Vitamin D3 and K2, the Missing Link in Immune Health

Vitamin D deficiency is a major public health problem worldwide in all age groups even in those residing in a tropical country such as Malaysia. Of late, there has been renewed interest in the ability of vitamin D to improve the immune function during pandemic. It is known to be important for protecting against lung infections. Vitamin D deficiency has been found to contribute to respiratory disease and/or severity of respiratory infections. Individuals with low levels of vitamin D have a higher risk of infections such as tuberculosis (TB), influenza, bacterial vaginosis and many more other infections. A review paper published in 2017 demonstrated that vitamin D supplementation was safe to be used to protect against respiratory tract infections. (Martineau et al 2017)

Vitamin D is a hormone rather than a vitamin in our body. The main difference between vitamin D and  vitamin C  is vitamin C  is a helper molecule that assists in many of the body’s processes to fight the infections. Vitamin D interacts with the cell receptors and is able to send messages to the cells. Vitamin D is a very powerful hormone because it controls how the cells work. It instructs the cells to fight the infections by producing enzymes to destroy any invaders.

Your Body’s Natural ‘Antibiotic’ Booster

When vitamin D is absorbed into the white blood cells and combined with a vitamin D receptor, it will trigger cells to produce a natural weapon. This natural weapon is called CAMP (cathelicidins antimicrobial protein) that kills and lowers viral replication rate. These host-derived proteins kill the invading pathogens through disruption of cell walls and preventing virus replication. Furthermore, CAMP releases some chemicals to attract other white blood cells to the site of infection and then destroy the pathogens. This process plays an important role to regulate the precise location of the white blood cells during an immune response. (Gombart 2009)

A recent study has shown that patients hospitalized with COVID-19 with healthy levels of vitamin D had a decreased risk of adverse outcomes and death. Besides regulating and enhancing the immune system, Vitamin D plays a part in reducing the cytokine storm – a violent inflammatory response of the immune system that is usually harmful and can be fatal. During a viral or bacterial infection, the innate immune system will generate both pro-inflammatory and anti-inflammatory cytokines. Innate immunity is our inborn defense against pathogens that gives instructions to our adaptive immune system to produce antibodies against viruses. The cells that make up the body’s innate immune system could over-react to the pathogens and this can produce uncontrolled inflammation that can be detrimental to us. Vitamin D plays a role in reducing concentrations of pro-inflammatory cytokines,

which can injure the lining of the lungs, leading to pneumonia. Vitamin D also boosts the concentrations of anti-inflammatory cytokines that regulate the pro-inflammatory cytokines response. It is now well -known that the killer of COVID-19 is not only the virus itself but the immune response towards it. This over-acting response can lead to cytokine storms. In order to survive this pandemic, it is vital to modulate the immune response.

Vitamin D sufficiency reduces the risk for morbidity and mortality in COVID-19 patients. This is crucial as high blood pressure, heart disease, asthma, diabetes and among other chronic diseases are related to low vitamin D levels in the body. (Gombart 2009) A possible reason for the increase in death rate could be due to the presence of these chronic illnesses. Vitamin D deficiency is related to an increase in the C-reactive protein (CRP), a type of inflammatory marker. An increase in CRP increases the death due to acute respiratory distress syndrome (ARDS), heart failure and diabetes. Those with high CRP level have a larger diameter of lung lesion. In order to reduce the death rate, it is important to manage the disease as well as the incidence of chronic diseases with vitamin D. (Daneshkhah et al, 2020; Holick et al,)

Too Much Vitamin D Could Cloud Its Benefits

Despite COVID-19 being a respiratory disease, one of its complications is heart disease.A high prevalence of pre-existing heart diseases has been observed in COVID-19 patients with these comorbidities being associated with increased death rate.  COVID-19 promotes the development of heart diseases and the concerns about the outcomes had started since the early stages of the pandemic. 

 

Even though vitamin D is known for its multiple health benefits, consuming too much of vitamin D can have deleterious effects if it is not properly regulated. Taking high doses of vitamin D could lead to an increase in calcium levels in the blood  since vitamin D increases calcium absorption. This leads to calcium deposition in the blood vessels. This can disrupt the vital functions of

the lung and the heart. The deposition of calcium in the lungs can also lead to fibrosis, while in the heart, it can cause heart attack or stroke. (Nutraceutical Business Review, 2020)

Vitamin D3 and K2 – The Perfect Match 

Vitamin K2 functions to stop and reverse the deposition of calcium into the blood vessels and lungs. There has been growing scientific evidence that shows a correlation between low vitamin D3 and K2 levels are related with a more severe outcome of COVID-19. Recent studies evaluating vitamin K2 levels in COVID-19 hospitalized patients found that those with poor outcomes had the lowest levels of vitamin K2. Conversely, those tested negative for COVID-19 infection showed sufficient vitamin K2 levels.

