- Vitamin K Deficiency: Practice Essentials, Physiology, Etiology
- Do You Get Enough Vitamin K?
- Vitamin K Deficiency – Symptoms, Causes and Best Sources
- How do We Get this Vitamin – The Best Natural Sources
- Vitamin K Benefits
- Dietary Supplements
- Vitamin K2 Deficiency Symptoms
- Vitamin K2 deficiency can cause following health conditions:
- Vitamin K Deficiency Risk Groups
- Vitamin K – Required Amounts and Availability
- Learn signs of vitamin K deficiency | Ada
- Vitamin K deficiency symptoms
- Symptoms of vitamin K deficiency in infants
- Vitamin K deficiency bleeding (DB)
- Risk factors for DB
- Prevention and treatment of DB in infants
- Vitamin K deficiency causes and risk factors
- Vitamin K deficiency diagnosis
- Vitamin K deficiency prevention
- Vitamin K deficiency treatment
- Vitamin K deficiency FAQs
- Other terms associated with vitamin K deficiency
- What is Vitamin K Deficiency Bleeding? | CDC
- What is Vitamin K Deficiency Bleeding or DB?
- Why are babies more ly to have vitamin K deficiency and to get DB?
- What can I do to prevent my baby from getting vitamin K deficiency and DB?
- Is the Vitamin K shot safe?
- What might cause babies to be deficient in vitamin K and have bleeding problems?
- How often are babies affected with vitamin K deficiency bleeding?
- What things should I look for in my baby if I think he or she might have DB?
- Vitamin K deficiency: Causes and symptoms
Vitamin K Deficiency: Practice Essentials, Physiology, Etiology
In infants, the low transmission of vitamin K () across the placenta, liver prematurity with prothrombin synthesis, lack of in breast milk, and the sterile gut in neonates account for deficiency. [2, 3, 4, 15] Neonatal diseases that cause cholestasis can result in deficiency.  Parental refusal of prophylaxis at childbirth can result in bleeding sequela. 
In adults, the causes of deficiency include the following [15, 16] :
- Multiple abdominal surgeries
- Long-term parenteral nutrition
- Parenchymal liver disease
- Inflammatory bowel disease
- Drugs – Antibiotics (cephalosporin), cholestyramines, warfarin, salicylates, anticonvulsants, and certain sulfa drugs) are some of the common causes of deficiency
- Disseminated intravascular coagulation (DIC) – Severe
- Chronic kidney disease/hemodialysis 
The synthesis of -dependent factors are decreased by parenchymal liver diseases, such as cirrhosis secondary to viral hepatitis, alcohol intake, and other infiltrative diseases; hepatic malignancy; amyloidosis; Gaucher disease; and alpha-1 antitrypsin deficiency. Therefore, supplementation with is not effective unless a patient has severe bleeding and fresh frozen plasma is administered in addition to correcting the coagulopathy.
Malabsorption syndrome affects absorption in the ileum. Celiac sprue, tropical sprue, Crohn disease, ulcerative colitis, Ascaris infection, bacterial overgrowth, chronic pancreatitis, and short bowel syndrome resulting from multiple abdominal surgeries can result in poor absorption of (which can be corrected with supplementation). 
Cystic fibrosis patients who have pancreatic insufficiency, excessive or chronic antibiotic usage, or short bowel due to intestinal resection are at increased risk for vitamin K deficiency due to malabsorption. 
Biliary diseases, such as common duct obstruction due to stones and strictures, primary biliary cirrhosis, cholangiocarcinoma, and chronic cholestasis, cause maldigestion of fat. The decrease in fat absorption leads to a deficiency of fat-soluble vitamins, such as .  In addition, surgery and T-tube drainage of the bile duct can lead to a -deficient state.
Dietary deficiency occurs in people with malnutrition, alcoholics, and patients undergoing long-term parenteral nutrition without supplements. A large amount of vitamin E can antagonize and prolong the prothrombin time (PT).
