Aortic stenosis is +/- 2% once age 65 and +/-4% for those over
85; but that's still
+/-300,000 valve replacements done yearly for it. I'm not passing myself as the doctor here, so following is what I think is relevant science.

The cytokine TGF-B1 (transforming growth factor beta)is seen in the blood progressively more as the aortic stenosis pathology worsens. Other elevated indicators
are fibronectin, collagen I & II, plus sarcomeric protein myosin light-chain 2.

All of the preceeding seem to be driven by TGF-B1 kinase-1 (TAK1) pathway, &/or TGF/SMAD transcription factors. The obstructive build up involves TGF-B1 inducing a pheno-type alteration of the local fibroblasts into more of a matix.

It's altered the valvular cells' environment, so to speak, and so extra cellular matrix (ECM) components acrue. Calcium in circulation is capable of depositing in the aged valve matrix; which, scaffolding matrix, youth don't have to "trap" the calcium.

The treatment of very high
vitamin D would down-regulate the cytokine TGF-B1, high vitamin K2 encourage matrix solubility and restricted calcium mineral with it's ion dynamics take the load off valve.

Doc, this is a phenomenal result!!  Thanks should be given to your keen medical insight and willingness to try alternative medicine in helping your patients!  You have what I consider to be probably the best website of its kind on the internet.  
     I live in a Chicago S/W suburb, which is really not that far, from your Milwaukee Office.  I have gone to your city a few times on business over the past couple of years and I regret not making an appointment in getting an exam.  One of these days I will make the trip to see you with or without an accompanying business trip.  Maybe this will spur more folks from the Chicago area to make the trip up North.

Excellent work Dr.Davis.Vitamin K2 ensures that calcium ends up where we want it.The combination of vitamins D3
and K2 has many benefits.

I am thrilled to read this thread. I am a 64 y/o woman diagnosed w/"mild to moderate" aortic stenosis with some regurgitation as well as some mitral valve regurg. As a child I had several severe strep throats, had a total hysterectomy at 42, and subsequently have been diagnosed with hypothyroidism, all of which I have read might be causative.  My MGH cardiologist says I'm not "bad enough" for surgery,and of course I don't want it, but I feel really awful--very tired, some chest pain at times, and occasional feelings that I can't get my breath.
I need a plan--and would appreciate any help.
Laura

Ever since I came across Dr Davis's heart scan blog four years ago I have been waiting for more more info on this. I have aortic valve stenosis - not due to degenerative changes but due to congenital aortic valve defect - a bicuspid aortic valve - and I have been supplementing with high dose vitamin D ever since.

Maybe for those who have severe calcification, they should avoid calcium. However, for the rest of the population, ensuring enough K2+D3+retinol(natural form)+magnesium and other nutrients is probably a better approach. Calcium itself protects against the heavy metal burden the body has been shown to accumulate with age. Calcium has also been proven to result in lessened inflammation (CRP), less genomic damage, longer telomeres, and lessened mortality. In the end, I would say, don't avoid calcium. Just make sure you don't get too much ***in relation*** to the other nutrients you are getting.

Echocardiograms can have substantial variability, certain assumptions are built into the mathematical formulas used to evaluate aortic valve stenosis. Was there any differences noted in the doppler velocity (Lvot, cw)or outflow tract dimension? Small differences in these measurements can yield large variability in aortic valve area. Just playing devils advocate here.......

I read some comments by a doctor on a website.He said,"Vitamin K2 decreased calcium deposits in aortic valves.Some of my patients' stenotic aortic valve systolic gradients decreased by about 20mm mercury."

Intestinal absorption of calcium can double or even quadruple when vitamin D levels approach desirable levels.Therefore, calcium supplements are not required.Hypercalcemia can lead to heart attacks, kidney stones , atherosclerosis and arthritis over long periods of time.There is plenty of calcium in food.

So you're saying my knees won't get better?!

1000 mcg per day!  Is that 1000 of MK-4 or MK-7.
For about 6 months a while backmI ws taking 1000 of MK-7
the-kid

I found out about K2 when my Dad was diagnosed with aortic stenosis. I tried to convince him to try Vitamin D and K2 but he went the conventional route and now has a cow's aortic valve.

I have been taking 200mcg K2 every day along with my ~4000 IU/day Vitamin D. I have never had a scan and always wonder how blocked my arteries are and whether the vitamin k2 is regressing any blockage.

A nice blog post from Nephropal on Vitamin K2

Thanks again Dr. Davis, your dedication to your job is incredible!
I have looked for K2 supplements containing both MK-4 and MK-7 but can't find them anywhere? They are not to be found in your own online shop at https://shop.trackyourplaque.com/ - where can I buy them in this proposed heavy duty dose (is's like 20 x 50mcg pills a day, quite a lot)? And what is the right balance between MK-4 and MK-7? Anyone?
Thanks - The Viking.

Viking,

I have searched long and hard for such a supplement with no success.  My guess is it doesn't exist because these two forms of K2 come from two completely different sources.

