Vitamin K2 is similar to D3 in many ways
- Both vitamins were initially confused with its lesser form (D2 ==> D3, K1 ==> K2)
- Both vitamins appear to influence health in large number of ways
- Both vitamins in the body are about 1/10 that of a century ago
Example: Grass-fed beef has a lot more K2, D3, and Magnesium - Need very little of both vitamins: <1 milligram daily
- When Vitamin D3 is increased, it appears that Vitamin K2 should also be increased
- Vitamin K2 understanding and research is about 20 years behind that of Vitamin D3
One of the reasons: No simple blood test for K2 as of Jan 2020
Table of contents
- K2 with some K1 - - - - -
- Importance of K2
- See VitaminDWiki category: Vitamin K
156 items and it's associations to other categories - See VitaminDWiki
- Apparently K2-MK7 Trans form is much better than Cis (Super K etc.) - Nov 2024
- Vitamin K deficiency is only important at low ievels of Vitamin D - GRH 2020
- Many benefit of vitamin K - Dr. Berg video- Fall 2022
- The Ultimate Vitamin K2 Resource- Chris Masterjohn Dec 2016
- Vitamin K2 and the Calcium Paradox - 2012 book
- Some suppliers of large amounts of K2
- See on web
3 Mortality and Low Vitamin K studies - Natto starter kit
- Slide show for Vita K from Dec 2010 is attached at the bottom of this page
- RCT 1500 micrograms daily K2 preserves bone - 2013
- Appears that Vitamin K is needed to prevent bone loss - 2012
- Dr. Sarah Booth Jan 2014
- MK7 is a natural form and is more effective in the body and teeth
- Vitamin K2 is good for cardiovascular - July 2015
- Dr Price in 1930's found people with good teeth consumed 10X more fat-soluable vitamins 8 minute video
- Citizen petition to increase Vitamin K2 to 200 micrograms/day - Feb 2016
- Vitamin K2 content of foods (US - 2015)
- Vitamin K2 (menaquinone) Supplementation and its Benefits in Cardiovascular Disease, Osteoporosis, and Cancer - 2016
- ...Differences between Vitamin K1 and K2 in Health and Disease - 2019
- Natto, which is a good source of Vitamin K2, treats nasal polyps in sinus - Feb 2018
- K1 compared to K2 - Sept 2018
- k-vitamins.com - learned of it Jan 2023
- VitaminK2.ORG
- Life Extension: K2 prescribed in Japan to prevent bone loss for several decades - March 2022
- Vitamin K and Cardiovascular
26 studies - Vitamin K and Bone
29 studies - Vitamin K and Calcium
17 studies - Vitamin K and Falls/Fracture
9 studies - Vitamin K and Kidney
4 studies - Vitamin K and Magnesium
28 studies - All 22 associations with the category Vitamin K
- K1 and K1 compared to K2 - - - - - - -
- Overview of K1 vs K2 controversy
- Vitamin K1 = phylloquinone = phytomenadione = phytonadione
- Both K1 and K2 promote blood clotting (Koagulations vitamin, from German)
- Vitamins K1 and K2 - Schwalfenberg 2017
- Medical studies - Vitamin K in title: 8,000 as of Feb 2023
- Green Medical Info has many medical references for Vitamin K1 and K2
- Higher Vitamin K1 intake reduces type 2 diabetes risk by over 30 percent in a 20-year study - May 2023
K2 with some K1 - - - - -
Importance of K2
- Makes for harder bones and softer arteries
- Appears to increase the effectiveness (Bioavailability?) of Vitamin D by 10%
Perspective of the importance of Vit D and co-factors to health
See VitaminDWiki category: Vitamin K
156 items and it's associations to other categories Table of contents
- Importance of K2
- See VitaminDWiki category: Vitamin K
156 items and it's associations to other categories - See VitaminDWiki
- Apparently K2-MK7 Trans form is much better than Cis (Super K etc.) - Nov 2024
- Vitamin K deficiency is only important at low ievels of Vitamin D - GRH 2020
- Many benefit of vitamin K - Dr. Berg video- Fall 2022
- The Ultimate Vitamin K2 Resource- Chris Masterjohn Dec 2016
- Vitamin K2 and the Calcium Paradox - 2012 book
- Some suppliers of large amounts of K2
- See on web
3 Mortality and Low Vitamin K studies - Natto starter kit
- Slide show for Vita K from Dec 2010 is attached at the bottom of this page
- RCT 1500 micrograms daily K2 preserves bone - 2013
- Appears that Vitamin K is needed to prevent bone loss - 2012
- Dr. Sarah Booth Jan 2014
- MK7 is a natural form and is more effective in the body and teeth
- Vitamin K2 is good for cardiovascular - July 2015
- Dr Price in 1930's found people with good teeth consumed 10X more fat-soluable vitamins 8 minute video
- Citizen petition to increase Vitamin K2 to 200 micrograms/day - Feb 2016
- Vitamin K2 content of foods (US - 2015)
- Vitamin K2 (menaquinone) Supplementation and its Benefits in Cardiovascular Disease, Osteoporosis, and Cancer - 2016
- ...Differences between Vitamin K1 and K2 in Health and Disease - 2019
- Natto, which is a good source of Vitamin K2, treats nasal polyps in sinus - Feb 2018
- K1 compared to K2 - Sept 2018
- k-vitamins.com - learned of it Jan 2023
- VitaminK2.ORG
- Life Extension: K2 prescribed in Japan to prevent bone loss for several decades - March 2022
- Vitamin K and Cardiovascular
26 studies - Vitamin K and Bone
29 studies - Vitamin K and Calcium
17 studies - Vitamin K and Falls/Fracture
9 studies - Vitamin K and Kidney
4 studies - Vitamin K and Magnesium
28 studies - All 22 associations with the category Vitamin K
- Overview of K1 vs K2 controversy
- Vitamin K1 = phylloquinone = phytomenadione = phytonadione
- Both K1 and K2 promote blood clotting (Koagulations vitamin, from German)
- Vitamins K1 and K2 - Schwalfenberg 2017
- Medical studies - Vitamin K in title: 8,000 as of Feb 2023
- Green Medical Info has many medical references for Vitamin K1 and K2
- Higher Vitamin K1 intake reduces type 2 diabetes risk by over 30 percent in a 20-year study - May 2023
See VitaminDWiki
- Vitamin K1 and Vitamin K2 importance to health – Feb 2019
- Vitamin K is important to health - review Jan 2020
- Intracranial arterial calcification in 85 percent of ischemic strokes (Vitamin K and Vitamin D should help) – Oct 2017
- Perhaps should not take K2 concurrently with Vitamin D. Vitamin D decreases the uptake of Vitamin K1 by 50%
- Better bones again associated with higher vitamin K intake – Nov 2015
- The health benefits of vitamin K – Oct 2015
- If you must take statins and want to avoid hardening of arteries, take vitamin K2 – RCT May 2015
- Vitamin K2-7 decreases arterial stiffness (cleans arteries) – RCT Feb 2015
- Vitamin K-2 – bone biomarkers indicate at least 600 ug of MK-4 are needed daily – Sept 2014
- Vascular calcification greatly reduced by 3 per week 1000 ug of Vitamin K2 MK-7 – Dec 2013
- Increased Vitamin K2 reduces the problems of excess Calcium – Nov 2013
- Vitamin K-2 (180 ug MK-7) helped both bone density and strength – RCT March 2013
- Synergism between Vitamin D, Vitamin K-2, and Vitamin A: Masterjohn – Sept 2013
- Hip fractures greatly reduced by sunshine, vitamin D, and Vitamin K – meta-analysis Sept 2012
- Vitamin K2 is a vitamin D co-factor Dr Colgan, etc.
