What are the implications of elevated liver enzymes, specifically Vitamin K2 (Vitamin K2), on liver function?

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Last updated: March 19, 2025View editorial policy

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From the Guidelines

Vitamin K2 supplementation is not directly implicated in reducing elevated liver enzymes, but rather, addressing underlying vitamin K deficiency, particularly in patients with cholestatic liver disease, is crucial for maintaining proper blood clotting and bone health, as evidenced by the most recent study 1. When considering the implications of elevated liver enzymes on liver function, it is essential to address the underlying causes of liver disease, such as alcohol consumption, obesity, viral hepatitis, or medication side effects. The most recent study 1 highlights the importance of assessing vitamin K status, particularly in patients with cholestatic liver disease, as vitamin K deficiency can lead to coagulopathy. Key points to consider:

  • Vitamin K2 (MK-7) supplementation may be beneficial for patients with vitamin K deficiency, but its direct impact on reducing elevated liver enzymes is not well-established 1.
  • Patients with cholestatic liver disease are at risk of vitamin K deficiency and may require parenteral supplementation 1.
  • Lifestyle modifications, including weight management, limiting alcohol, regular exercise, and a balanced diet, are crucial for improving liver health and should be prioritized alongside any supplementation regimen.
  • The measurement of PIVKA-II (protein induced by vitamin K absence or antagonism-II) is a sensitive biomarker of hepatic subclinical vitamin K deficiency, and concentrations <0.15 mg/L are indicative of vitamin K1 depletion/deficiency 1.
  • Patients taking blood thinners like warfarin should consult their doctor before taking K2 supplements, as it may interfere with these medications.

From the Research

Implications of Elevated Liver Enzymes and Vitamin K2 on Liver Function

  • The relationship between elevated liver enzymes and Vitamin K2 is not directly addressed in the provided studies, but the role of Vitamin K in liver function is explored 2, 3, 4.
  • Vitamin K is essential for the posttranslational modification of liver precursors of prothrombin and other blood coagulation factors, and its deficiency can lead to coagulopathy 4.
  • The administration of Vitamin K1 does not seem to improve coagulation parameters in patients with liver disease, suggesting that Vitamin K therapy may not be routinely indicated in these patients 3.
  • Elevated liver enzymes can have various causes, including rheumatic disease, anti-rheumatic medication, and associated autoimmune diseases 5.
  • The prevalence of abnormal plasma liver enzymes is high in older people with Type 2 diabetes, with 29.1% of patients having one or more plasma liver enzymes above the upper limit of the normal reference range 6.
  • Vitamin K2, in the form of MK-7, has been shown to regulate osteoporosis, atherosclerosis, cancer, and inflammatory diseases without risk of negative side effects or overdosing 2.

Vitamin K2 and Liver Function

  • Vitamin K2 acts as a cofactor for the enzyme gamma-glutamylcarboxylase, which is involved in the carboxylation of glutamic acid residues in proteins, including those involved in blood coagulation and bone metabolism 2.
  • The difference in structure between Vitamin K1 and K2 affects their absorption rates, tissue distribution, and bioavailability, which may impact their role in liver function 2.

Elevated Liver Enzymes

  • Elevated liver enzymes can be caused by various factors, including liver disease, medication, and associated autoimmune diseases 5, 6.
  • The prevalence and distribution of abnormal plasma liver enzymes can vary depending on the population and underlying conditions, such as Type 2 diabetes 6.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

The coagulopathy of liver disease: does vitamin K help?

Blood coagulation & fibrinolysis : an international journal in haemostasis and thrombosis, 2013

Research

Prevalence of abnormal plasma liver enzymes in older people with Type 2 diabetes.

Diabetic medicine : a journal of the British Diabetic Association, 2012

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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