K2-MK4 (menatetrenone) is the animal form. The richest natural food source is found in green grass-fed cow's butter.  Supplements made from the natural source of menatetrenone are hard to find. The only one I'm aware of is a product called X-Factor Butter Oil made by Radiant Life.  There are less expensive synthetic forms of menatetrenone sold by Carlson Labs and Thorne Research.

K2-MK7 (menaquinone-7) is the plant form. Its richest food source is fermented soy beans, also called "natto".  Supplements made from a natural source of menaquinone-7 are widely available.

Life Extension's 'Super K' formula contains MK4 & MK7 and is available everywhere - try iherb.com

Natto is fermenting here at home; it's remarkably easy and cheap. Doc's posted data is for each 100 grams Natto (3.5 oz., +/- 2 shot glasses volume) Mk-7 = 1,000 mcg, plus Mk-8 = 84 mcg.

Home preparations won't exactly match commercial products analysis. Previously Doc stated that Natto raises serum Mk-4 & is active inside us for up to 4 hours; Mk-7 potent longer.

G.E.M. Cultures (now in Washington state) sell pure Japanese Natto spores by mail order. I've no financial interest here, just their long term customer. (Natto's poly-glutamic acid was a melting stabilizer in a tropical dairy development project's ice cream manufacturing.)

Buying the "commercial" size spore vial will let your learning curve be cheap. Online are plenty of variations on how to make Natto; G.E.M. ships with instructions in English and Japanese original.

To make 1 pound soy bean batch you just need to incubate a dish +/- 10 inches by 10 inches and less than 2 inches deep. It'll last a person weeks refrigerated.

I take one Life Extension Super K with Advanced K2 Complex softgel capsule per day.
Each capsule contains 1000 micrograms Vitamin K2 as menaquinone-4, 100 micrograms
Vitamin K2 as menaquinone-7 and 1000 micrograms of vitamin K1. I buy the capsules
at iHerb.com but other places sell them including Life Extension.
Invite K2 capsules contain 500mcg of MK-4,500mcg of MK7 and 1000mcg of vitamin K1.

Hi, Might'--

Thanks, as always, for your incredibly insightful comments. I, too, suspect that there are discrete, identifiable pathways that would provide a plausible basis for a D3/K2 effect on aortic valve pathology.


Anonymous with questions about the echo Doppler data--

The aortic valve areas were obtained with 3 views on the maximal aortic supravalvular velocity, using both the standard transducer as well as the Pedoff. On both studies, the LV outflow tract diameter was 2.1 cm. The second aortic valve diameter was also confirmed with planimetry.

Notably, peak aortic valve velocity dropped from 20 mmHg to 9 mmHg. I watched the echo tech (a very capable one, by the way) while he interrogated the valve. I am confident that we obtained the maximal peak velocity.

All in all, I believe it is a real effect.

Anonymous and Paul--

I have been advising the Life Extension "Super K."

Super K contains 900 mcg MK-4, 100 mcg MK-7, as well as 1000 mcg vitamin K1.

Have you seen any results like this on any of the other heart valves?
My Dad has severe mitral valve stenosis. I am taking D and K2 and trying to convince him to do the same.

Thank you, Dr. Davis.

Looks like I'm in need of sharpening my search skills.

Super K looks like a good deal.  I'll have to check it out when my supply of K2 runs low.

In the Life Extension Super K, is the 1000 mcg of K1 a problem as far as causing clotting?

I always understood that K2 (both MK-4 & MK-7) do not cause clotting like K1 does.

Would love to see some calcium scoring results (and/or angiogram) before and after K2 administration, as well as carotid ultrasound results.

Thanks for this blog, I visit it often.

I'm curious if the addition of large doses of fish oil to the formula would also help decrease stenosis.

FWIW, another source of K2: http://www.vitacost.com/NSI-Ultra-Vitamin-K-with-Advanced-K2-Complex/?ntt=844197013470

I don't have the links at hand, but I remember reading second-hand a study that showed excess K1 does NOT up-regulate clotting. Unless you are on Warfarin, K1 is completely safe, even for stroke patients.

Good luck.

Off topic but amusing considering...

http://www.sciencedaily.com/releases/2011/02/110223122425.htm

High Vitamin-D Bread Could Help Solve Widespread Insufficiency Problem

ScienceDaily (Feb. 24, 2011) — With most people unable to get enough vitamin D from sunlight or foods, scientists are suggesting that a new vitamin D-fortified food -- bread made with high-vitamin D yeast -- could fill that gap. Their study, confirming that the approach works in laboratory tests, appears in ACS' Journal of Agricultural and Food Chemistry.

Wow, to any regular reader of this (wonderful) blog that (i.e., the vitamin D bread) is hilarious!!!

Measured my just finished Natto yield from 1 pound dry soy beans. Digital scale here is down, so spring scale reading is ~ 875 grams Natto made.

Spores cost $14 (plus shipping) and are enough to make +/- 86 pounds of finished Natto. That's 39,000 grams of Natto.

If 100 grams Natto offering 1,000mcg Mk-7 is fine, then that's 390days worth. Dry soybean substrate for 390 days Natto is 45 pounds of soy (using my spring scale yield data).

