The Role of Vitamin K
Vitamin K is fat-soluble group of vitamins that are essential in the synthesis of proteins in the human body.
The proteins that this class of vitamins help build are necessary for blood coagulation and calcium retention in bones and tissues.
Vitamin K plays a central role in blood coagulation, where a lack thereof severely impairs coagulation resulting in incessant bleeding.
Proteins have a biological structure which renders them incapable of binding calcium ions, it is only after the vitamin K induced modification that calcium is bound to be used for building and repairing the body.
Decreasing levels of vitamin K result in weakening of the bones and increased calcification in arteries and in other tissues.
The reason attributed is that the low levels of vitamin K prove insufficient in calcium to protein binding, as a consequence calcium starts accruing in the blood vessels and tissues, as they are not used up but are continually consumed in the diet.
Food rich in vitamin K includes the category of leafy green vegetables and naturally produced oils from soybeans, canola and olives.
Some vitamin K is also synthesized by bacteria present in the human colon. In adults, the deficiency can only be contracted by very low intake of the vitamin through food, although this happens in rare cases.
There are three main types of vitamin Ks. Vitamin K-1 (chemical name phylloquinone or phytonadione) this variant is produced from plants, K-2(menaquinon) which is produced by the intestines and K-3 which is an artificially manufactured variants used for treatment.
Vitamin K Deficiency
The deficiency has been characterized as a form of avitaminosis(a chronic condition arising because of a long term deficiency or also by faulty metabolic conversions of the required vitamin)that results from insufficient quantities of either vitamin K1 or vitamin K2, and in some cases both may contribute.
Vitamin K3 is synthetic and does not play a role in causing the deficiency. A deficiency in the variant K2 causes severe calcification in the arteries and may result in all-cause mortality.
Causes of Vitamin K Deficiency
The deficiency may arise by disruptions in the intestinal uptake in the digestive tract, or by the case of a vitamin K1 antagonist, mostly warfarin, backfiring.
In only very rare cases will a nutritional deficiency will present itself in an adult.
Infants, however, are the most vulnerable group and the can be affected inside the womb during the crucial period of fetal development, due to reduced vitamin K reaching them from the placenta.
Signs of Vitamin K Deficiency
The most commonly associated symptoms are skin that is easily bruised and proliferation of hematomas.
Due to the deficiency being strictly against coagulation of blood, bleeding from surgical or puncture sites may be copious.
The effect of the deficiency on the digestive tract results in stomach pains of high intensity.
Any small cut can prove deadly, as the person becomes vulnerable to massive uncontrolled bleeding.
The inability for muscles to bind the calcium ions will result in the spread of calcium elsewhere, popular sites are the cartilage, the calcification of which can prove incredibly painful and within the arteries, where atherosclerosis takes root.
There has been increasing evidence which suggests that drastic malformations may occur in developing bones. While adults are known to exhibit a link with osteoporosis.
Osteoporosis is an alarming consequence, as the decreased bone strength may make the bones extremely fragile and susceptible to fractures.
While this disease was previously associated with the elderly, it has shown increasing occurrence among middle age people, most of them who displayed other symptoms.
Incidence of Vitamin K Deficiency
A deficiency of vitamin K is extremely rare in adults, because most diets contain it.
Newborns, however, have a high tendency to develop a deficiency shortly after birth.
This deficiency usually manifests itself in the form of hemorrhagic diseases.
The incidence can be attributed to less vitamin K reaching the fetus in the womb, low presence of vitamin K in the breast milk and low synthesis of vitamin K by the bacteria present in the infant’s colon.
Other people who may find themselves susceptible to this deficiency include chronic alcoholics (high consumption of alcohol leads to extensive liver damage and cirrhosis), cystic fibrosis, bowel disease and people with whose abdomens have recently been cut open by surgery (there tends to be a loss of vitamin K due to bleeding and coagulation associated with surgery).
Markers of Vitamin K Deficiency
The most obvious signs of vitamin K deficiencies are related to bleeding and weak bones. Common signs are high menstrual bleeding, bleeding from the gums, and bleeding from the nose.
A person with low vitamin K may also bruise easily. The digestive tract may also become prone to bleeding because in the colon bacteria are involved that synthesize vitamin K.
In some extreme circumstances blood may also start appearing in the urine.
Signs of vitamin K deficiency in an infant or fetus can be harrowing. Newborns are the group most susceptible to deficiencies and they can also be the ones on whom the effect of deficiency can cause the most harm.
The absence can affect development of the child and result in malformed appendages and under-developed features particularly around the face, ears, nose and chin.
It is highly recommended that pregnant women be provided with additional quantities of vitamin K in the form of food supplements, to avoid the drastic consequences of vitamin K deficiency.
As vitamin K is essential for the clotting mechanism, a short supply of the vitamin can hamper proper blood coagulation which may cause hemorrhages.
The underlying cause is that reduced vitamin K leads to a reduced quantity of prothrombin in the bloodstream and this interferes with normal coagulation.
Blood clotting can also become disrupted and while research is still in the preliminary stages, a co-relation between vitamin K and Alzheimer’s has been found.
People who take large amounts of anti-coagulants may also develop the disease, their clotting process may become severely impaired, resulting in the loss of a lot of blood.
Hathaway, Wiliam E. “Vitamin K deficiency.” The Southeast Asian journal of tropical medicine and public health 24 (1992): 5-9.
Cornelissen, Marlies, et al. “Supplementation of vitamin K in pregnant women receiving anticonvulsant therapy prevents neonatal vitamin K deficiency.” American journal of obstetrics and gynecology 168.3 (1993): 884-888.
Motohara, K., et al. “Detection of vitamin K deficiency by use of an enzyme-linked immunosorbent assay for circulating abnormal prothrombin.” Pediatric research 19.4 (1985): 354-357.