
The recommended intake of Vitamin K varies with age however the recommended daily intake of Vitamin K for an adult is 90-120 mcg.
Summary
Vitamin K is a fat-soluble vitamin essential for regulating severe bleeding, bone health, metabolism, and other necessary body functions. It plays a vital role in protecting against osteoporosis and cardiovascular disease and internal bleeding, especially in newborns.
Although Vitamin K deficiency has several ill effects, it can be treated with the right consultation and medical supplements as prescribed by medical experts. The best possible way to avoid these complications by consuming an adequate amount of Vitamin K as per RDA through various Vitamin K-rich diets.
