Rx Vit D Ergocalciferol and K2 MK7: My doc rx 5... - Thyroid UK

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Rx Vit D Ergocalciferol and K2 MK7

000ggg
000ggg

My doc rx 50,000 once per week of vit D2 ergocalciferol. How much K2 MK7 do I need to take with this huge dose to protect my kidneys? I’m reading about potential side effects after reading that some people had vit D toxicity after high rx doses.

I’m kind of scared to take it now because one woman said she had terrible pain after one dose and she had to take pain killers for two weeks.

My vit D is 21 and I have high pth of 86 now, so I have hyperparathyroidism. I am also excreting a lot of calcium in urine or I was after two tests about 2 years ago. I assume it is the same since my vit d keeps dropping even though I have been taking 3-4000 iu vegan D with k2 drops daily. Calcium levels have been ok and remained in the nines after one 10.2 2-3 years ago.

For some background I also have hashimotos, type 1diabetes, prolly celiac, raynauds syndrome and chronic pain, osteoporosis and if that isn't enough a few other things😹 My latest levels seemed to be better with tsh down after starting T3 for a few months and I have increased the dose, but it is still low because I get palpitations.

34 Replies
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So the Vit D supplement I buy that has combined k2 in it works out around 40mcg of K2 per 1000IU of D3.

You don't HAVE to take the 50,000IU in one dose. The guidelines allow for 50,000IU per week OR "its equivalent of 6000IU per day " If you're concerned about taking it all in one go I'd go down that route. For 6000IU a day that would work out at 240mcg of K2 daily alongside it. What are the tablets he's given you? 10,000IU??? If so you coukd take 1 a day for 5 days out of the 7 if that makes sense? You're still getting the 50,000IU per week. Just spread out.

Also....elevated PTH can be an indicator of osteomalacia. A consequence of prolonged Vit D deficiency which looks identical on a DEXA scan to osteoporosis but requires different treatment. Has your doc mentioned this to you??

000ggg
000ggg
in reply to Portia1974

Thanks. I don't have osteomalacia, I have no signs of that, I read about it when this happened. my vit d has only been low for 2-3 years and it’s not that low and I’m in menopause. More likely I have celiac and or primary hyper parathyroidism and it is also menopause related. The rx is one pill 50,000 iu so I do have to take it that way. As far as I know it comes in 50,000 iu pills only?

240mcg is a huge dose per day though of vit K and I’m worried about that too because I had a dvt, also mk7 is not cheap even if it is safe for me. Does it really prevent kidney damage? Also I forgot to mention I had osteoporosis before my vit D was even low.

SeasideSusie
SeasideSusieAdministrator
in reply to 000ggg

000ggg

I take it that it is 21nmol/L and not 21ng/ml.

According to NICE Clinical Knowledge Summary for treatment of Vit D deficiency, the loading doses total 300,000iu so you should only have 50,000iu once a week for 6 weeks then reduce to a lower dose depending on your level which you should test after the loading doses - I would do this even if your GP won't test. If you are in the UK then you can do a fingerprick blood spot test with City Assays for £29 vitamindtest.org.uk

100mcg K2-mk7 is enough for up to 10,000iu Vit D. As you should only be taking 50,000iu for 6 weeks then I would just take the 100mcg. I find this one an excellent supplement and the best price here in the UK bigvits.co.uk/product.php?p...

K2 ensures that calcium is directed to bones and teeth where it is needed and away from arteries and soft tissue where it can be deposited and cause problems.

Is there a reason that you are prescribed D2 instead of D3?

000ggg
000ggg
in reply to SeasideSusie

Thanks, I’m in the US. I cant do any independent testing in NY state. I’m not sure why he rx D2 but I’m glad because D3 is made from lanolin and I’m allergic to wool, D2 is made from fungus so hopefully I’m not allergic to that so there be less chance to have a reaction to high doses from allergy.

Should I just take 100 mcg k2 per day then if I take the 50,000 d2? I bought some that is 90 mcg mk7 made by jarrow, this is supposed to be absorbed more easily so maybe that is ok?or I could take 2 per day maybe. I think I will just take the d2 for 6 weeks and then ask to be tested, or just go back to my 3-4000 drops and wait till my next test maybe, it is my endo doing the testing and since I have type 1 diabetes I get full testing every 3-4months. I’m not sure if I should ask about the smaller 10,000 iu pills, but mine is a gel cap so I can’t split it I dont think.