There are two functions of vitamin K2. Firstly, it reduces the side effect of vitamin D i.e. when one consumes a high amount of  vitamin D3, there will be an increased absorption of calcium.   The high doses of calcium can lead to many side effects if they are not directed to the bones to be utilized. The removal of calcium from the blood vessels and soft tissues needs vitamin K2-dependant protein. A vitamin K2-dependant protein is a protein that can bind calcium ions but only after being carboxylated. This carboxylation, said to activate the protein, is facilitated by Vitamin K2. 

There are two functions of vitamin K2. Firstly, it reduces the side effect of vitamin D i.e. when one consumes a high amount of  vitamin D3, there will be an increased absorption of calcium. The high doses of calcium can lead to many side effects if they are not directed to the bones to be utilized. The removal of calcium from the blood vessels and soft tissues needs vitamin K2-dependant protein. A vitamin K2-dependant protein is a protein that can bind calcium ions but only after being carboxylated. This carboxylation, said to activate the protein, is facilitated by Vitamin K2.  

Hence, vitamin K2 prevents calcium deposition in the soft tissues, directs them to the bone and builds stronger bone. The review published in the British Journal of Nutrition highlights the critical link between vitamin D3 and vitamin K2. High doses of vitamin D3 without vitamin K2 leads to breakdown of the soft tissues’ elasticity. This causes the lungs to become less elastic, causing scarring and hardening of the lungs tissue. When the lung cells become rigid or hard or fibrous, then the patient will not be able to breathe well. 

Next, vitamin K2 is known to improve the blood circulation. Vitamin K2 is associated with the inhibition of arterial calcification and arterial stiffening. An adequate intake of vitamin K2 has been shown to lower the risk of vascular damage because it activates a vitamin K2-dependent protein called matrix GLA protein (MGP), which inhibits the deposits of calcium on the walls. During this pandemic, it is important to consume Vitamin K2 for its benefits on heart health, diabetes and kidney problems in preventing the complications especially for those patients who suffer from these diseases.

In short, both vitamins are fat-soluble and work together to metabolize calcium in your body by activating helpful proteins. While vitamin D3 improves your calcium absorption, vitamin K2 allocates where that calcium can be used. (Nutraceutical Business Review, 2020)

Stay Healthy During This Pandemic

The combination of vitamin D3 and K2 has gained scientific and public attention recently due to their complementary effects. There has been an increase in promising research on the synergistic effect of combining these two vitamins in everyday supplements. You might say these two vitamins have a ‘Batman and Robin’ effect: they’re good on their own, but even better together when they work together. 

 

During the flu season or pandemic period, vitamin D can be particularly effective at reducing the risk of illness. A recent study has suggested that vitamin D can help lower your risk of falling ill with the flu and acute respiratory illnesses. The researchers recommend that people in at-risk groups take higher doses of vitamin D as a supplement to increase the concentration of vitamin D in the blood. The researchers also noted that vitamin D supplementation could reduce the risk of infection and death.  They recommend taking vitamin K2 along with vitamin D to prevent negative, long term health effects.

There is some evidence to suggest that taking the two vitamins together may help reduce the risk of developing conditions such as osteoporosis, or other chronic diseases like kidney or heart disease, though more research is needed in this area.

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References:

1. Adrian R Martineau et al (2017), Vitamin D supplementation to prevent acute respiratory tract infections: systematic review and meta-analysis of individual participant data. BMJ 2017; 356

2. Adrian F. Gombart (2009), The vitamin D–antimicrobial peptide pathway and its role in protection against infection. Future Microbiol. 2009 Nov; 4: 1151.

3. Daneshkhah et al (2009), The Possible Role of Vitamin D in Suppressing Cytokine Storm and Associated Mortality in COVID-19 Patients. https://www.medrxiv.org/content

4. Holick et al, Vitamin D sufficiency reduced risk for morbidity and mortality in COVID-19 patients. The Lancet-D-20-12067

5. Nutraceutical Business Review (2020), COVID-19 and cardiovascular health: the role of K2 in high vitamin D supplementation.

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