Elsewhere in this blog, Doc I think, stated 32.7 mcg K2 decreased aorta calcification. Maybe the decimal got misplaced in my notes. Or reversal, verses prevention, demands mega-dose vitamin K.

I fork mash +/- 50 gr. Natto and blend it in with  +/- 50 gr. Hummus. That amount of Natto will fit on 2 rice cakes as well.

Dr. Davis, my greatest respect for your work. Two questions to your groundbreaking observations on D3/K2:
1) Did the patient in question have a biscupid or triscupid valve?
2) Was the patient exposed to any other lifestyle changes apart from D3/K2 that could explain the remarkable change?
3) I have seen some sites selling K2 warning against taking them together with high fibre meals. Why is that, and what is the best time/frequency to take D3/K2?
Regards, Louis

I'm curious if Dr. Davis has seen any improvements in his patients using vit D3 alone.

I expect K2 (MK-7 to be exact) helped, but was just wondering how he knows what helps or doesn't, when his patients are doing several protocols at one time (D3, fish oil, no-wheat/low carbs, perhaps niacin)...

Might-o'chondri-AL,

Your notes are correct.  The 32.7 mcg K2 data point comes from the Rotterdam Heart Study.  It was the minimum dose in participants showing a lower risk of both heart attack and aortic calcification.

I use Life Extension Super K with Advanced K2 Complex that I buy from iherb. You can also get K-2 (MK-4)from High vitamin butter oil from green pastures. (You can buy it alone or with Fermented Cod Liver Oil)
Use this code to save $5.00 off your 1st order with iherb: ROV990

Hi, Louis--

The fundamental problem with retrospective observations is that you never know with absolute certainty what was done to achieve the observed effect.

However, everybody in the Track Your Plaque program and coming through my office do nearly the same thing, i.e., fish oil, vit D, diet, etc. I NEVER witnessed regression of aortic stenosis until we added vitamin D. I am speculating whether K2 adds yet another level of control over aortic valve disease.

This is still in the world of anecdotal observation. This is, of course, nothing even close to a clinical trial. But this can be how new ideas get their start.

Hi Doctor Davis,

I am new to your HS blog and, after reading a few, I'm glad I signed on. Great info. Quick question regarding this idea of "cleaning" or adding flexibility to the arteries: Do you put any value in Chelation therapy? I took oral chelation supplements for a time and it seemed to lower my triglyceride and cholesterol levels. Any thoughts on this, especially as it pertains to the oral version versus the IV method?

Thanks,  Chris

This is been amazing. I am take it seriously. Thanks for this information.

Chances are the calcium supplement you are taking now is a rock source of calcium. The label will say "calcium carbonate", which is nothing more than limestone. AlgaeCal Plus contains an organic, plant-sourced calcium form derived from a unique South American marine algae called Algas Calcareasâ„¢.

Dear Dr. Davis,

Thank you for your website.  I am a 68-yr female with AS.  My aortic valve area is 0.69.  I weigh 118, and fast-walk/jog for an hour 4 days/wk.  I am asymptomatic, and my cardiologist advises watchful waiting.  

How much Vit.D would you advise.  Is the amount weight related?

Thanks again.  

Karen

Intestinal absorption of calcium can double or even quadruple, when vitamin D levels levels.Therefore desirable approach, calcium can not required.Hypercalcemia to heart attacks, kidney stones, atherosclerosis and arthritis over a long period have lead tours is a lot of calcium in food.

Dr. Davis's heart scan blog ever since I met four years ago, I have been waiting for more information on this. I have aortic stenosis - not because of degenerative changes, but because of congenital aortic valve defect - bicuspid aortic valve - I have been using high doses of vitamin D supplements since.

Dr. Davis,

Do you mean to say that you put him on 1,000mcg of K2 MK-7 per day? (or was the 1,000mcg a combined total of all forms?)

Dear Dr. Davis, a Final Guidance question.....

I know Life extensions Super K is a good supplement, but the question that seems to have been asked a few times on this blog is..."what is a good & ideal target daily does combination of both MK-4 and MK-7" ?

We have heard you say that 1000 mg a day of mk4 & mk7 is a good target...but in what ratio?  Just like Omega3 has good target ratio of EPA/DHA....can you suggest some guidance as to what a good target ratio
of mk4 & mk7 would be ?

Thank you!

Adam

HI, Adam--

I wish I knew! This is the difficulty with K2: too little known.

Sure, there are plenty of opinions, but little fact. You and I can only continue to follow the emerging evidence and make our decisions as the evidence unfolds. Right now, it is simply not clear what the ideal regimen is.

Dear Dr,

I just came across your blog. Mind-blowing stuff. Especially because I have mild-moderate stenosis. Moderately calcified and bi-cusped. I wanted to know if any of your patients had bicusped aortic stenosis and your treatment with D3 and K2 might have seen reversals?

also, do you suggest K2 with Mk-4 and Mk-7 or is just MK-7 sufficient?
I am taking just about 2000 IU D3 and 100 MK-7 K2, fish oil and veggies, fruits, walking.