SeasideSusie
SeasideSusieAdministrator
in reply to 000ggg

90-100mcg is fine, so the Jarrows is OK. It contains olive oil to aid absorption like the Healthy Origins one does. I would just take one.

Is it 21ng/ml or 21nmol/L because that will make a lot of difference to how much Vit D you need.

000ggg
000ggg
in reply to SeasideSusie

Thanks. It is ng/ml. So if I take 50,000 I just take one 90mcg mk7 per day?

SeasideSusie
SeasideSusieAdministrator
in reply to 000ggg

000ggg

I would question as to how long your doctor intends you to take 50,000iu Vit D per week.

The Vit D Council, the Vit D Society and Grassroots Health all recommend a level of 40-60 ng/ml. So although you have a way to go to reach that level, unless you are careful and closely monitor your level then you could easily exceed the recommended level.

Once you reach the recommended level, you should then find your maintenance dose by trial and error.

000ggg
000ggg
in reply to SeasideSusie

Thanks. He seems to think I’m going to need it for 4 months or so, and someone said that it wont change your blood level for 4 months so I’m not sure what to do. Requesting a blood test sooner than that time may not show anything unless my body somehow absorbs too much and this is too high a dose for me. The timing also is a concern. 6 weeks may not be a problem, but if I stop and my levels aren’t up then it wont help me.

Most of the severe reactions I read about where people had toxic levels was on 50,000 iu daily or even more, one was for 180,000 inj or something crazy. But one woman said she had a bad reaction with a lot pain on the first large dose, but she didn't say what the dose was. I’m not sure what would cause that.

SeasideSusie
SeasideSusieAdministrator
in reply to 000ggg

000ggg

"someone said that it wont change your blood level for 4 months"

I'll just tell you my experience.

My level was 15nmol (recommended level 100-150nmol), serverely deficient, the equivalent of 6ng/ml.

I took loading doses of D3 softgels, followed by a lower dose, and after 2.5 months my level was 202nmol so then I had to reduce my dose then find a dose to maintain my level which I now aim to keep around the 150nmol level. So whoever said that it wont change your blood level for 4 months is incorrect. It would depend at what dose you are supplementing to raise your level.

000ggg
000ggg
in reply to SeasideSusie

It was someone in this post below. That’s interesting that yours did increase after 2 months so maybe I should request another test at 6 weeks or so and monitor my symptoms etc. Were you taking rx d3? How much did you take?

Portia1974
Portia1974
in reply to 000ggg

No not the only strebgth you cam get. I was given 20,000IU and told to take 2 aweek. Either together or seperately. That was on top of the 800IU a day I was already on. So other strengths are available. If you want to spread the dose out you could cut the pill in half or go back to your doctor and ask to have the equivalent in smaller doses to take throughout the week instead. Up to you.

Endocrine Society guidelines state:

" We suggest that all adults who are vitamin D deficient be treated with 50,000 IU of vitamin D2 or vitamin D3 once a week for 8 wk or its equivalent of 6000 IU of vitamin D2 or vitamin D3 daily to achieve a blood level of 25(OH)D above 75 nmol/L (30 ng/ml), followed by maintenance therapy of 1500–2000 IU/d (2|⊕⊕⊕⊕)."

3.5 In obese patients, patients with malabsorption syndromes, and patients on medications affecting vitamin D metabolism, we suggest a higher dose (two to three times higher; at least 6000–10,000 IU/d) of vitamin D to treat vitamin D deficiency to maintain a 25(OH)D level above 75 nmol/L (30ng/mL), followed by maintenance therapy of 3000–6000 IU/d (2|⊕⊕⊕⊕"

Source: press.endocrine.org/doi/10....

With regard to Re K2:

" The biological role of vitamin K2 is to help move calcium into the proper areas in your body, such as your bones and teeth. It also helps remove calcium from areas where it shouldn’t be, such as in your arteries and soft tissues. The optimal amounts of vitamin K2 are still under investigation, but it seems likely that 180 to 200 micrograms of vitamin K2 might be enough to activate your body’s K2-dependent proteins to shuttle calcium to the proper areas

If you take oral vitamin D, you also need to take vitamin K2. Vitamin K2 deficiency is actually what produces the symptoms of vitamin D toxicity, which includes inappropriate calcification that can lead to hardening of your arteries"

Source: articles.mercola.com/sites/...