- Cholesterol, Vitamins D3 and K2, heart disease, sulfates, LDL, – Masterjohn Interview Jan 2013
- Vitamin K1 reduced hip fracture but Vitamin K2 did not – Aug 2011
- All items in Bone-Health
311 items - All items in category K2
156 items - Interview of Doctor who has authored books on Vitamin K2 and Magnesium – Mercola June 2015
Apparently K2-MK7 Trans form is much better than Cis (Super K etc.) - Nov 2024
Taking Vitamin D3? This Might Save Your Life YouTube 20 minutes]
Before this video I was unaware of differences between forms
Presenter warns that if supplier does not list the Trans form it might not be in the capsule
Not all K2 suppliers use the Trans form
Perplexity AI agrees, Trans is far better than Cis
SuperK at Amazon I have used Super K many years.
Vitamin K deficiency is only important at low ievels of Vitamin D - GRH 2020
Many benefit of vitamin K - Dr. Berg video- Fall 2022
The Ultimate Vitamin K2 Resource- Chris Masterjohn Dec 2016
Here
Nice overview
Statins restrict K1 conversion to K2
All animals convert K1 or K2-M7 to K2-M4 for use
Recommends 100 micrograms - which no mention of increasing dose with higher levels of vitamin D
Good review of the commercial K combinations available on the market - here is just a portion of it - without hyperlinks- Life Extension Super K With Advanced K2 Complex — 1 mg K1, 1 mg MK-4, 200 μg mK-7, with an additional 10 mg ascorbic acid from 25 mg ascorbyl palmitate. Sold by iHerb ($22.50) but cheaper at Amazon ($17.93). Eligible for Prime and Amazon Fresh. 20 cents per capsule, 3 cents per day to average 200 μg/d. Beware of the subscription button when buying on Amazon. The vitamins are synthetic. According to Life Extension, the MK-7 is synthesized in China and is bioidentical, but they could not verify for me that it is 100% all-trans, which is the natural form. The reason I do not advocate this supplement is because the high dose of K1 adds little value, and although there is no well-characterized risk of high doses, it is possible that multiple milligrams per day of vitamin K (this supplement itself provides 2.2 mg per capsule) may unnecessarily tax the body’s antioxidant system.
- Maxx Labs Vitamin K2 Complex — 500 μg MK-4, 100 μg MK-7, 100 mg calcium from calcium citrate. 20 cents per capsule, 7 cents per day to average 200 μg/d. $17.98 on Amazon, where it is fulfilled by Amazon and eligible for Prime. Be careful to avoid the subscription setting if you only want to order one bottle. Free of GMOs and allergens.
- Innovix Full-Spectrum K2 — 500 μg MK-4, 100 μg MK-7. 24 cents per capsule, 8 cents per day to average 200 μg/d. $21.97 on Amazon, fulfilled by Amazon and eligible for Prime. Both forms of K2 in this product appear to be synthetic but bioidentical. It contains caramel coloring derived from non-GMO corn, a potential source of allergens. I consider this the best choice for a mixed MK-4/MK-7 supplement.
- Country Life Vegan K2 Strawberry Smooth Melt — 500 μg total K2. MK-4 and MK-7 in unidentified proportions. 19 cents per smooth melt, 8 cents per day to average 200 μg/d. Almost identical prices on Amazon ($16.65) and iHerb ($16.67). On Amazon, it is fulfilled by Amazon and eligible for Prime. It is not clear where the vitamins come from or whether the MK-7 is bioidentical. It is free of GMOs, soy, and other common allergens.
- Pure Encapsulations Synergy K — 1,000 IU Vitamin D3, 1 mg MK-4, 500 μg K1, 45 μg MK-7. 47 cents per capsule, 9 cents per day to average 200 μg/d. $56 on Amazon, where it is fulfilled by Amazon and eligible for Prime. Free of GMOs and allergens. Taken to yield an average close to 200 μg K2, the amounts of vitamin D (200 IU) and MK-7 (9 μg) are rather low compared to the Innovix Full-Spectrum K2 (20 μg MK-7) or the Thorne Research D/K2 (1,000 IU vitamin D), but the unique combination of the three vitamins may be optimal for some people whose nutritional needs fit it just right.
MK-4 Supplements
- Thorne Research Vitamin K2 — 1 mg MK-4. 5 cents per drop, 1 cent per day to average 200 μg/d. Similarly priced at Amazon ($64.62) and iHerb ($64.65), and if ordered on Amazon it is fulfilled by Amazon and eligible for Prime. It is dissolved in a base of nothing but MCT oil and mixed tocopherolsd. This is the least expensive option in the list.
- Thorne Research D/K2— 1000 IU vitamin D and 200 μg MK-4. 4 cents per day to obtain 200 μg from each two-drop serving. Although available on Amazon from third party shippers at prices ranging from $36-$70, it is not eligible for Prime and it is much less expensive ($23.70) through iHerb. This is a great option for someone who also needs to improve their vitamin D status. When compared to the Thorne Vitamin K2, it has the added benefit that the dose of MK-4 is smaller so it is easier to take a consistent dose of 200 μg every day. However, don’t be fooled by the price difference: the bottle costs less (hardly more than a third the price), but on a per 200 μg basis it is four times as expensive.
