EP355: Vitamin K and Lipid Lowering Therapy
Description of EP355: Vitamin K and Lipid Lowering Therapy
Welcome to my podcast. I am Doctor Warrick Bishop, and I want to help you to live as well as possible for as long as possible. I’m a practising cardiologist, best-selling author, keynote speaker, and the creator of The Healthy Heart Network. I have over 20 years as a specialist cardiologist and a private practice of over 10,000 patients.
In this podcast, Dr. Warrick Bishop discusses the significance of vitamin K, particularly its roles in blood coagulation and bone health. Vitamin K is a fat-soluble vitamin essential for blood clotting and is administered to newborns to prevent bleeding complications. The conversation highlights the two forms of vitamin K: K1, found in green leafy vegetables, and K2, which has various subtypes and is involved in bone mineralization through the protein osteocalcin. Dr. Bishop explains how vitamin K helps regulate the balance between osteoblasts (bone-building cells) and osteoclasts (bone-resorbing cells), thereby impacting conditions like osteoporosis and aortic valve disease.
He emphasizes the potential interplay between vitamin K and lipid-lowering medications, such as statins and ezetimibe, which may affect vitamin K absorption and production. While current research lacks definitive links between statin therapy and vitamin K deficiency, the mechanisms suggest a possible impact on bone health and calcium deposition. Dr. Bishop encourages patients on lipid-lowering regimens to consider vitamin K supplementation due to these potential interactions. The discussion concludes with an invitation for listeners to engage with further inquiries.
Takeaways:
Vitamin K Overview: Vitamin K is a fat-soluble vitamin essential for blood clotting and plays a crucial role in bone health.
Types of Vitamin K: There are two main types: K1 (phylloquinone) found in green leafy vegetables, and K2 (menaquinone), which has several subtypes.
Bone Health Connection: Vitamin K facilitates the function of osteocalcin, a protein that helps incorporate calcium into the bone matrix, promoting bone mineralization.
Osteoblast and Osteoclast Balance: Vitamin K supports the production of osteoblasts (bone-building cells) while inhibiting the formation of osteoclasts (bone-resorbing cells), maintaining bone density.
Calcium Regulation: Vitamin K helps ensure calcium is deposited in bones rather than in soft tissues, which can lead to conditions like aortic stenosis.
Warfarin Interaction: Warfarin, a blood-thinning medication, blocks vitamin K, which can negatively impact bone mineralization and density.
Impact of Lipid-Lowering Drugs: Statins and ezetimibe, used to manage cholesterol, may affect vitamin K levels by interfering with its production and absorption.
Mechanisms of Statins and Ezetimibe: Statins inhibit HMG CoA reductase, which is involved in the production of vitamin K2, while ezetimibe reduces the absorption of both cholesterol and vitamin K.
Potential Risks: There may be a link between lipid-lowering therapies and calcium misallocation, potentially leading to osteoporosis and calcification in the aortic valve.
Supplementation Consideration: The speaker suggests that individuals on lipid-lowering medications may benefit from vitamin K supplementation to mitigate potential deficiencies.
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