Vitamin K Deficiency

Vitamin K Deficiency - General Information

Vitamins are a group of organic substances that help the body to function properly and are required in small amounts in diets of both animals and humans. If they are absent, a deficiency occurs which in turn causes poor mental, physical and psychological growth and other syndromes. Thirteen vitamins are known -Vitamin A, B (a group), C, D, E, and K.

Vitamin K is an anti-hemorrhagic and a fat-soluble vitamin, occurring in two main forms (1) plant origin (phyto-menadione or phylloquinone), and (2) animal origin (menaquinone). Its Chemical Name is Naphthoquinone and is a part of proteases that helps in blood clotting; controls internal bleeding and heavy menstrual flow. It also prevents the hardening of the arteries and other soft tissue, strengthens bone tissue and health and reduces bone fractures; reduces morning sickness in pregnant women. When the levels of K vitamin within the human body fall under a certain value we’re facing a Vitamin K Deficiency.

It exists in several forms like Vitamin K1 (phylloquinone) which comes from green plants; vitamin K2 (menaquinone) from the intestinal bacteria and the menadione (vitamin K3). Thus, it requires bile salts for absorption and is stored in the body. It has been used with oral antibiotics to prevent bleeding in newborns; jaundice, sprue and for anticoagulant therapy. It is required for the synthesis of Prothrombin, Stuart factor, Christmas factor, serum prothrombin conversion accelerator, and the liver.

Vitamin K is found in leafy vegetables, some vegetable oils (soya oil), tomatoes, egg yolks, liver, Cabbage, spinach, broccoli, lettuce, soybeans, meats, cow milk, fruits, and some fermented Asian food. Moreover, it is also produced by the intestinal bacteria (gut bacterial that produces the maximum supply).

Vitamin K Deficiency - Symptoms

Deficiency of vitamins can be a primary one (improper diet with insufficient vitamins); or a secondary one (body’s disorder that interfere with the vitamins functioning). Therefore, having a proper diet eliminates the chances of a vitamin deficiency occurring (including the Vitamin K Deficiency). Vitamins need to be consumed regularly as they are not stored in the human body. Vitamin K deficiency though rarely due to dietary intake, occurs as the bacteria of the intestine (known as the gut flora) produces insufficient vitamin K.

However, Vitamin K deficiency can occur: (1) insufficient intake of vitamin K, which causes spontaneous or prolonged or excessive bleeding even through a small cut; (2) in newborns having hemorrhagic disease; (3) people taking certain antibiotics treatment (coumarin therapy) and (4) people having liver damage or improper absorption of the vitamin by the intestine. Therefore, when the diet and the failure of intestine bacteria to produce occur, the Vitamin K levels goes down causing a Vitamin K deficiency. Since, this deficiency affects prothrombin which is a protein for blood-clotting; thus causing bleeding. It also causes loss of minerals in the bone (physical problems) and arteries clog up (heart problems).

Other symptoms are one gets bruised easily, epistaxis, internal (intestinal) bleeding, menorrhagia and hematuria, excessive hemorrhage and bleeding. A symptom called bleeding diathesis, wherein one is vulnerable to bleeding due to the lack of clotting which is due to lack of the calcium as bones lose their strength. This can be mild or even fatal and can be Leukemia, Scurvy, von Willebrand Disease, Hemophilia, Glanzmann thrombasthenia and Bernard-Soulier syndrome

Vitamin K Deficiency - Treatment

Vitamin treatment is important and is done when the deficiency is found (primary reason), next is to prevent any occurrence of a deficiency and the last is to ensure that no diseases occur especially when unable to detect the vitamin deficiency. It is important for people having diseases that can harm or destroy the vitamins’ functioning and therefore, require higher doses. Treatment can be done via a proper diet with the RDA of vitamin K, oral supplements for those not having proper intake of natural sources of vitamin K and injections for people with diseases that prevent the absorption of the fat-soluble vitamins.

The Vitamin K recommended dietary allowance (RDA) for adults is 70-140 mg/day with 80 mg/day for males, 65 mg/day for females and 5 mg/day for newborns. The general treatment recommended is phytonadione (brand name - Mephyton®) to be given as per the person and diagnosis. The dose for adults is 5-20 mg in crucial cases and 2.5-10 mg in non-emergency cases. The Vitamin K levels usually correct themselves within 6 to 12 hours during which time; the dosage needs to be gradually reduced. Even a lower dosage of 1-2.5 mg can be given. The same can be use to treat bleeding in infants with the dosage 1 mg sc or IM once. If the levels do not stabilize, then dosage needs to be increased in all above cases.

Generally newborns are treated using a single injection of phylloquinone (5 mg); while adults having a deficiency of vitamin K require daily doses of 10 mg phylloquinone for 7 days. Vitamin supplements though available should not be taken without the consultation of the doctor as an overdose is dangerous. Supplements of Vitamin K are available in Oral, Topical, Synthetic and injectable forms, but need to be taken only if prescribed as an overdose can cause flushing, sweating, jaundice and anemia. Injections can be obtained only on prescription as their usage and quantity of vitamin K to inject is very crucial and can cause complications if used wrongly. They are generally in the form of phytonadione being the most effective and its toxicity is lower than other types.

There are various drugs, like the Phytonadione, Vitamin K1 being sold under Brand names: Mephyton®, AquaMEPHYTON®. Others include Phytonadione, Vitamin K1 injection and Phytonadione, Vitamin K1 tablets. Before taking any medication, please inform the doctor if you have any liver disease, is pregnant or is breast-feeding or going for any operation; and any kind of allergies. The allergic reactions can be nausea, rash, flushed skin, rash, and itching. You should also check out the medicines you are already taking with the physician as they can interact with the Vitamin E. Moreover, you may need to reduce or stop smoking, drinking caffeine/alcohol or any kind of drugs as they can also interact.

Side effects can include difficulty breathing, dizziness, palpitations, changes in taste, swelling or pain at the site of injection area; flushing of the face. Moreover, infants can suffer from hemolytic, anemia (high bilirubin levels) which requires immediate attention as it can cause liver or brain damage. Medications that can interfere with the functioning or the absorption of the Vitamin K are the antacids, anticoagulants (Warfarin), Sucralfate, dactinomycin; drugs control cholesterol levels (colestipol and cholestyramine). Others can include anticonvulsants, antibiotics, and medications used to treat skin infections; mineral oils and many more. Therefore, you need to be very careful before taking any Vitamin K supplements.