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MK4: The Missing Ingredient for Fracture Prevention
By Dr. John Neustadt, ND

More than 10 million Americans have the bone-weakening disease osteoporosis—approximately 15% of women and 4% of men over the age of 50. Another 34 million or so have osteopenia—bone density that is below normal and may lead to osteoporosis. And every year, two million people with osteoporosis have a so-called "osteoporotic fracture," usually of the hip, spine, or wrist.

Experts know that an osteoporotic hip fracture is disastrous, as 12% to 40% of victims die within six months (partly because they tend to become depressed and more sedentary). But when Australian researchers studied more than 4,000 people age 60 and older for 18 years, they found that almost any kind of osteoporotic fracture increased the risk for death. Focusing on people over age 75, they found that breaking a wrist increased mortality risk by 40% in women and 80% in men, a spinal fracture doubled mortality risk in both sexes, and a hip fracture more than doubled mortality risk in women and tripled it in men.

It has also been found that bone mineral density (BMD) does not accurately reflect fracture risk. A dual energy X-ray absorptiometry (DEXA) test measures the BMD in your hip, spine, and wrist. A score of –1 to –2.5 indicates osteopenia and a score under –2.5 signals osteoporosis. But in one study, 82% of women who reported fractures of the wrist, forearm, hip, rib, or spine in the year after a BMD test did not have scores indicating osteoporosis (scores of –2.5 or lower). Overall, BMD predicts only 44% of fractures in elderly women and 21% of fractures in elderly men.

The BMD test indicates the hardness of bone, imparted by the minerals calcium and magnesium. But flexibility is what helps bones resist fracture—the bone's ability to bend a bit and not break. Flexibility is created by the bone's collagen, the protein-rich infrastructure. To build bone collagen, you need vitamin K.

The Power of MK4
Doctors from England analyzed the data from 13 studies on osteoporosis and a form of vitamin K called MK4. They found vitamin MK4 decreased hip fractures by 73%, spinal fractures by 60%, and non-spinal fractures by 81%. Compare those results to the average 19% decrease in fracture risk from taking supplements of calcium and vitamin D (which aids in the absorption of calcium). And in a clinical trial, when MK4 (45 mg daily) was combined with calcium and vitamin D, the patients had an incredible 87% fracture reduction.

To help my patients, I developed a supplement that contains the same amount and type of the nutrient (45 mg of MK4) used in the clinical trials. The supplement, called Osteo-K, also contains calcium and vitamin D.

MK4 May Help You if You're Taking Corticosteroids
Medications called corticosteroids (cortisone, prednisone, hydrocortisone) are powerful anti-inflammatory agents. They are synthetic versions of cortisol, an adrenal hormone. They often are prescribed to help control the symptoms of chronic diseases with an inflammatory component, such as rheumatoid arthritis, inflammatory bowel disease, lupus, and severe asthma. Taken regularly for six months or more, corticosteroids can cause osteoporosis. Additionally, taking these medicines for more than six months increases the risk for vertebral fracture by up to 200%. Clinical trials have shown that taking 45 mg daily of MK4 decreases bone loss and fractures caused by corticosteroids.

MK4 May Help You if You're Taking Acid- Blocking Medicine
Medications such as Protonix, Prevacid, Zantac, Nexium, Aciphex, Prilosec, are powerful acid-suppressing medications. Many people take them for years without knowing that they increase the risk for osteoporosis and fractures. In one study published in the JAMA, taking these medications for four years increased the risk for hip fracture by nearly 60%. While no clinical trials have been conducted with MK4 and acid-blocking medications, MK4 has been shown to decrease bone loss and fractures due to many medications, including prednisone, leuprolide, and phenytoin.

What About Taking Bone-Building Drugs?
You might think that a MK4 supplement would be a lightweight compared to the widely prescribed bisphosphonate drugs, such as alendronate (Fosamax), risedronate (Actonel), raloxifene (Evista), and zoledronic acid (Zometa). But drugs are less effective at decreasing fracture risk than vitamin K. For example, Fosamax decreases vertebral fracture risk by 47%, compared with a reduction of up to 60% for MK4. And the latest research shows that these bone-building drugs can hurt your health, causing esophageal cancer, heart problems, osteonecrosis of the jaw, and even increased fracture risk!

If you are concerned about losing bone density in the natural aging process, or you currently have low bone density, consider adding Osteo-K to your supplement regime.

Caution: If you are taking the anticoagulant warfarin (Coumadin), talk to your doctor before taking any type of supplemental vitamin K, which can block the action of the drug.

Siris ES, Chen Y-T, Abbott TA. Bone Mineral Density Thresholds for Pharmacological Intervention to Prevent Fractures. Arch Intern Med 2004;164:1108-12.

Cockayne S, Adamson J, Lanham-New S, Shearer MJ, Gilbody S, Torgerson DJ.. Vitamin K and the Prevention of Fractures: Systematic Review and Meta-analysis of Randomized Controlled Trials Arch Intern Med 2006;166:1256-61.

Yang YX, Lewis JD, Epstein S, Metz DC. Long-term proton pump inhibitor therapy and risk of hip fracture. JAMA. 2006;296(24):2947- 2953.

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