- Superior Source Sublingual MK-4 Tablets — 500 μg MK-4. 29 cents per tablet and 12 cents per day to average 200 μg per day. Similar price from Amazon ($17.59), where it is shipped and sold by Amazon as well as eligible for Prime, and iHerb ($17.79). The company claims that the sublingual formulation offers superior absorption but I’m not aware of any specific evidence of this. It contains lactose, so should be avoided by people with lactose intolerance.
Vitamin K2 and the Calcium Paradox - 2012 book
- Vitamin K2 and the Calcium Paradox – 2012 book review by VitaminDWiki
- Interview of author by Mercola Dec 2012
Same interview and perhaps updated data Mercola Nov 2017
CLICK HERE for transcript with highlights by VitaminDWiki
Highlight from interview: GUESS 100 ug of vitamin K2 PER 1000 IU of vitamin D
+Which would be 1500 ug of K2 (1 Super K capsule) per 15,000 IU Vitamin daily
Some suppliers of large amounts of K2
- Thorne liquid 10 drops = 1000 mcg K2 (MK4) and 5,000 IU vitamin D3
125 servings (of 10 drops) per $22 bottle - Bone restore with K2 Life Extension (improved)
4 capsules: Vitamin D3 1000 IU (low) ; MK-7 200 mcg, Ca 700 mg, Magnesium (citrate) 300 mg, Zinc 2 mg, Manganese 1 mg, Silicon 5 mg, Boron 3 mg - Natures Life Vitamin K-2 Menatetrenone — 5000 mcg - 60 Tablets $17
Comment by admin of VitaminDWiki: taking this about once every 4 days with vitamin D, and hoping that the half-life of K2 is long enough
See on web
- http://vitamink2.org/ International Health and Science Foundation, Poland
Working with Nattopharma to establish an RDI for K2 2018
K2 for MS?
K2 and fracture risk
K2 in Cheese Vermeer 2018 - Vitamin K and bone health – need more research Oct 2013
- Effects of vitamin K in postmenopausal women: Mini review Nov 2013
interesting abstract which finishes with MK-4 seems safe even at doses as high as 45mg/day. - Strong bones recommendation by VitaminDWiki admin - approx 2005
- Mercola video interview of Vermeer 10 parts July 2010
- CLICK HERE for transcript of the interview]
- CLICK HERE for Mercola's summary after? the interview
Includes the following charts
- how Vitamin K (1, 2, or 5) combined with Sorafenib treats Pancreatic Cancer perhaps 20X better than either item by itself
Journal Cell Physiology, 2010, full text on-line - Vitamin K2 administration is associated with decreased disease activity in patients with rheumatoid arthritis Nov 2012
- Mark' Daily Apple on Vitamin K2 Feb 2009
Extensive description of all of the vitamin K around the world, lack of RDA for K2, etc. - Phylloquinone and vitamin D status: associations with incident chronic kidney disease in the Framingham Offspring cohort. 2012
Higher K1 associated with an increased risk of incident CKD. - by 2x - Vitamin K1 intake cuts risk of diabetes in the elderly by 50 percent Natural News Dec 2012
- Coronary artery calcification in Japanese men in Japan and Hawaii. 2007 full text online
The Japanese living in Hawaii (and not eating Natto as much) had 4X more Coronary Artery Calcification.
Those in Hawaii also happened to smoke 4X less than those in Japan - Mercola long article on importance of Vitamin K2 and Vitamin D March 2011
- Vitamin K status and cognitive function in healthy older adults Neurobiology of Aging, Sept 2013
Vitamin K1 (not K2) improved 20 minute recall. Details of how much K1 and how much improvement are behind a paywall - Intracranial haemorrhage is linked to late onset vitamin K deficiency in infants aged two to 24 weeks Feb 2014
ALL infants with Intracranial haemorrhage had significantly low vitamin K level. - Huge overview of Vitamin K Examine.com; here are just the topic areas covered
- Examine.com update June 2018
Sources and Structure; Sources and Origin; Structure and Properties; Mechanisms and the Vitamin K Cycle; Mechanisms Independent of the Vitamin K Cycle; Recommended Intake; Deficiencies; Supplemental Forms of Vitamin K;
Pharmacology; Absorption; Distribution; Serum; Tissue/Cellular Uptake; Colonic Kinetics and Fermentation; Excretion; Topical Application;
Longevity; Mitochondria; Aging;
Neurology; Mechanisms; Neuroprotection; Neuroinflammation; Cognition; Multiple Sclerosis;
Cardiovascular Health; Cardiac Tissue; Coagulation and Clotting; Calcification;
Interactions with Glucose Metabolism; Insulin; Insulin sensitivity;
Fat Mass and Obesity; Mechanisms;
Skeleton and Bone Metabolism; Mechanisms Independent of the Vitamin K Cycle; Mechanisms via the Vitamin K Cycle (Osteocalcin); Bone Mineral Density; Fractures; Joint Health;
Inflammation and Immunology; Cytokines;
Interactions with Hormones; Sex Hormone Binding Globulin; Testosterone; Cortisol;
Interactions with Organ Systems; Liver; Pancreas; Male Sex Organs;
Interactions with Cancer Metabolism; Mechanisms; Hepatocellular Carcinoma;
Interactions with Aesthetics; Skin;
Interactions with Pregnancy; Requirements (Pregnancy); Requirements (Lactation);
Interactions with Disease States; Cystic Fibrosis; Pseudoxanthoma elasticum;
Nutrient-Nutrient Interactions; Vitamin C; Vitamin D; Vitamin E; Sesamin; Anticoagulants;
Safety and Toxicology; General; Case Studies; Menadione;
- Vitamin K1 and 25(OH)D are independently and synergistically associated with a risk for hip fracture in an elderly population: A case-control study. Jan 2014
- EFSA (European Food Satefy Agency) no Vit K change Nutraingredients May 2017
Still 70 micrograms for adults, still lump K1 and K2 together - Vitamin K deficiency: What you need to know Medical News Today Dec 2017
3 Mortality and Low Vitamin K studies Items in VitaminDWIKI in both categories Vitamin K and Mortality are listed here:
- - - - - - - - - - - -
Combination of Low Vitamin D AND Low Vitamin K increased mortality by 1.5X Aug 2020, FREE PDF
- - - - -
Cardiovascular Mortality much worse if lacking Vitamin K2 from MenaQ7.com
The above is their advertisement
- - - - - -
Vitamin K1 is Inversely Associated with Mortality Risk, K2 is also good - March 2014
Dietary Intake of Vitamin K Is Inversely Associated with Mortality Risk.
