Vitamin K2 MK-4 vs Vitamin K2 MK-7
How vitamin K2 MK-4 and vitamin K2 MK-7 differ in potency, absorption, tolerance, and cost.
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Side by Side
| Vitamin K2 as MK-4 (Menatetrenone) | Vitamin K2 as MK-7 | |
|---|---|---|
| Absorption | Low | High |
| How it is absorbed | Short-chain menaquinone with a half-life of hours. A 420 mcg oral dose was not detectable in serum in Sato 2012, so it requires milligram doses taken several times daily. | Long-chain menaquinone, well absorbed with fat and carried in LDL. Half-life of about 3 days (Schurgers 2007) produces stable blood levels with once-daily microgram doses. |
| Typical dose | 45 mg daily in divided doses (Japanese osteoporosis regimen) | 90-180 mcg daily |
| Common uses | osteoporosis (approved drug in Japan) | bone health, paired with vitamin D3 |
| Side effects | Interacts with warfarin. | Even low doses can disturb warfarin anticoagulation; avoid unless the prescriber agrees and INR is monitored. |
| Cost | Moderate | Moderate |
| Also called | menatetrenone, MK-4 | menaquinone-7, MenaQ7 |
| Labels in index | 97 | 734 |
When to Choose Vitamin K2 as MK-4 (Menatetrenone)
Choose vitamin K2 MK-4 when a clinician uses the high-dose Japanese osteoporosis protocol. The body also converts K1 to MK-4 in tissues.
Vitamin K2 as MK-4 (Menatetrenone)
At microgram doses it barely registers in serum. At the 45 mg Japanese dose it is a drug, not a supplement.
What to look for: Skip low-dose MK-4 products. The milligram regimen belongs under medical supervision.
Find on iHerb Affiliate linkWhen to Choose Vitamin K2 as MK-7
Choose vitamin K2 MK-7 when you want once-daily microgram dosing with stable blood levels. Naturally abundant in natto. Outcome evidence for fracture and arterial calcification is mixed.
Vitamin K2 as MK-7
Long half-life, and the form used in the Dutch bone and artery-stiffness trials. Fracture benefit is unproven.
What to look for: 90-180 mcg all-trans MK-7 (MenaQ7 is the trial raw material). Not with warfarin unless the prescriber agrees.
Find on iHerb Affiliate linkProducts on Titrate
In Titrate's index of NIH label data, 97 labels named as vitamin K2 products list vitamin K2 MK-4 and 734 list vitamin K2 MK-7.
Vitamin K2 does not have its own search category yet. Each product above links to its full label in the NIH database.
Related
References
NIH Office of Dietary Supplements. Vitamin K: Fact Sheet for Health Professionals.
Geleijnse JM, et al. Dietary intake of menaquinone is associated with a reduced risk of coronary heart disease: the Rotterdam Study. J Nutr. 2004;134(11):3100-3105.
Cockayne S, et al. Vitamin K and the prevention of fractures: systematic review and meta-analysis of randomized controlled trials. Arch Intern Med. 2006;166(12):1256-1261.
Schurgers LJ, et al. Vitamin K-containing dietary supplements: comparison of synthetic vitamin K1 and natto-derived menaquinone-7. Blood. 2007;109(8):3279-3283.
Sato T, et al. Comparison of menaquinone-4 and menaquinone-7 bioavailability in healthy women. Nutr J. 2012;11:93.
Theuwissen E, et al. Effect of low-dose supplements of menaquinone-7 (vitamin K2) on the stability of oral anticoagulant treatment: dose-response relationship in healthy volunteers. J Thromb Haemost. 2013;11(6):1085-1092.
Knapen MH, et al. Three-year low-dose menaquinone-7 supplementation helps decrease bone loss in healthy postmenopausal women. Osteoporos Int. 2013;24(9):2499-2507.
Diederichsen ACP, et al. Vitamin K2 and D in Patients With Aortic Valve Calcification: A Randomized Double-Blinded Clinical Trial. Circulation. 2022;145(18):1387-1397.