So in the context of that, maybe you'd feel more reassured on 180-200mcg of K2.

000ggg
000ggg
in reply to Portia1974

Thanks, I’m just wondering if I do take the 50,000 once per week should I take 250 mk7 per day or take 5 x that in one day?

Portia1974
Portia1974
in reply to 000ggg

I can't answer that from any position of authority or experience not having taken the 50,000IU in one dose myself. I woukd personally take k2 daily rather than 5 in one go. There also doesn't seem to be a great deal of consensus on how much to take. Depending on what articles you read could be anywhere from 100-200mcg daily. (My previous extrapolation was based on the contents of the tablets I take. But its unclear to me whether k2 doseage increases proportionately with vit d doseage if that makes sense) Research is still at a fairly early stage I think. So it's something you are probably going to have to take a view on yourself. Im not a doctor. Just a patient ✊ These articles and the one I linked for you previously should help:

riordanclinic.org/2013/10/v...

vitamindprotocol.com/the-vi...

Note: you mentioned DVT I think? One or other of these articles talks about making sure your k2 supplement doesn't also contain K1 if you are on blood thinners or similar. It also has some interesting things to say about how k2 doesn't CAUSE coagulation but balances it as I read it. Anyway. Have a read. See what you think.

000ggg
000ggg
in reply to Portia1974

Thanks. I will read these links. I think I will take 2 prolly. I read in a study in Japan a while back that large doses of mk7 and another vit K helped treat osteoporosis, but I think they said it is not recommended for people with a history of blood clots. I’m not on warfarin anymore, I was on it for 6 months until the clot was reabsorbed and then stopped it because I have no hereditary clotting factors but I still need to be careful.

Hidden
Hidden
in reply to 000ggg

In early April my Vit D level was 16 (VERY low here in the US). I was having horrible generalized muscle and joint aches and pains that one doc said was fibromyalgia. I refused to take any meds and shortly was seen by my new effective endo. So since then I have taken 50,000 IU of Vit D weekly-currently on my 13th week with labs due again next week. After the third weekly dose of the high dose Vit D my pain disappeared. I spoke to my electrophysiologist about adding the K2 and he advised this. I bought the Jarrow brand 90mcg softgels and I take 2/day which gives me enough to cover my 50,000 Vit D weekly. I also make it a rule never to buy vitamins/supplements in combination (except for Thorne B complex) as I want to decide the best doses to take. I don't want the pharma company making decisions based on marketing and what they believe works best for the most people. I will decide how to combine my supplements to get the most benefits and least problems from them. One of the combos I frequently see is magnesium with added calcium. This ia a button pusher for me. It's worth reading about calcium and magnesium interaction and amounts needed. Most of us don't need any more calcium-we just need it redistributed correctly in our cells. This is the reason for taking K2-mk7.

000ggg
000ggg
in reply to Hidden

Thanks, that is good it helped you so much. I read here that you should not supplement calcium unless it is low so I stopped it and just get it from my diet hopefully. I’m going to take 2 jarrows Mk7 per day assuming I get my courage up to take the 50,000 iu lol.

Hidden
Hidden
in reply to 000ggg

If it's any help other symptoms seem better in subtle ways since taking the Vit D. It should not be taken within 4 hours of thyroid meds. At least I was told this and take my thyroid meds early like 5am(set phone alarm) then go back to sleep. Sx like brain fog, and other mental sx seem better but as I'm also taking B12 injections and better thyroid meds it's hard to know where the help is coming from. Hope you begin to feel better also. irina

000ggg
000ggg
in reply to Hidden

Thanks! Thats good it helped your mental functioning, I hope it helps me too. I’m taking the t3 at 4-7 am now so I will take the vit d with dinner at night prolly around 8-11 pm. I may need more t3 too, but I will try this first prolly and see if it helps. If none of this helps then I guess something else may be going on. I’m still on a nocturnal schedule even worse now and I’m trying to shift it back to less nocturnal.