J Nutr. 2014 Mar 19
Juanola-Falgarona M1, Salas-Salvadó J, Martínez-González MA, Corella D, Estruch R, Ros E, Fitó M, Arós F, Gómez-Gracia E, Fiol M, Lapetra J, Basora J, Lamuela-Raventós RM, Serra-Majem L, Pintó X, Muñoz MA, Ruiz-Gutiérrez V, Fernández-Ballart J, Bulló M.Vitamin K has been related to cardiovascular disease and cancer risk. However, data on total mortality are scarce. The aim of the present study was to assess the association between the dietary intake of different types of vitamin K and mortality in a Mediterranean population at high cardiovascular disease risk. A prospective cohort analysis was conducted in 7216 participants from the PREDIMED (Prevención con Dieta Mediterránea) study (median follow-up of 4.8 y). Energy and nutrient intakes were evaluated using a validated 137-item food frequency questionnaire. Dietary vitamin K intake was calculated annually using the USDA food composition database and other published sources. Deaths were ascertained by an end-point adjudication committee unaware of the dietary habits of participants after they had reviewed medical records and linked up to the National Death Index. Cox proportional hazard models were fitted to assess the RR of mortality.
Energy-adjusted baseline dietary phylloquinone intake was inversely associated with a significantly reduced risk of cancer and all-cause mortality after controlling for potential confounders (HR: 0.54; 95% CI: 0.30, 0.96; and HR: 0.64; 95% CI: 0.45, 0.90, respectively).In longitudinal assessments, individuals who increased their intake of phylloquinone or menaquinone during follow-up had a lower risk of
- cancer (HR: 0.64; 95% CI: 0.43, 0.95; and HR: 0.41; 95% CI: 0.26, 0.64, respectively) and
- all-cause mortality (HR: 0.57; 95% CI: 0.44, 0.73; and HR: 0.55; 95% CI: 0.42, 0.73, respectively)
than individuals who decreased or did not change their intake.
Also, individuals who increased their intake of dietary phylloquinone had a lower risk of cardiovascular mortality risk (HR: 0.52; 95% CI: 0.31, 0.86).
However, no association between changes in menaquinone intake and cardiovascular mortality was observed (HR: 0.76; 95% CI: 0.44, 1.29).
An increase in dietary intake of vitamin K is associated with a reduced risk of cardiovascular, cancer, or all-cause mortality in a Mediterranean population at high cardiovascular disease risk.
This trial was registered at http://www.controlled-trials.com as ISRCTN35739639, PMID: 24647393
Natto starter kit
Make your own Vitamin K2 / Natto at home from a starter kit
Called Natto in Japan and Thau-nao in Thailand this cultured whole bean soy food has a strong, somewhat persistent, unique flavor.
The bacteria, Bacillus subtilis var natto, that culture the cooked soybeans make a sticky, viscous polymer during the 6-12 hours of incubation.
This creates wispy threads evident when the cultured soybeans are pulled apart.A good source of protein, this robust soyfood adds zest to any grain or noodle dish, soup or sandwich.
A little goes a long way, so what is not intended for use in a day or two may be easily frozen.
Our Natto starter, imported from Japan, has a 6 month or more shelf life.Natto Starter Kit:
This 11gm packet contains culture directions, recipes, and enough spore to start 3 batches of natto, each making 5 cups or 1.5 pounds.
$3.00 + $3.00 shipping in the US. As of July 2011 the supplier only accepts check of money order, no on-line sales
- - - - - - - - - - - - - -
Cees Vermeer (64) is Associate Professor of Biochemistry at the Maastricht University and since 10 years also CEO of VitaK, a spin-off company focusing on research on vitamin K and vitamin K-dependent proteins. VitaK employs 14 researchers (Ph.D., MSc, and BSc) who are all working on a) clinical trials to demonstrate health effects of vitamin K, b) development of new biomarkers based on vitamin K-dependent proteins and c) analysis of K-vitamins in foods and body fluids. Cees Vermeer has been the supervisor of 16 Ph.D. students and is an author in over 300 papers in the international scientific press. VitaK is specialized in bone and cardiovascular health and has a long-standing R&D collaboration with NattoPharma; we have demonstrated the quality and health effects of MenaQ7 in several independent clinical trials and also act as consultant for scientific and regulatory affairs as well as for designing and defending IPR.Dr. Vermeer studied Biochemistry at Leiden, where he also presented his Ph.D. thesis (1974) on the initiation of protein biosynthesis in E coli. In 1975 Dr. Vermeer was appointed at the Department of Biochemistry of the Universiteit Maastricht, where he has founded the Division on Vitamin K In 1984 he was appointed as an Associate Professor of Biochemistry and Principal Investigator at CARIM. In 1994 Dr. Vermeer was appointed as a temporary adviser of the World Health Organization and in 2001 he received the honorary title of Doctor honoris causa at the University of Medicine and Pharmacy "Iuliu Hatieganu" of the city of Cluj-Napoca, Romania. Moreover, in 2001 Dr. Vermeer founded the company VitaK BV, where he became the first CEO of the company.
Slide show for Vita K from Dec 2010 is attached at the bottom of this page
The following are some of the slides
Cees Vermeer, PhD; Associate Professor of Biochemistry; BioPartner Center Maastricht; c.vermeer at bioch.unimaas.nl
RCT 1500 micrograms daily K2 preserves bone - 2013
Low-dose vitamin K2 (MK-4) supplementation for 12 months improves bone metabolism and prevents forearm bone loss in postmenopausal Japanese women May 2013
6 month Random Controlled Trial: Control group with no K-2 had decreased forearm BMD, 1.5-mg K-2 MK-4 has no decrease
Appears that Vitamin K is needed to prevent bone loss - 2012
Vitamin K-Dependent Carboxylation of Osteocalcin: Friend or Foe?