Hope you can respond.

As always, thank you for all the good work you do.

Tom.

life extention vitmin k2 is from GMO soy.  Shame on them for trying to poison us.

Can you tell me how you found out that Super K contain GMO soy?

My father was just diagnosed with aortic stenosis and I had to go to a friend who is a biochemist to discuss some nutritional options for an 83 year old man.  I have used Isotonix supplements or the Nutrametrix line of same product since 1995.  Personally I wanted to go in that direction with a scientific mind to talk with. My Dad''s doctor told me he personally uses supplements but was not allowed to direct my father on them.  He is basically following a check list.  My Dad is a player and I have him on a great regimen.  After finding your blog, I am looking to add d with k2 in Isotonix.  I have him on an Isotonix Calcium supplement that has d3 in it.   Not junk calcium or tums.  
http://dwithk2.blogspot.com/
this is my blog and you can go to the bottom of it to see label on the product.
Our next stop is the cardio doc who we were advised would want to replace his aortic valve.  I really think that should be a very last resort.  
Really, I believe some lifestyle changes and bumping some Isotonix supplements to heavy dosing is a better option.

The key, in my view, for control over aortic stenosis (thought I have not YET published the observations) is:

1) Supplement vitamin D to achieve a 25-hydroxy vitamin D level of 60-70 ng/ml, and
2) Vitamin K2 supplementation to provide 1000 mcg MK-4 or at least 100 mcg MK-7, and
3) Take NO supplemental calcium, as calcium is passive "mortar" that will calcify the aortic valve.

Pertaining to myself (aortic valve stenosis and stenosis of the spine) and my wine (parathyroid adenoma (non malignant) on Sinsipar to control without surgery.

If we eliminate calcium  supplements (which this  makes me consider), can I forget about getting too much in food (I also take buffered Vitamin C, which will be a problem, since I have gastritis).

Also wonder if magnesium, boron & strontium are good or bad to take??????

Last, can you give me a link for natural treatment of parathyroid adenoma. My wife also refuses to take Boniva and her bone density is bad.

Thanks in advance.

Dr. Edwards--

Unfortunately, no data.

You are venturing further into the world of "normalizing" calcium metabolism. I'd like to believe that all this makes sense, as they tend to benefit osteoporosis/osteopenia, and removal of calcium as a supplement is likely a good thing, given its contribution to cardiovascular risk.

But we lack real data on the effects. I will tell you that the vitamin D, however, is very real, having now done this in around 60+ patients.

Dr. Davis,
     I'm 67, female with CAVD.  Heart murmur, dizziness, exhaustion since holidays led to apt with cardiologist resulting in mild aortic stenosis diagnosis in early April.
     I have taken Vitamin D3 over last two years after Welcome to Medicare physical showed low levels.  I have now added CoQ10.  After stumbling upon your blog, I'm now adding 135 mcg K-2 Mk7.  
     Despite the fact that I'm symptomatic, I'm hoping to avoid heart surgery until the new trans-vascular technique is approved for a wider range of patients.  I return to my cardiologist in early August and I will be most interested in comparing new test results against my April numbers--call it a personal clinical trial of one.
     A few years ago I observed open heart surgery at a major surgical center in Houston.  I vowed I would never have it myself, but here I am now, staring it squarely in the face.  I can't thank you enough for your website. It's given me a small measure of hope.

Dr Davis:
I am a 70 year old slim athletic male with a bicuspid aortic valve that has been stable for about 6 years with echo area measurements showing 1.2 to 1.3 sq cm.  When I got my first echo 6 yrs ago I searched published literature and decided to start 200mg MK-7 daily and I take quite a few supplements, including vit D, niacin, and about 3 gms fish oil (EPA+DHA).  My cardiologist is surprised to not see a reduction in area, and valve replacement seems to have been put off successfully.  This year, however, my ascending aorta was measured at  48 mm by echo, up from 44 (MRI measurement) a year ago.  Surgery was recommended, based on the aneurysm, not the valve, but of course both would be done at the same time.  A cardiac CT scan was ordered by the potential surgeon and the radiologist report indicated a maximum ascending aortic diameter of 45mm, but the surgeon said he looked at the 3-D CT images and it looked more like 47-48 mm to him.  Search for coronary artery plaque indicated all arteries "normal" except for the "1st Obtuse marginal: Tiny focal calcified plaque causing no luminal narrowing" .Beginning January, 2012, I have eliminated wheat and calcium supplements and have actually gone low-carb, high fat, adequate protein to the extent to be in "nutritional ketosis".  Ketones range from 0.5 to 1.9, depending on time of day and whether it is before or after exercize, etc.  I feel great!  Given that I am "on the boarder line" where surgery is recommended, I have thought about giving this more stringent diet a year to see if the aneurysm shrinks.

My question is this:  Some time ago you posted your experience of seeing patients ("Jake") where diet/supplements contributed to reducing the size of an aneurysm, but I cannot find any follow-up information in your excellent blog (or publications).  What is the best diet/supplement regime that would optimize reduction of an aneurysm?  If the mechanism for the aortic wall degredation is the same as for artery plaque, then I know your answer because of your writings on this subject.  My interest in writing is to determine if there are other dietary or supplement changes I should make that would optimize my chances of improvement in my one-year trial, should I decide to do it.  Also, do you agree that nutritional ketosis (which I have no problem staying on) should be advantageous?

