Vitamin D deficiency: Wrong dosage and not including vitamin K2 can increase deficiency

This Morning: Dr Michael Mosley discusses vitamin D dosage

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Getting adequate amounts of vitamin D and vitamin K is essential for your health. Getting enough, but not too much, vitamin D is needed to keep your body functioning well. Vitamin D helps with strong bones and may help prevent some cancers. But some sources claim that supplementing with vitamin D is harmful if you are low in vitamin K. Dr John Tsagaris, an expert in traditional Chinese medicine spoke exclusively to to offer his insights on the importance of adding vitamin K2 to gain the full benefits of vitamin D and reduce a deficiency.

If you choose to supplement with vitamin D, you also need to consume in your food, or take in supplement form, vitamin K2. Vitamin K2 works together with Vitamin D3 to support healthy bones.

Experts recommend taking vitamin D with vitamin K2 if you are supplementing. 

Vitamin D is a fat-soluble vitamin and increases calcium levels in the body.

Vitamin D3 and vitamin K2 ensure that calcium is absorbed easily and reaches the bone mass, while preventing arterial calcification. Helping to keep your heart and bones healthy.

“Combining vitamin D3 and K2 is the best way to absorb the nutrient correctly, as both vitamins have a synergetic effect,” said Dr Tsagaris.
He added: “Both vitamins are fat-soluble and work together to metabolise calcium in your body by activating helpful proteins.

He added: “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.

“Vitamin D is beneficial in bone density issues or menopause, and even depression.

“Vitamin K2 promotes strengthening of the bones and at the same time prevents calcification of soft tissues such as vessels and organs.”

What is vitamin K2

Vitamin K activates proteins that play a role in blood clotting, calcium metabolism and heart health.

One of its most important functions is to regulate calcium deposition.

In other words, it promotes the calcification of bones and prevents the calcification of blood vessels and kidneys.

Getting enough vitamin D may also play a role in helping to keep you healthy by protecting against the following conditions and possibly helping to treat them. These conditions can include:

Heart disease and high blood pressure


Infections and immune system disorders.

Falls in older people.

Some types of cancer, such as colon, prostate and breast cancers

Multiple sclerosis
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Vitamin B3 as a possible treatment for glaucoma


Glaucoma involves a high risk of losing sight. Researchers at Karolinska Institutet and St. Erik Eye Hospital, among others, have now studied the effects of nicotinamide, the amide of vitamin B₃, on animal and cell models for glaucoma. The study, published in Redox Biology, may be a future neuroprotective therapy in glaucoma in humans. A clinical trial will start in the autumn.

Glaucoma affects 80 million patients globally and approximately 100,000-200,000 in Sweden.

In glaucoma, the optic nerve, which connects the eye to the brain, is progressively damaged, often in association with elevated pressure inside the eye.

The only treatment strategies currently available target the pressure in the eye using eye drops or surgery.

Despite the availability of these treatments, the risk of blindness in at least one eye is still high.

Most people with glaucoma are over 50 years old and there is an inherited increased risk.

Focus on new treatments

What causes optic nerve degeneration in glaucoma is not entirely known, but there is currently a large focus on identifying new treatments that prevent retinal ganglion cells (the output nerves of the retina) from dying, as well as trying to repair vision loss through the regeneration of diseased nerve fibers in the optic nerve.

Previously, scientists have identified that the molecule NAD declines in the retina in an age-dependent manner and renders retinal ganglion cells susceptible to neurodegeneration.

Preventing NAD depletion via administration of nicotinamide (the amide of vitamin B3, a NAD precursor) robustly prevents glaucoma in chronic animal models.

They also demonstrated that elevating NAD levels through nicotinamide administration can improve visual function in existing glaucoma patients.

Numerous neuroprotective effects

In a large international study, researchers at among others Karolinska Institutet, St. Erik Eye Hospital, Singapore National Eye Center, Singapore, and Cardiff University in the UK have now examined several effects of nicotinamide on the visual system under both normal conditions and in glaucoma.

In the current study, the scientists investigated many of the effects that nicotinamide has on the visual system (in normal conditions and during glaucoma). This is an important step for moving treatments from the lab to the clinic.

“We have confirmed nicotinamide’s neuroprotection in additional cell and animal models that recapitulate isolated features of glaucoma but are also common neurodegenerative features. We also have developed sensitive tools to investigate NAD metabolism, and the metabolism of other essential metabolites, in the visual system,” says the study’s first author James Tribble, a postdoctoral researcher at the Department of Clinical Neurosciences, Karolinska Institutet, and in the Williams laboratory at St. Erik Eye Hospital. “We demonstrated that systemic nicotinamide administration has limited molecular side-effects, but provides a robust reversal of the disease metabolic profile of glaucoma prone animals.”

The researchers’ work has, among other things, resulted in several tools for investigating the protective effect of nicotinamide.

“Using these varied platforms, we determined that nicotinamide provides numerous neuroprotective effects. These include buffering and preventing metabolic stress, and increasing mitochondrial size and mobility to provide an environment where retinal ganglion cells are less susceptible to glaucoma related stresses,” says corresponding author Pete Williams, Assistant Professor and Research Group Leader for glaucoma at the Department of Clinical Neurosciences, Karolinska Institutet, and St. Erik Eye Hospital. “These data support the continued determination of the utility of long-term nicotinamide treatment as a neuroprotective therapy for human glaucoma.”