Caren M. Gundberg3, caren.gundberg at yale.edu, Jane B. Lian4, and Sarah L. Booth (see also below) 5
3Orthopaedics and Rehabilitation, Yale School of Medicine, New Haven, CT
4Department of Cell Biology, University of Massachusetts Medical School, Worcester, MA; and
5Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA
Adv Nutr March 2012 Adv Nutr vol. 3: 149-157, 2012Osteocalcin originates from osteoblastic synthesis and is deposited into bone or released into circulation, where it correlates with histological measures of bone formation. The presence of 3 vitamin K-dependent ? carboxyglutamic acid residues is critical for osteocalcin’s structure, which appears to regulate the maturation of bone mineral. In humans, the percentage of the circulating osteocalcin that is not ?-carboxylated (percent ucOC) is used as a biomarker of vitamin K status. In contrast, when ucOC is not corrected for total osteocalcin, the interpretation of this measure is confounded by osteoblastic activity, independent of vitamin K. Observational studies using percent ucOC have led to the conclusion that vitamin K insufficiency leads to age-related bone loss. However, clinical trials do not provide overall support for the suggestion that vitamin K supplementation of the general population will reduce bone loss or fracture risk. More recently, results from in vitro and in vivo studies using animal models indicate that ucOC is an active hormone with a positive role in glucose metabolism. By inference, vitamin K, which decreases ucOC, would have a detrimental effect. However, in humans this hypothesis is not supported by the limited data available, nor is it supported by what has been established regarding osteocalcin chemistry. In summary, the specific function of osteocalcin in bone and glucose metabolism has yet to be elucidated.
Dr. Sarah Booth Jan 2014
Video from Grassroots
PDF including all images is attached at the bottom of this pagehere are some of the images
Her 2008 PDF is attached at the bottom of this page
MK7 is a natural form and is more effective in the body and teeth
Accumulation in the serum
The long half-life of MK-7 results in significantly better accumulation compared to MK-4. Research shows that in only 8 days MK-7 has 6 times better absorption. Hence, smaller quantities and less frequent intakes of MK-7 is sufficient in order to supply all of the tissues.MK7 more effective
MK-7 is much more effective than MK-4 at doses that do not exceed the present recommended intake for vitamin K. MK-4 has to be applied in very high pharmacological doses (milligrams) to demonstrate benefits for bone and heart health. In case of MK-7, doses in micrograms – 1000x less - are sufficient for significant bioactive effect.
Vitamin K2 is good for cardiovascular - July 2015
 Download the PDF from VitaminDWiki
Dr Price in 1930's found people with good teeth consumed 10X more fat-soluable vitamins 8 minute video
Citizen petition to increase Vitamin K2 to 200 micrograms/day - Feb 2016
Citizen Petition asking the National Academy of Sciences to set a designated reference index for vitamin K2 of 200 micrograms/day Dr. David Cundiff
Vitamin K2 content of foods (US - 2015)
 Download the PDF from VitaminDWiki
Vitamin K2 (menaquinone) Supplementation and its Benefits in Cardiovascular Disease, Osteoporosis, and Cancer - 2016
 Download the PDF from VitaminDWiki
...Differences between Vitamin K1 and K2 in Health and Disease - 2019
 Download the PDF from VitaminDWiki
Natto, which is a good source of Vitamin K2, treats nasal polyps in sinus - Feb 2018
Nattokinase for Nasal Polyps and as a Mucolytic Green Med Info.
Note: The word VITAMIN does not occur once in the article.
There are many articles on the web about Vitamin K2 reducing nasal polypsK1 compared to K2 - Sept 2018
k-vitamins.com - learned of it Jan 2023
lots of information
Founder was saved by Vitamin K disolving plaques in his arteries
huge amount of Vitamin K information
He also sells a very high dosage combination Vitamin K pill
Vitamin K1 (5 mg) , MK4 (25 mg) , and MK7 (0.5 mg), and Astaxanthin (2 mg)
Research tab has
VitaminK2.ORG
VitaminDWiki became aware of this nice site in Sept 2019
Site Table of Contents
Vitamin K Myths- 1.Myth: Vitamin K is a single vitamin.
- 2.Myth: I eat a lot of green leafy vegetables, so I am getting my vitamin K2.
- 3.Myth: With all the green leafy vegetables I eat, I am getting the benefits of vitamin K2.
- 4.Myth: I feed my children packaged cheese because I want to make sure they get plenty of vitamin K2.
- 5.Myth: I can follow adequate daily intake levels of vitamin K so I am sure I am getting enough vitamin K2.
- 6.Myth: I am taking a blood-thinning medication so I absolutely should not eat foods with vitamin K or take vitamin K supplements.
- 7.Myth: I feel great so I am definitely not vitamin K2 deficient.
Deficiency
|
Rare, except in newborns.|
CommonDaily Value (RDA)
|
90 micrograms for women
120 micrograms for men|
Not yet established, but experts recommend 100 to 200 micrograms of K2 daily.Toxicity
|
No known toxicity if taken at recommended levels.|
No known toxicity if taken at recommended levels.Deficiency symptoms
|
- Bruises
- Increased bleeding time
- Small blood clots under nails
- Increased bleeding in mucous membranes.
|
- Weak bones
- Increased plaque deposits along gumline
- Increase in cavities
- Arterial calcification
Causes of deficiency
|
- Lack of green leafy vegetables in diet
- Anticoagulant medications (Warfarin/Coumadin)
- Antibiotics
- Fat malabsorption disorders.
|
Lack of fermented foods and organ meats in diet.Circulation in blood
|Brief (hours)|
Prolonged (days).
Due to Vitamin K2's longer molecule, it is transported by different carriers in the blood than K1 and therefore, to different locations in the body.Effect on bone health
|
Minimal|
ModerateEffect on heart health
|Minimal|Moderate
Present in brain
|No|
Yes.
The MK-4 form of Vitamin K2 is the predominant form found in the brain, but we don't yet know what it does there.What happens after consumption?
|
- Vitamin K1 travels to liver more effectively than to bones.
- Liver uses Vitamin K1 to activate proteins needed for blood clotting.
|
- Vitamin K2 travels to bone more effectively than K1.
- Bones use K2 to produce Osteocalcin, a bone-building protein hormone, which also supports metabolic health.
- The MK-4 form of Vitamin K2 is effective at reaching tissues other than liver and bones.
- The MK-7 form of K2 is 3X better at reaching bones . .