Dr. Davis,
I chanced upon your blog while searching for content of MK7 in natto! What a fortuitous discovery for me.

I started taking a Vitamin D3 supplement last year when my level was diagnosed at 20 ng/ml. I took about 3000 IU per day for 9 months and my level rose to 27 ng/ml. I did so using a D3 spray in coconut oil sprayed under my tongue.

Recently, I came across research that D3 supplementation, even in the 2000-3000 IUs a day dosage, without K2 supplementation will cause calcification of arteries and soft-tissues.

Wanted to ask for your input on this:
- How much K2 should I take, especially to reverse calcification? Seems like 100 mcg of MK7 and 1000 mcg of MK4 are common doses.
- Can I take K2 just 2-3 times a week, just to be conservative. How about if I just eat Natto for MK7 and stay away from the supplements?
- Would you still recommend D3 along with K2? If so, what is a safe D3 dose to go with 100 mcg of MK7?
- Is calcification observed in those who were taking Calcium with D3 or it can be seen even without Calcium supplementation? I eat a pretty low-carb, high-fat, decent amount of proteins, less red meat diet. Also, I take no dairy, calcium supplement or calcium fortified foods.

Thanks so much for your time.

Update to my first comment after six months.  

After six months of K2/D3, CoQ10, and Niacin supplements, I had my first nuclear stress test at my cardiologist's office.  Photos were picture perfect--strong, well functioning heart.  Efficiency percentage was mid 60s in March, but went to 87% in late August.  Primary Care physician had difficulty locating murmur that was pronounced in March.  I'm now scheduled for a second echocardiogram in early February.  That will be the acid test.  

Despite excellent test results, I'm still experiencing some fatigue and dizziness, but not nearly so much as when first diagnosed.  I remain hopeful that with continued supplement therapy and good eating habits, I'll be one of the lucky ten percent who experience remission from AS with K2/D3 therapy.

Hi Rita I thought to mention that I've been going through the comments here and really appreciate that you are giving us updates of your progress. Hoping for good results for you next round!

Dear Dr.Davis,
I came across your blog by chance and very interested in your opinion regarding valve problems. I would be most grateful if you can advice me on my situation:
I always believed that I have a strong heart as I excercised a lot--swimming and hiking, never expected that the first thing knocked me down is my heart. Starting this year from January, I went to Hospital Emergency 8 times, 4 in Jan, 2 in Feb and 1 in April and anthor 1 in Nov, all because of very fast heartbeat. The first 4 made me hard to breath and thought I was dying. All the blood tests at the hopsital came out normal. However, the ecogram showed that I had moderate aortic valve regurgitation. As meantime I was suffering from gastric problems of not being able to eat much, my heart condition gave me scaring experience of being extreme fatigue, dizzy, chest pain, neck and should pain.  Doctors said I do not need to do anything.
Even the fast beat of my heart is getting better recently, constant fatigue and dizziness and neck pain prevents from living a normal life.

I am also scared to see my 4 year ecogram with only "traces of aortic valve regurgitation," now changed to moderate.

I would likfe to know why my valve degenerate so fast? what can I do to stop the process. After seeing your blog, I bought vitamin D (my level is 43) and K2 (both mk4 and 7), how much dose should I take, will these vitamins alone help stop the degeneration process?

I also considering coming down to see you if you give appointments for consultation.

Thanks for your help!

Holly

by the way, I am 50 years old and have a stressful job.
HOlly

Dr Davis,

Any research on a wheat less diet and lipoproteins and their affects on Aeortic stenosis? If elemenating them will prevent or reverse this condition?

Thank you,

Karen

There are several different causes of aortic stenosis. Congenital (ie bicuspid aortic valve) and rheumatic fever start at younger ages. ASc or sclerosis is a disease of older people, same age risk as ASHD or coronary disease (atherosclerosis) and is nothing more than a variant manisfectation of the same risk factors that causes myocardial infractions., high blood pressure, smoking, obesity, diabetes and lipid disorders from high carb diets or a combination commonly called Metabolic syndrome. All of these risk factors cause coronary artery disease and/or ASc, it is just a crap shoot as to which one may show up first...but, treat both the same. Does that mean Vit D doesn't work? Of course not, newer studies beginning to show high Vit D levels are Importent in atherosclerosis Ann cancer prevention.

My husband has a coronary calcium score of over 900. His cholesterol levels were: total:217, HDL:44, LDL:147, trigyclerides:167. His cardiologist wanted to put him on Provastatin and scheduled him for an echo-cardiogram stress test. He has chosen to put off taking the statins and has started taking K2 and magnesium supplements. Is this ok? Should statins be recommended for his score?

Is there a cardiologist in or near Santa Fe, NM, who has an understanding of nutrient issues similar to yours?