In autumn 2021, the long-term clinical Swedish Glaucoma Nicotinamide Trial, led by Umeå University, Karolinska Institutet and St. Erik Eye Hospital will begin.

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What are the symptoms of a vitamin B12 deficiency? Full list of 10 common signs

Dr Dawn Harper on signs of vitamin B12 and vitamin D deficiency

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Vitamin B12 is a type of water-soluble vitamin that’s crucial for the body’s overall function. If you aren’t getting enough B12 in your diet, you may start to develop some noticeable symptoms, including a sore tongue and irritability.

Vitamin B12 is used by the body to make red blood cells and DNA.

But the body doesn’t naturally manufacture B12, like it does for vitamin D, for example.

So it’s essential that you get enough vitamin B12 in your daily diet.

If you develop a B12 deficiency, you may slowly start to notice some key symptoms which you shouldn’t ignore.

READ MORE: Vitamin B12 deficiency – breath symptoms to spot

There are 10 common signs of a deficiency, but as they tend to develop quite slowly, you might not even notice they’re there.

You may start to change the way you walk or move around the house, or have subtle changes to your vision.

Some people even have an increasingly swollen tongue or persistent mouth ulcers.

The symptoms may be caused indirectly by a lack of red blood cells – which is also known as anaemia.

Vitamin B12 deficiency: White spots on forearms is a sign [RESEARCH]
Vitamin B12 deficiency symptoms: Pins and needles might be a sign [ANALYSIS]
Vitamin B12 deficiency: Facial neuralgia is a sign [NEWS]

Vitamin B12 deficiency symptoms

  • Pale yellow tinge to your skin
  • Sore and red tongue (glossitis)
  • Mouth ulcers
  • Pins and needles (paraesthesia)
  • Changes in the way that you walk and move around
  • Disturbed vision
  • Irritability
  • Depression
  • Changes in the way you think, feel and behave
  • Decline in your mental abilities, such as memory, understanding and judgement (dementia)

“See a GP if you’re experiencing symptoms of vitamin B12 or folate deficiency anaemia,” said the NHS.

“These conditions can often be diagnosed based on your symptoms and the results of a blood test.

“It’s important for vitamin B12 or folate deficiency anaemia to be diagnosed and treated as soon as possible.

“Although many of the symptoms improve with treatment, some problems caused by the condition can be irreversible if left untreated.”

The best sources of vitamin B12 include animals foods, or some products that have been fortified with it.

Dairy products, eggs, fish, meat and poultry all rich in vitamin B12.

But, that means vegans and – to a lesser extent – vegetarians are most at risk of the deficiency.

Taking B12 supplements is an easy way to treat a deficiency.

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New research shows the importance of consuming enough vitamin B12 in pregnancy


A new study published in Nutrition Research has found that children born to a mother with low intake of vitamin B12 during pregnancy were at increased risk of adverse development specific to certain speech and mathematical abilities.

The study, from Professor Jean Golding and colleagues at the University of Bristol, used data from the renowned long-term health study Children of the 90s.

Information on details of the diets of almost 14,000 pregnant women was collected by the Children of the 90s study (also known as the Avon Longitudinal Study of Parents and Children or ALSPAC), based in Bristol, UK. Their children have been followed over the years and their abilities tested at various time points. A publication in the journal Nutrition Research reports on the results of comparing the children born to women who were eating a diet relatively low in vitamin B12 with children whose mothers ate a diet higher in the vitamin.

Professor Golding explained: “Many nutrients in pregnancy have beneficial effects on the brain of the unborn child, with resulting improved childhood abilities in regard to intelligence and educational abilities. However, it is unclear whether vitamin B12 has a similar effect.

“Vitamin B12 is found in foods such as meat, fish, eggs, cheese, milk and some fortified breakfast cereals. For vegans and vegetarians, Marmite is a rich source of vitamin B12 and other B vitamins.”

Researchers compared 29 different test results of which 26 were shown to differ with levels of vitamin B12, a far higher amount than would have been expected.

However, the mothers who had a diet low in vitamin B12 differed from the rest of the population in 9 different independent features. Once these factors had been taken into account there were no residual effects with social class or any other socioeconomic measure. These nine variables were all taken into account when assessing the possible effects of the mother’s diets during pregnancy on her offspring’s abilities.

Whilst many of the differences such as reading and spelling abilities, as well as aspects of IQ could be explained by other background factors, there were six associations which could not be explained away. These indicated that the children born to women with the lowest intake of vitamin B12 were at increased risk of poor vocabulary at 24 months, reduced ability at combining words at 38 months, poor speech intelligibility at six years, poor mathematics comprehension at school years four and six (ages eight to nine and 10-11 years), and poor results on the national mathematics tests (age 13). There were no significant associations with mental arithmetic, indicating that the mathematics results were specific to a reasoning component rather than computational abilities.

The numbers involved in these results were as follows: 24 month vocabulary (n=9140); combining words at 38 months (n=8833), poor speech intelligibility at six years (n=7,647), poor mathematics comprehension at school years four and six (ages eight to nine (n=4,093) and 10-11 years (n=6,142), and poor results on the national mathematics tests (age 13 (n=8,215).

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