Life Extension: K2 prescribed in Japan to prevent bone loss for several decades - March 2022
 Download the PDF from VitaminDWiki
Vitamin K and Cardiovascular
26 studies - Vitamin K, cardiovascular health, and stroke - many studies
- Bone loss results in blood vessel plaque if low Vitamin K2, less bone loss if high K2– April 2021
- Cardiovascular Disease prevented by Vitamin K2-4 when enough is used – RCT review Sept 2020
- Calcium Supplementation is OK provided you also take Vitamin K – Feb 2019
- Vitamin K reduces calcification (reported yet again) – Feb 2019
- Vitamin K (across all dose sizes and types) decrease Vascular Stiffness – meta-analysis - Dec 2018
- Vitamin D and Vitamin K together fight CVD Part 1- Pizzorno
- Vitamin K, Cardiovascular and interactions with Vitamin D and Vitamin A – Pizzorno July 2018
- Mortality associated with Vitamin K insufficiency (PREVEND Study) – Nov 2017
- Intracranial arterial calcification in 85 percent of ischemic strokes (Vitamin K and Vitamin D should help) – Oct 2017
- Decalcify Aortic Valve – 3 year trial with 1 mg of Vitamin K and 5,000 IU of Vitamin D – 2021
- Cardiovascular problems reduced by low dose aspirin and perhaps Omega-3 (also Vit K) – Sept 2017
- Athletes maximal cardiac output increased 12 percent with Vitamin K2 – RCT July 2017
- Fast blood flow 6.8 X more likely if high vitamin D AND high vitamin K – Aug 2017
- Low Vitamin K2 is as risky as smoking for heart disease - Oct 2016
- Cardiovascular death: 9 percent due to hypertension or air pollution, 7 percent: low Vitamin K2 or smoking – Oct 2016
- Decreased need for warfarin after Vitamin D levels optimized – RCT May 2016
- Cardiovascular calcification prevented by Omega-3, Magnesium, Vitamin K, and Vitamin D – April 2015
- The health benefits of vitamin K – Oct 2015
- If you must take statins and want to avoid hardening of arteries, take vitamin K2 – RCT May 2015
- Vitamin K2-7 decreases arterial stiffness (cleans arteries) – RCT Feb 2015
- Hypothesis: Vitamin K will reduce prostate blood vessel problems – Jan 2015
- Increased Vitamin K2 reduces the problems of excess Calcium – Nov 2013
- Cholesterol, Vitamins D3 and K2, heart disease, sulfates, LDL, – Masterjohn Interview Jan 2013
- Soft Bones, Hard Arteries, Vitamin D, Vitamin K2 and antibiotics – Sept 2012
- Low Vitamin D and Vitamin K: brittle bones and hardened arteries – LEF Sept 2010
Vitamin K and Bone
29 studies - Which supplements are often taken for healing hairline bone fractures
- Vitamin K2-7 helps bone, blood vessels, cancer, diabetes, etc. – June 2022
- Role of Vitamin K in Bones and Muscles - Feb 2022
- Bone loss results in blood vessel plaque if low Vitamin K2, less bone loss if high K2– April 2021
- Bone increased : Stiffness (Vitamin D), Flexibility (Vitamin K2) – Sept 2020
- Bone quality improved 2X by Vitamin D plus Vitamin K2 (trend) – meta-analysis March 2020
- Vitamin D and Calcium do not increase bone density (also need exercise, Mg, K2, protein etc.) – RCT Aug 2019
- Vitamin K (any amount and any kind) reduced bone fractures by 24 percent – meta-analysis – May 2019
- Calcium Supplementation is OK provided you also take Vitamin K – Feb 2019
- Hard bones, soft arteries, rather than vice versa (Vitamin D and Vitamin K) – March 2016
- Many seniors do not get enough protein, Vitamin D, Mg, etc. needed for bones – Feb 2019
- Adding just vitamin D again failed to add bone density (also need Magnesium, Vitamin K, etc) – RCT Aug 2018
- Osteocalcin – overview of the hormone needed to build bones, etc. Jan 2018
- Vitamin K and bone – review Oct 2017
- Bone formation in the lab is aided by Vitamin D, Vitamin K1, and Vitamin K2 – meta-analysis Nov 2017
- Better bones again associated with higher vitamin K intake – Nov 2015
- Vitamin K-2 – bone biomarkers indicate at least 600 ug of MK-4 are needed daily – Sept 2014
- Vitamin K2 (as MK-7) is needed for bone quality – Review Feb 2013
- Increased Vitamin K2 reduces the problems of excess Calcium – Nov 2013
- Vitamin K and bone health – need more research Oct 2013
- Vitamin K-2 (180 ug MK-7) helped both bone density and strength – RCT March 2013
- Healthy bones need Ca, Silicon, Vitamins B, C, D, and K – Dec 2012
- Increasing bone mineral density increases breast cancer by at least 2X – Aug 2012
- Healthy bones need: Calcium, Vitamin D, Magnesium, Silicon, Vitamin K, and Boron – 2012
- Vitamin D, K2, Magnesium, etc increase bone density when taking together– Jan 2012
- BONE SPURS not produced if have enough Vitamin D3, Vitamin K2, etc. – Nov 2011
- Vitamin K1 reduced hip fracture but Vitamin K2 did not – Aug 2011
- Women with hip fractures very low on vitamins D3 and K – Mar 2011
- Vitamin K2 from natto improved bone mineral density – March 2011
Vitamin K and Calcium
17 studies - Which supplements are often taken for healing hairline bone fractures
- Calcium and Vitamin K2 - many studies
- Excellent reviews of supplements at ConsumerLab
- Lowering Calcium Risk when having High Dose Vitamin D3 – Cawley Dec 2019
- Hypercalcemia in critically ill patients taking 10,000 IU of vitamin D (many solutions) – Oct 2019
- Calcium Supplementation is OK provided you also take Vitamin K – Feb 2019
- Calcium supplements go to muscle, not bone, unless have enough Vitamin K – Feb 2019
- Drugs which create deficiencies in Vitamin D, Vitamin K, Magnesium, Zinc, Iron, etc. – Sept 2017
- Vitamin D Cofactors in a nutshell
- Vascular calcification greatly reduced by 3 per week 1000 ug of Vitamin K2 MK-7 – Dec 2013
- Increased Vitamin K2 reduces the problems of excess Calcium – Nov 2013
- Review of Micronutrients such as vitamin D for women and childhood – Aug 2013
- Healthy bones need Ca, Silicon, Vitamins B, C, D, and K – Dec 2012
- Interview of Vitamin K2 and Calcium Paradox author by Dr. Mercola – Dec 2012
- Vitamin K2 and the Calcium Paradox – 2012 book
- Low cost cofactors for vitamin D
- Postmenopausal women should supplement vitamins C D K and Calcium – June 2010
Vitamin K and Falls/Fracture
9 studies - Hip fractures requiring hospitalization cut in half by Vitamin K1 (100 mcg per day) – Sept 2022
