From the Guidelines
Low vitamin K1 and slightly low vitamin E gamma tocopherol levels are typically caused by inadequate dietary intake, malabsorption disorders, certain medications, and liver disease, with fat malabsorption, long-term antibiotic use, and liver disease being specific contributors to vitamin K deficiency, as noted in the espen-espghan-ecfs guidelines on nutrition care for infants, children, and adults with cystic fibrosis 1. To address these deficiencies, it is essential to increase consumption of leafy green vegetables like kale, spinach, and collard greens for vitamin K1, and consume nuts, seeds, and vegetable oils for gamma tocopherol. Some key points to consider include:
- Malabsorption conditions such as celiac disease, Crohn's disease, ulcerative colitis, and cystic fibrosis can prevent proper absorption of these fat-soluble vitamins.
- Medications including antibiotics, blood thinners like warfarin, cholesterol-lowering drugs, and certain seizure medications can interfere with vitamin K levels or absorption.
- Liver disease affects vitamin storage and metabolism since these fat-soluble vitamins require bile for absorption.
- Chronic alcohol consumption can also deplete these vitamins. If dietary changes don't improve levels, supplementation may be necessary, with the espen-espghan-ecfs guidelines suggesting regular supplementation of vitamin K1 at 0.3-1.0 mg/day for infants and 1-10 mg/day for older children and adults 1, and vitamin E (alpha-tocopherol) to maintain serum alpha-tocopherol levels in the normal range 1. It is crucial to consult a healthcare provider before starting any supplementation, especially if you're taking blood thinners or have underlying health conditions, to determine the best course of action and ensure safe and effective management of these deficiencies 1.
From the Research
Causes of Low Vitamin K1 and Slightly Low Vitamin E Gamma Tocopherol
- Low vitamin K1 levels may be linked to inadequate dietary intake, as there is a lack of comprehensive vitamin K database on individual foods, making it difficult to accurately calculate vitamin K1 intake 2.
- Vitamin K insufficiency and deficiency have been linked to vascular calcification, a marker of advanced atherosclerosis, highlighting the importance of adequate vitamin K intake for cardiovascular health 2.
- Slightly low vitamin E gamma tocopherol levels may be due to various factors, including:
- High intake of polyunsaturated fatty acids (PUFAs), which can increase the requirement for vitamin E 3.
- Inadequate dietary intake of gamma tocopherol, which is the major form of vitamin E in many plant seeds and in the US diet 4, 5.
- Malabsorption or metabolic disorders, such as celiac disease, which can lead to deficiencies in fat-soluble vitamins, including vitamin E 6.
- The relationship between vitamin E intake and consumption of highly unsaturated fatty acids is not well established, and further studies are required to determine the optimal vitamin E requirement in these cases 3.