I stumbled upon your blog a year ago when researching how to reverse aortic valve calcification.  At the time I was 49 and had just gotten my echo results.  I was told that I had abnormal relaxation of my left ventricle consistent with diastolic dysfunction, a trileaflet aortic valve with a trace of regurgitation and mild calcification.  My aortic root is borderline in size.  Well that was a heck of a blow because my echo the previous year was normal.  (I have echos done because I had chest pain several years ago that turned out to be esophageal spasm.  However, everyone in my family died from heart disease and my father had his major MI at age 47.  My grandmother died from aortic stenosis... so they do yearly echos on me.  I also have hypothyroidism, polycystic ovary syndrome and my ApoE genotype is 3/4)

After I read your blog, I went out and bought Life Extension Super K.  I have been taking it for over one year--since last July.  I found in my research that people with the ApoE4 allele don't hold on to vitamin K2 as well as those who do not have this genotype, so I didn't know if one pill a day was enough.  After a gigantic hassle trying to find a lab that runs the undercarboxylated osteocalcin test, I finally had my level drawn.  It came back at 3.8.  (Normal was anything below 12.1).  The results provided a graph which showed I am in the low normal end of the spectrum.  It showed that 80% of the population is lower than me--which surprises me because I bet most of the population doesn't take vitamin K2.  Maybe the only people having this test done are those who do supplement with vitamin K...   In any case, that lab was drawn in mid May, and since that time I doubled my dose to 2 capsules per day.  What should my undercarboxylated osteocalcin level be?  I can't find any data about what level is acceptable to reverse calcification.  I have also been taking vitamin D for several years--my level was originally 9.  I take 50,000 units once a week.  My last D level was 87.4, so I'm pretty close to the 70 that you suggest.  I also throw in about 8,000 u of vitamin A twice a month because I read that it's necessary to downregulate the D.  My D had gotten as high as 115 last year but has been in the mid 60s-80s since.  I also take CoQ10 200mg per day and fish oil. (I was taking it daily, but what do you think about the new study out saying it increases the incidence of prostate cancer?  I didn't want to increase my possibility of any kind of cancer, so I'm only taking it twice a week now... thoughts?)

I had an echo and a Lexiscan (because I couldn't walk on the treadmill due to foot problems and foot surgery 1.5 yrs ago) done last week.  I get my results tomorrow and am hoping that the calcification is gone... When I had my echo done last year I was overweight (BMI 38.8) with some sleep apnea.  After that appointment, I walked out of that office and changed my life.  I have been on basically a "no white" diet--no sugar, flour, pasta, rice, bread, sweets, etc.  Because of my PCOS, I can't even eat complex carbs without gaining weight.  (I have done strict Atkins before but couldn't sustain it because it was so strict.  This is working for me.  My carbs come from low glycemic fruits and vegetables primarily.  I do eat meat, dairy and nuts).  I went back to the gym and go every other day.  I lift weights (my son is a personal trainer), climb the stair master for 20 minutes and then go home to ride my exercise bike for 45 minutes every day.  I ride my exercise bike every day for at least 45 minutes and sometimes do double cardio days on weekends.  I have lost 63 pounds in the last year.  I would like to lose another 20 pounds.  I have an oral appliance for the sleep apnea and will have another sleep study done after I lose the last 20 lbs.  I know that I didn't used to snore when I was thin (pre-pregnancy).  I'm only 11 lbs above my pre-pregnant weight now.  I know that the sleep apnea can lead to diastolic dysfunction.  I'm hoping I'm reversing that!

Any other suggestions for me?  I'm especially interested to know how much vitamin K2 I need to take to potentially reverse this darn calcification.  I've mentioned the K2 to my other doctors and so far they're all in the dark and don't even seem to care about it... I'm shocked, because there are big studies out there that back it up.  I don't know about my cardiologist because I don't see him until tomorrow.  I'm shocked that my endocrinologist didn't seem to care because he does bone density scans in his office.  I'm getting one done in a couple months.  In my past 2 scans, I was dropping towards osteopenia.  I'm hoping with the vitamin K2 that I show dramatic improvement so that I can show him I was right about the K.

Thank you for any help,
Lisa D. RN

Oh come on Jim, try google every once in awhile.  This isn't Dr. Davis' discovery...it's been studied and written about for at least 8 years now.

Isn't that the brand that everyone over on the Inspire.com site is having problems with?  Seriously, there's been quite a discussion about it.  Many found that once they switched to Carlson's K2 only, that their palpitations, etc., went away.

We use an EMR and recently on the online forum for the EMR, an MD posted a question about an error message he received when he transmitted an rx electronically to the pharmacy.

He said he had written for 50,000 IU of Vitamin D (weekly x 8 weeks) and during the transmission, the comma was dropped so the pharmacist received a RX that only read "50 IU."

The MD posted the issue b/c he wanted to know if others were having the same problem with RXs that contained a comma.

I replied to the post and answered his technical question, but was disappointed in his choice for intervention. I didn't reply with any info about D2 versus D3 (who am I to educate a physician about medicine?) but in hindsight, I probably should have. Who knows how many other people will receive suboptimal Vitamin D treatment.