- Bone increased : Stiffness (Vitamin D), Flexibility (Vitamin K2) – Sept 2020
- Vitamin K (any amount and any kind) reduced bone fractures by 24 percent – meta-analysis – May 2019
- Hard bones, soft arteries, rather than vice versa (Vitamin D and Vitamin K) – March 2016
- Low-energy bone fractures far more likely if poor Vitamin K ratio – June 2018
- Bone fracture (low energy) 19X more likely in children if low vitamin K2 - June 2017
- Hip fracture 50 percent more likely if low in both vitamin D and vitamin K1 – Dec 2015
- Hip fractures greatly reduced by sunshine, vitamin D, and vitamin K – meta-analysis Sept 2012
- Low Vitamin D and Vitamin K: brittle bones and hardened arteries – LEF Sept 2010
Vitamin K and Kidney
4 studies
Vitamin K and Magnesium
28 studies - Cofactors are needed when taking high-dose vitamin D - video Nov 2024
- Which supplements are often taken for healing hairline bone fractures
- Supplements taken by the founder of VitaminDWiki
- Co-factors increase Vitamin D response for the GRH cohort - Jan 2023
- Excellent reviews of supplements at ConsumerLab
- Nutritional supplementation during COVID hospitalization helped - RCT - Jan 2022
- Response to Vitamin D increased if take Magnesium and Vitamin K2 – Grassroots March 2020
- Vitamin D and Calcium do not increase bone density (also need exercise, Mg, K2, protein etc.) – RCT Aug 2019
- Supplements taken by US Adults, Grassroots Health – March 2019
- Many seniors do not get enough protein, Vitamin D, Mg, etc. needed for bones – Feb 2019
- Less DNA repair if nutrient deficient (Vitamin D, Magnesium, Omega-3, Vitamin K, etc) – Ames Oct 2018
- Adding just vitamin D again failed to add bone density (also need Magnesium, Vitamin K, etc) – RCT Aug 2018
- Bulk supplementation of Vitamin D, Magnesium, Zinc, B-12, K2, Boron etc. - lower cost and easier than pills
- Stroke is strongly associated with Calcification of cerebral arteries (perhaps low Vitamin D, Vitamin K, Mg…) – March 2018
- Drugs which create deficiencies in Vitamin D, Vitamin K, Magnesium, Zinc, Iron, etc. – Sept 2017
- Vitamin D monotherapy is good, Vitamin D multitherapy is great
- Cardiovascular calcification prevented by Omega-3, Magnesium, Vitamin K, and Vitamin D – April 2015
- Vitamin D Cofactors in a nutshell
- Interview of Doctor who has authored books on Vitamin K2 and Magnesium – Mercola June 2015
- Micronutrients, methylation, epigenetics, longevity podcast by Rhonda Patrick and Tim Ferriss - June 2015
- Synergism between Vitamin D, Vitamin K-2, and Vitamin A: Masterjohn – Sept 2013
- Vitamin D monotherapy reduces colorectal cancer but has calcemic side effects – April 2013
- A balanced diet is no longer enough – supplements needed - VitaminDWiki Oct 2012
- Healthy bones need: Calcium, Vitamin D, Magnesium, Silicon, Vitamin K, and Boron – 2012
- Vitamin D, K2, Magnesium, etc increase bone density when taking together– Jan 2012
- Reasons for low response to vitamin D
- Hypothesis: Age-related diseases due to lack of nutrients like vitamin K – Ames Triage Theory
- Low cost cofactors for vitamin D
All 22 associations with the category Vitamin K
Vitamin K associations with: Bone - Health 28; Cardiovascular 25; Magnesium 23; Top news 16; Omega-3 15; Calcium 14; Vitamin A 11; Falls and Fractures 8; Vitamin B12 7; Osteoporosis 7; Seniors 7; Boron 6; Zinc 6; Virus 6; Supplement 6; Vitamin C 5; Diabetes 5; Iron 5; Iodine 4; Cancer 4; Meta-analysis 4; Kidney 4 As of Nov 2022 Click below to see detailed current associations
K1 and K1 compared to K2 - - - - - - -
Overview of K1 vs K2 controversy
K1 K2 M-4 K2 M-7 Supplement Synthetic/Natural Synthetic Synthetic Natural Food Source Green leafy vegetables Cheese, animal fat, egg yolk,
natto, free-range lardBone Slight ability to activate osteocalcin Strong ability to build strong bones Duration in body Days Hours days Recycled in body Yes - so not need much
deficiency is uncommonNot recycled Ability to activate MGP and reduced arterial plaque Slight Strong Amount needed for health 90 ug not specified 90 -300 -1000ug
Japanese have 45,000 ugVitamin K1 = phylloquinone = phytomenadione = phytonadione
(memory aid: K1 = P = Plant)
Vitamin K2 = menaquinone = menatetrenone
Both K1 and K2 promote blood clotting (Koagulations vitamin, from German)
Controversy, but appears that
- K2 better than K1 at building bones
- Coumadin (warfarin) blocks all forms of vitamin K
- 2007 – vitamin K2 is the most bioavailable, bioactive and longest lasting form of vitamin K
- Extensive interaction between Vitamin K, Vitamin D, and Calcium (bones, prostate, arteries, . . . )
Vitamins K1 and K2 - Schwalfenberg 2017
Vitamins K1 and K2: The Emerging Group of Vitamins Required for Human Health - 2017
 Download the PDF from VitaminDWiki
Medical studies - Vitamin K in title: 8,000 as of Feb 2023
https://is.gd/kpubmed PubMed
"vitamin k" OR "vitamin k1" OR "vitamin k2" OR "Vitamin K(2)" OR phylloquinone OR phytomenadione
OR phytonadione OR menaquinone OR menatetrenone in Title- Vitamin K2 Needs an RDI Separate from Vitamin K1 2020 Jun doi: 10.3390/nu12061852. FREE PDF
- Calcium, vitamin D, vitamin K2, and magnesium supplementation and skeletal health - 2020 Oct doi: 10.1016/j.maturitas.2020.05.020
- Vitamin K2-a neglected player in cardiovascular health: a narrative review 2021 Nov: 10.1136/openhrt-2021-001715 free pdf
- Vitamin K Deficiency Jan 2022 free book
- Vitamin K Jan 2022 Free book
- Effect of vitamin K2 on type 2 diabetes mellitus: A review 2018 Feb doi: 10.1016/j.diabres.2017.11.020
- Role of Vitamin K in Intestinal Health 2022 Jan doi: 10.3389/fimmu.2021.791565. eCollection 2021. FREE PDF
- The Medical Benefits of Vitamin K2 on Calcium-Related Disorders 2021 Feb doi: 10.3390/nu13020691.FREE PDF
- 2017 Prevalence and Effects of Functional Vitamin K Insufficiency: The PREVEND Study
 Download the PDF from VitaminDWiki - 2017Vitamin K and bone
 Download the PDF from VitaminDWiki - 2017 Effect of vitamin K2 on type 2 diabetes mellitus: A review - DOI: 10.1016/j.diabres.2017.11.020
- 2016|What Is Vitamin K2 and Does It Have an Impact on Bone Health?