Hidden
Hidden
in reply to 000ggg

Sounds like a good plan. I take my Vit D (every Thursday) separately to give it every chance to be absorbed well. Also, re taking the Vit D you probably already know this but we need the vitamins, esp D, for our thyroid meds to be absorbed best and work effectively. I'm excited to see what my Vit D lab will show and will know how long I need to continue the 50,000/week. My endo said it might be a couple of months longer depending on level but he has already prescribed 5000 IU Vit D3 daily to start after he discontinues the weekly 50,000. He says I will need to take Vit D indefinitely as even though my diet has been good for quite a while evidently I don't absorb many oral meds well. I can only speak for myself but as yesterday's weekly dose was my 13th week I have had no side effects that I'm aware of and after so many years of chronic aches and pains being gone I'm a believer. Give it a try. One thing I did notice is early on I still had an occasional day of some mild pain, This is gone now but I've learned from this forum that often when we correct a deficiency and relieve symptoms, they may take a little time to resolve completely as the supplement has a lot of hungry cells to replenish and some symptoms are relieved first. I guess it's our bodies knowing their priorities. Just my theory. One thing I understand about the Jarrow brand is the softgels contain olive oil. This is important to me because too often Pharma companies use soybean oil which is so unhealthy. Take care. irina

000ggg
000ggg
in reply to Hidden

Thanks😊 I just hope I dont have some terrible reaction, I’m really nervous about that. I have a lot of other health issues and chronic pain from injuries for many years so I dont expect that to go away. But hopefully this will help me feel better in some way. How long are you taking this for? I think I may need to get a blood test before 3 months because if I take this it may raise my levels too high. Seasidesusie said hers went up alot after 2 months.

Hidden
Hidden
in reply to 000ggg

I have taken the 50,000 weekly dose for 13 weeks and my labs next week will tell the endo whether he wants me to continue that dose or cut down to a much lower daily maintenance dose. My Vit D level 13 weeks ago was 16 which is not only very low but not even within the lab range. I am also taking 2 Jarrows 90 mcg gelcaps/day and will continue this. If I have to continue the 50,000 dose a while longer I will consider taking 3 K2-mk7 (90 mcg ea ) daily until the Vit D3 dose is lowered. This is my own idea but I will run it by my Electrophysiologist rather than my endo as my new endo is good but he doesn't have the level of knowledge about atrial fibrillation and I trust my electrophysiologist more than any of my other doctors. I don't absorb well so this might be I am on the high dose for so long.

000ggg
000ggg
in reply to Hidden

Do you have afib, are you on warfarin?

Hidden
Hidden
in reply to 000ggg

Yes I have permanent a-fib and this my 8th year-not all were in permanent AF just the last three. In 2016 I had a pacemaker insertion and an AV node ablation. And have not had to take any cardiac drugs since then except warfarin which I monitored myself at home.I didn't like the side effects so in January of this year I had a left atrial appendage occlusion with a Watchman device fitted. All is working well. Glad to be rid of the warfarin. I am stable, comfortable, and feel my quality of life is good. I look at my a-fib as a chronic illness that is well controlled.

000ggg
000ggg
in reply to Hidden

Sorry you have a fib, and all those other problems, I have never heard of the watchmen device. I am glad it is well-controlled. My father has afib also as well as sic sinus rhythm. He had a pacemaker put in about 20 years ago now I guess after passing out a few times and an asthma medication induced a fib crisis. He is older and dealing with multiple health issues but the pacemaker controls his heart rhythm pretty well most of the time. He is on warfarin also.

I have something going on with my heart maybe so I think that it is in the early stages, but maybe it’s thyroid. So far the only thing that shows up is I have a fast heartbeat sometimes and sometimes an irregular heartbeat when I wore a halter. And I get palpitations sometimes too when I lie down to go to sleep. I had a couple of instances where I was very dizzy and felt like I was going to pass out and it was not my blood sugar as far as I could tell. No one knows for sure what is going on but my heart rhythm is normal.