P.S. If you need a good laugh, grab a copy of the latest AFP magazine and read the D article. Their suggested intervention for D deficiency....50,000 IU D2 for 8 weeks. Yauzers.

I might keep the article for historical significance. My hope is that in just a few short years, we'll look back on such non-sense and be proud of how far we've come with treating D.

P.P.S. I'm going to the Vitamin D conf in Toronto on Tuesday! I cannot wait!!

The way the nurse kept asking if it was okay to have the patient take the D2 tablets, I couldn't help wonder if the pharmacist was getting a kick back for those tablets. What also bugged me was how she didn't want to "hear" or honor what you had to say even though you are the patient's doctor. Not good.

I'd LOL if it weren't so sad.

BTW, I've gotten two doctor neighbors and family on vitamin D and probiotics.  One is egotistical, the other grateful.  Thanks for all you do.

So they needlessly increased her costs? Great :/

You know, I don't bother telling doctors exactly how much D3 I'm taking. I just get them to check my blood levels and they see no problems with the results. But they would probably balk at the fact I take 10k per day.

I am a bit disgusted about this whole thing. This shows ones again how stupid the whole industry is… I was just recently at my doctor to take a few tests after some horrible years on the birth control pill Yasmin (it had basically taken me 7 years to put two and two together because no doctor would believe my symptoms well at least not connect them to the birth control). He asked me why I was taking all these vitamins and supplements – Preventive maintenance, was my answer. No comment back except for a smirk. Well yesterday they called me to tell me that everything was ok, but didn’t understand why I wanted to see my own lab results… the woman I was speaking to almost questioned my motive for wanting to see it. What the heck is wrong here… ???

Nutrient Biomarkers Analytical Methodology: Vitamin D Workshop
The National Institutes of Health (NIH) Office of Dietary Supplements (ODS) is sponsoring the Nutrient Biomarkers Analytical Methodology: Vitamin D Workshop on Wednesday, December 16, 2009 at the Bethesda North Marriott Hotel & Conference Center, Bethesda, Maryland.


Workshop Summary
Vitamin D is a fat-soluble vitamin that is naturally present in very few foods, added to others, and available as a dietary supplement. It is also produced endogenously when ultraviolet rays from sunlight strike the skin and trigger vitamin D synthesis. Vitamin D obtained from sun exposure, food, and supplements is biologically inert and must undergo two hydroxylations in the body for activation. The first occurs in the liver and converts vitamin D to 25-hydroxyvitamin D [25(OH)D], also known as calcidiol. The second occurs primarily in the kidney and forms the physiologically active 1,25-dihydroxyvitamin D [1,25(OH)2D], also known as calcitriol.

Serum concentration of 25(OH)D is the best indicator of exposure to vitamin D from all sources. It reflects vitamin D produced cutaneously and that obtained from food and supplements. There is considerable discussion of the serum concentrations of 25(OH)D associated with deficiency (e.g., rickets), adequacy for bone health, and optimal overall health. In fact, different assay methods are used to assess 25(OH)D. The methods themselves vary and there are considerable differences among laboratory results even when they use the same method.

Given the uncertainties in vitamin D measurement, the NIH/ODS will host this one-day workshop to evaluate the state of analytical methods. The intent of the Nutrient Biomarkers Analytical Methodology: Vitamin D Workshop is to develop strategies for resolving inconsistencies between results obtained following quantitative determination of selected nutrients in biological materials such as serum when different measurement techniques are used. The desired outcomes of this meeting are to identify strengths and weaknesses of analytical approaches available for the quantification of the nutritional biomarker of Vitamin D status, circulating 25(OH)D in biological samples and to discuss analytical methods, including criteria for selection of method(s); role of reference methods and samples; sample preparation and interpretation of results.

The workshop will consist of a series of short, focused podium presentations interspersed with open discussion sessions on the currently available analytical methods and interpretation of findings. A final session will summarize the discussions, identify knowledge gaps, and suggest a research agenda for future studies.


Registration
Space is limited and will be filled on a first-come first-served basis. There is no registration fee to attend the workshop. To register please forward your name and complete mailing address including phone number via e-mail to Ms. Tricia Wallich at twallich@csionweb.com. Ms. Wallich will be coordinating the registration for this meeting. If you wish to make an oral presentation during the meeting, you must indicate this when you register and submit the following information: (1) a brief written statement of the general nature of the comments that you wish to present, (2) the name and address of the person(s) who will give the presentation, and (3) the approximate length of time that you are requesting for your presentation. Depending on the number of people who register to make presentations, we may have to limit the time allotted for each presentation. If you don't have access to e-mail please call Ms. Wallich at 301-670-0270.


