Vitamin K

By: Joe Hing Kwok Chu

 Vitamin K is a non steroid, fat soluble, and non emulsifiable vitamin that plays an important role in blood clotting.

Vitamin K is classified into K₁ and  K₂ . 

Vitamin K1 ( phylloquinone, phytonadione ) is an indirect product of photosynthesis in leaves where it occurs in chloroplasts (chloroplastid) and participates in the overall photosynthetic process.

Vitamin K1 can prevent sodium fluoride induced skeletal fluorosis.

Vitamin K2 (menatetrenone) can prevent fractures and sustains lumbar bone mineral density in osteoporosis.  (if link fails, click here for image)

Vitamin K2 and its derivatives induce apoptosis in leukemia cells and enhance the effect of all-trans retinoic acid.

The possibility of vitamin K2 therapy for lung cancer.
 

Vitamin K₃   and  K₄  are pharmaceutical  products.

Foods rich in vitamin K:  alfalfa, spinach, tomatoes,  asparagus, bacon, beef liver,  cabbage, fish,  cauliflower, and other green leafy vegetables. These food can interfere with warfarin (Coumadin) therapy. Large intake of these foods may impair the function of warfarin and make it necessary to use larger dosage. However, contrary to popular belief, people on warfarin do not have to avoid foods with high vitamin K because the dosage of warfarin can be adjusted for the level of dietary vitamin K intake. It is better to eat the same amount of every day so that the level of thinning effect remains stable.

K₁  and  K₂  are fat soluble. Their absorption depends on the secretion of bile while K₃   and  K₄    are water soluble so they can be taken orally or by injection.

Vitamin K₃   (Menadione Sodium Bisulfite)

Characteristics: It is a white or near white powder. It attracts moisture easily and dissolves in water easily, (ratio of 1:2). Disintegrates when exposed to light. Loses its effectiveness in contact with alkaline.

Uses: To prevent bleeding. Being used in bile blockage, atrophy of gall bladder, chronic diarrhea, absorption problem after removal of intestine, premature babies, low in factor II, bleeding caused by low in factor II because of overdose of warfarin (Coumadin) or aspirin. Also used in preventing vitamin K being too low due to long term usage of antibiotics.

External application, as a massage lotion, usually suspended in emotion, is being used for small blood vessel injuries and spider veins.

As pain killer: gall bladder stone; round worms in bile duct.

Antidote for Diphacin poisoning ( a rat poison)

Application: 

To stop bleeding:  muscle injection: 4 mg each, 2~3 times a day. For preventing newborn babies from getting hemolytic anemia, apply with injection one week before delivery of 2~4 mg daily.

(2) Biliary colic: muscle injection of 8~16mg each.

Warning:

(1) Might cause nausea, vomiting and other gastro-intestinal reactions.

(2) Large dosage may cause hemolytic anemia  or elevated bilirubin and jaundice  in newborn babies and may induce hemolytic anemia in patients with red cell  6-phospho dehydrogenase deficiency.

(3) May cause liver damage. Patients with impaired liver function can use K₁ instead. Not effective for patients with hardened livers or advanced stages of liver diseases.

Prepared Dosages: injection liquid: 2mg (1ml), 4 mg (1ml).

Storage: Avoid light. Store in a cool, dry place.

Vitamin K₄ ( acetomenaphthone)

(more to be loaded)

Drugs that deplete Vitamin K
These include: Barbiturates ,  Aureomycin, Declomycin, Mineral oil, Penicillins, Tetracyclines.

See: USDA site on vitamin K food list

See: Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University

See: Vitamin K and calcium

Click on warfarin (Coumadin) and read the item "Medical Function" to understand how vitamin K works with blood clotting factors.

Bibliography

 Chen Xin Qian, Jin You Yu et al , New Edition of Pharmacology, 1996; 340