Well I took the first dose of 50,000 iu last Friday and I have not had a bad reaction so far. I think occasionally I feel a little more energy too so maybe this will help me, fingers crossed. My reflux to get very severe again the next day but I don’t think it was from the vitamin D. I was at my neighbors house and drank some fizzy mineral water I think that was what did it. Another thing that I have to avoid my diet that I like 🙁

I took 50,000 iu of D3 but it was only 1 tablet a week and only for 6 weeks. Then I was told to buy otc vit d. How long is the course of vit d?

000ggg
000ggg
in reply to purple64

I think he said prolly a few months, it depends on if my vit d comes up and pth goes down. My next blood work will be 3 months from now but I guess if I feel sick I will just stop it, but if I get a lot of pain and high calcium that could be dangerous etc. I have been taking about 3-4000 otc vegan drops but it just keeps dropping. Very odd. Did you have your levels tested at 6 weeks and they were higher etc?

purple64
purple64
in reply to 000ggg

They didn't test it again but have suggested I have it done in about 2 months time so I have no idea what the level is like.

000ggg
000ggg
in reply to purple64

Do you feel better yet, did you have symptoms from low vitamin d?

Hidden
Hidden
in reply to 000ggg

I learned that I had low levels of Vit D - 17 - last year & was put on Colecalciferol 1000iu daily & then had another blood test 4 months later. It takes 4 months for it to show in the blood. In January [I think] my level had reached 51, a vast improvement but when I saw the Bone Consultant, I was told to keep taking the D3 - for life.

I had a DXA scan in February, which was good, no osteoporosis or similar.

I have Sjogren's Syndrome which is known to deplete the body of VitD. I am also taking Prednisolone, which isn't helping but my other minerals are ok

I don't know whether this helps you at all

000ggg
000ggg
in reply to Hidden

Thanks, was that an rx? I was tested for sjorgens due to dry eye but it was negative. I already had osteoporosis in 2012 only 2-3 years after menopause but my doc didn't tell me so I found out in 2016 on another bone scan. My recent bone scan showed it has stayed the same but it is pretty bad apparently. No fractures though thank goodness etc. I’m not sure now if I should take this high a dose for more than 6 weeks, I’ll have to ask my doc again. Before my type 1diagnosis in 2012 my level was 40-50, then after it started dropping and is now at 21, even though I always supplemented vit d during that time. I had a reactivation of epstsein barr at that time so I wonder if that is playing a role too.

Hidden
Hidden
in reply to 000ggg

I see a lot of different Consultants & a Derm referred me to the Bone Specialist because he was concerned because I had been taking steroids for so long, it was the Bone Sp who did the bloods & gave me the Rx for D3 & also arranged the next DXA because the previous one had just done bits of me, for some obscure reason!

I also see Oral people & one of the Hygienists asked me whether my dry mouth caused problems, so my GP did a blood test for Sjogren's & something came out positive. My eyes are 'borderline' but I have been referred to a Rheumy re the Sjogren's, which the Dental Hosp appear agreed that I have & I certainly have joint problems, which also come with it.

Certainly the 1000iu daily appears to be the right dose, I thought that it wouldn't be but my VitD3 levels have improved but could easily have dropped again by now, they don't check it that often.

000ggg
000ggg
in reply to Hidden

Thats good you got the right dose and you don’t have osteoporosis. Sorry you are dealing with sjorgen’s. Here my gyn does my bone scans and they look at your hips and spine. I already had advanced osteoporosis only 2-3 years after full meno which is weird. Did you feel better if you had symptoms after your vit d increased? i’m on restsasis but I wonder if higher D will help my eyes too.

Hidden
Hidden
in reply to 000ggg

Keeping our calcium from getting too high is one of the main reasons it's important to supplement the Vit D with K2-mk7. By the way, I have never seen K2 combined with K1 where I shop but in case any pharma company does this don't buy it. K1 and K2 have very separate functions and uses. This is especially important if we take any kind of anticoagulant meds. K1 is what helps our blood to clot and can alter anticoagulant effects. Probably everyone knows this but it's too important to not mention just in case. I also ran my adding K2-mk7 by my cardiologist and he was fine with it.

000ggg
000ggg
in reply to Hidden

I have never seen k1 anywhere. K2 can also be bad in huge doses though for people with previous Dvt. If you have primary hyperparathyroidism it can be dangerous to take high dose vit d.in that case a tumor increases calcium in the blood and your body lowers vit d to stop that and excretes calcium in urine.

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