Workshop Details
Agenda

Meeting Location:

Bethesda North Marriott Hotel & Conference Center
5701 Marinelli Road
North Bethesda, MD 20852
Phone: 301-822-9200
Website: http://bethesdanorthmarriott.com

http://ods.od.nih.gov
What profit is there for one to gain the whole world yet lose or forfeit himself? Luke 9:25

Dr. Davis,
Great post, I enjoyed the way you wrote the dialogue between you and the nurse at the hospital--very, very realistic, and kind of spooky at the same time.  Unfortunately, this is just the tip of the iceberg--from my own personal experiences with my type 2 diabetic father in the hospital, getting insulin right is a total nightmare.  They use this arbitrary sliding scale which in some cases is totally ineffective and makes for unnecessarily high sugars--I remember how my father was merely 2 days post-op and was sitting there furious because the staff thought it was okay for him to be lying there with sugars in the low 200's, based on their scales and protocols.  
You've got to stay out of hospitals.
Great post.
Adam

Well good luck getting anything "health promoting" while in a hospital!

Last year, while hospitalized for a bout of Takotsubo syndrome,  they wouldn't let me use my own: fish oil, Vitamin D3, Vitamin K, multi-vitamin, compounded bi-est or progesterone, and so on...

They did manage to have Armour thyroid available to dispense to me.  Instead of the bi-est and progesterone they offered me Prempro... shudder, and these two meds could be had at the hospitals nifty pharmacy prices.

So 4 days without the vitamins probably did no harm... but the hormones???  Yikes, by the 2.5 day mark my husband was forced (by me) to become a criminal and smuggle the compounded meds in to me during the night.  What could they do to me that would be worse than hormone withdrawl on top of Takatsubo syndrome?  HA... don't answer that!

I got better as quickly as I could, and got the Heck out of there.  BTW, I don't think anyone on the nursing staff understood the difference between a heart attack and Takatsubo syndrome... BIG difference!

Oh... and I got rid of the "precipitating event" that caused the whole thing, and that has greatly de-stressed my life.

My advice: stay away from hospitals if at all possible... unless you are a doctor, nurse or hospital administrator.

madcook

Great post, and great comments, especially this one from Helena:
"Well yesterday they called me to tell me that everything was ok, but didn’t understand why I wanted to see my own lab results… the woman I was speaking to almost questioned my motive for wanting to see it. What the heck is wrong here… ???"

That sounds so familiar. If I could just go directly to a lab without doctor's orders, I would almost drop completely out of the whole doctor and hospital system.

I hope I never have to go in the hospital.  They will probably feed me the standard "diabetic diet," low fat-high carb, and send my blood sugar into orbit.

They do seem very reluctant to tell you the numbers.  After my last blood test, the nurse called and said my cholesterol was "high" and the doctor prescribed simvastatin.  I had to pry the numbers out of her:  LDL - 128, trigs - 55.  I consider the "high" LDL to be a case of skewed freidenwald and haven't bothered with the simvastatin.

Note to Jim Purdy:  You can get your own tests.  
www.MedLabUSA.com
www.MyLab.com
www.HealthCheckUSA.com (I think the .com is correct but not sure.)

Jim-

Try these self-directed lab test companies:

www.directlabs.com

or

www.privatemdlabs.com

I've used both of them a lot.  PrivateMDlabs even gives you a 15% discount on top of their reasonable lab test prices.

Rich

JPB,

You make a good point.  In most states, it is possible for people to go directly to labs.  However, I want to point out that a few states, including NY, prohibit people from dealing directly with labs unless you are a licensed medical practitioner. New Yorkers can't even participate in the Vitamin D project.  It's infuriating, and I think it encroaches on basic liberty.

Any guess on how much the hospital charged the insurance company for that single pill of second rate Vit D?

Living in New Jersey, I too suffer from "nanny-state" laws which prohibit me from getting my blood drawn for direct-to-consumer testing in New Jersey.

However, it is perfectly legal to order the tests and get the labwork done at a Labcorp (usually the draw site used) in a neighboring, less-restrictive state.

I am fortunate to live in southern New Jersey 20 miles from Philadelphia, so I get my lab draws by going over the bridge to Pennsylvania.  BTW, the other nanny-states which restrict direct-to-consumer lab tests are New York and Rhode Island.

New York even restricts "blood-spot" testing (finger-prick) done at home and mailed in, which can be used for HbA1c, vitamin D, and other tests. To get around that, folks have had the tests mailed to friends or family in other states, who then forward it.  Our politicians are truly moronic.

Rich

Jim, I am right there with you... and Rich - thanks for the links I will be taking a look at that since I want to make sure I stay in good range without over doing my supplements.

Thanks Dr Davis for a great post, once again.

I'm a little concerned (as an RN), that the RN and the Pharm were under the impression D affected coagulation. Working in managed care, I see a ton of misconception. Im always astounded at how much a non issue nutrition is, with the exception of diabetics, renals, and your bariatric surgery patients. The only places that get it are centers like Memorial Sloan Kettering, taking a whole body approach. But even there, wrong MD on your case, and your sunk. Do not get sick, and if you do, don't try to heal in the average hospital.

I'm allergic to corn so I live in fear of having to be hospitalized. You can't even imagine all the ways they could make me sicker. The worst part is that my own doctor has told me that I couldn't possibly be reacting to a corn derivative because all the corn protein had been processed out. I can almost guarantee that they wouldn't have a medicine to treat me that didn't contain corn.