- 2014 K2 reduces Osteoporosis for postmenopausal women: a meta-analysis]
- 2012 Vitamin k and the nervous system: an overview of its actions -full text on-line
- 2012 Vitamin K-antagonists create arterial plaque. Vermeer full text on-line
- 2012 The role of vitamin k in soft-tissue calcification. -full text on-line Vermeer
- 2012 Vitamin k status and vascular calcification: evidence from observational and clinical studies -full text on-line
- 2012 Vitamin K, an emerging nutrient in brain function
- 2012 Vitamin K: the effect on health beyond coagulation - an overview -PDF at bottom of this page (Vermeer)
- 2011 Conclusion: A low intake of vitamin K1, but not K2, was associated with an increased risk of hip fractures.
This is the opposite of current belief - 2011 Bone quality in diabetics improved with vitamin K2
- 2011 Vitamin K, bone fractures, and vascular calcifications in chronic kidney disease: an important but poorly studied relationship.
Clinical Trials for "vitamin K" 568 as Feb 2023
- Effect of Vitamin K Supplementation on Markers of Diabetes Risk in Overweight Children
- The Efficacy of Vitamin K2 n Human Osteoporosis, Blood-vessel Calcification and Sclerosis
- Vitamin K-absorption From Dairy
- The Effects of Vitamin K2 Supplementation on the Progression of Coronary Artery Calcification (VitaK-CAC)
- Beneficial Effects of Long Term Menaquinone-7: 180 µg menaquinone-7 daily for three years; Bone Loss & Arteriosclerosis
- Comparison of Absorption of Vitamin K2: softgel capsules containing 180 µg MK-7 and 750 IU vitamin D3 + 120 µg MK-4
- The Effect of Vitamin K2 on Bone Turnover
Green Medical Info has many medical references for Vitamin K1 and K2
- Menaquinone-7, a form of vitamin K2, may prevent age-related bone loss.
- Dietary intake of menaquinone is associated with a reduced risk of coronary heart disease, cardiac mortality, aortic calcification and all-cause mortality.
- Vitamin K may reduce the risk for artherosclerosis.
- Vitamin K may be effective in preventing and treating osteoporosis and arterial calcification.
- Evidence shows that deficiency of Vit. K may contribute to the development of cardiovascular plaque (increased intima media thickness)
and supplementation may reverse or forestall the process of calcification. - Vitamin K supplementation inhibits the progression of coronary artery calcification in older men and women.
- High dietary menaquinone (Vitamin K2) intake is associated with reduced coronary calcification.
- Vitamin K(2) may represent a new agent for the treatment of rheumatoid arthritis.
- Vitamin K supplementation in postmenopausal women wih osteopenia appears to protect against bone fractures and cancers.
- Vitamin K1 and K2 exhibit anti-fracture activity.
- The intake of natto, an excellent source of vitamin K2, may reduce bone fracture risk.
- Menaquinone-7 (vitamin K2) supplementation increases osteocalcin carboxylation associated
- High-dose vitamin K supplementation reduces fracture incidence in postmenopausal women.
- Vitamin K2 (MK-4) may be beneficial in the maintenance of bone health in postmenopausal women.
- Supplementation with phytonadione (Vitamin K1) and menaquinone (Vitamin K2) , particularly menaquinone-4, is associated with increased BMD and reduced fracture incidence.
- vitamin Vitamin (2) works synergistically with alendronate on improving both osteocalcin carboxylation and BMD of femoral neck in postmenopausal women with osteoporosis.
- Low vitamin K status is associated with abnormal cartilage, bone mineralizations and osteoarthritis in the hand and knee.
- Vitamin K3 induces programmed cell death in breast cancer cells.
- Vitamin K2 inhibits cell growth in cholangiocellular carcinoma cell lines.
- Pharmacological Actions : Apoptotic, Cell cycle arrest
- Supplementation of vitamin K antagonists with 100 mcg of vitamin K improves stability of anticoagulant therapy and reduces side effects.
- High dietary intake of vitamin K rich foods is associated with a lower risk of coronary artery disease.
- Research indicates that vitamin K2 intake reduces coronary heart disease events.
- A high vitamin K2 (menaquinone) intake reduces the incidence of coronary heart disease.
- Vitamins K2 and D3 have a protective effect on prednisolone-induced loss of bone mineral density in the lumbar spine.
- High dose vitamin K is efficacious in correcting vitamin K deficiency in cystic fibrosis.
- Vitamin K2 may improve bone quality in type 2 diabetes.
- Low levels of vitamin D and K are highly prevalent and independent of overall malnutrition in the institutionalized elderly.
- Vitamin K2 induces cell cycle arrest and programmed cell death in gastric cancer cell lines.
- Levels of menaquinone-7 and vitamin D are lower in those with hip fracture, indicating they may have a role in fracture prevention.
Higher Vitamin K1 intake reduces type 2 diabetes risk by over 30 percent in a 20-year study - May 2023
https://doi.org/10.1210/clinem/dgad293 FREE PDF
Overview Vitamin K and Vitamin D138983 visitors, last modified 01 Nov, 2024, This page is in the following categories (# of items in each category)Attached files
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