Various drugs, such as cholestyramine, bind to bile acids, thus preventing fat-soluble vitamin absorption. Warfarin blocks the effect of epoxide reductase and reductase, thereby inducing an intracellular deficiency.
Cefamandole, cefoperazone, salicylates, hydantoins, rifampin, isoniazid, and barbiturates are some of the common drugs that are associated with deficiency, but their mechanism of action in this condition is unknown.
Because 2 main sources of exist, neither dietary deficiency nor gut sterilization produces significant coagulopathy in a healthy person.
Do You Get Enough Vitamin K?
- All About Vitamin K
- Tips for Taking Blood Thinners
Vitamin K plays a key role in helping the blood clot, preventing excessive bleeding. Un many other vitamins, vitamin K is not typically used as a dietary supplement.
Vitamin K is actually a group of compounds. The most important of these compounds appears to be vitamin K1 and vitamin K2. Vitamin K1 is obtained from leafy greens and some other vegetables. Vitamin K2 is a group of compounds largely obtained from meats, cheeses, and eggs, and synthesized by bacteria.
Vitamin K1 is the main form of vitamin K supplement available in the U.S.
Recently, some people have looked to vitamin K2 to treat osteoporosis and steroid-induced bone loss, but the research is conflicting. At this point there is not enough data to recommend using vitamin K2 for osteoporosis.
Low levels of vitamin K can raise the risk of uncontrolled bleeding. While vitamin K deficiencies are rare in adults, they are very common in newborn infants. A single injection of vitamin K for newborns is standard. Vitamin K is also used to counteract an overdose of the blood thinner Coumadin.
While vitamin K deficiencies are uncommon, you may be at higher risk if you:
- Have a disease that affects absorption in the digestive tract, such as Crohn's disease or active celiac disease
- Take drugs that interfere with vitamin K absorption
- Are severely malnourished
- Drink alcohol heavily
In these cases, a health care provider might suggest vitamin K supplements.
Uses of vitamin K for cancer, for the symptoms of morning sickness, for the removal of spider veins, and for other conditions are unproven.
The recommended adequate intake of vitamin K you take in, both from food and other sources is below. Most people get enough vitamin K from their diets.
|Children 0-6 months||2 micrograms/day|
|Children 7-12 months||2.5 micrograms/day|
|Children 1-3||30 micrograms/day|
|Children 4-8||55 micrograms/day|
|Children 9-13||60 micrograms/day|
|Girls 14-18||75 micrograms/day|
|Women 19 and up||90 micrograms/day|
|Women, pregnant or breastfeeding (19-50)||90 micrograms/day|
|Women, pregnant or breastfeeding (under 19)||75 micrograms/day|
|Boys 14-18||75 micrograms/day|
|Men 19 and up||120 micrograms/day|
There have been no adverse effects of vitamin K seen with the levels found in food or supplements. However, this does not rule out danger with high dose. Researchers have not set a maximum safe dose.
Good natural food sources of vitamin K include:
- Vegetables spinach, asparagus, and broccoli
- Legumes green beans
You can also meet your daily requirement with foods that have lesser amounts of vitamin K:
- Meat liver
Side effects of oral vitamin K at recommended doses are rare.
Interactions. Many drugs can interfere with the effects of vitamin K. They include antacids, blood thinners, antibiotics, aspirin, and drugs for cancer, seizures, high cholesterol, and other conditions.
Risks. You should not use vitamin K supplements unless your health care provider tells you to. People using Coumadin for heart problems, clotting disorders, or other conditions may need to watch their diets closely to control the amount of vitamin K they take in. They should not use vitamin K supplements unless advised to do so by their health care provider.
Longe, J., ed. The Gale Encyclopedia of Alternative Medicine, second edition, 2004. Natural Standard Patient Monograph: “Vitamin K.” Office of Dietary Supplements: “Important information to know when you are taking Coumadin and Vitamin K.”
Vermeer, C. Hematology/Oncology Clinics of North America, 2000.
National Academies Press: “Dietary Reference Intakes for Vitamin A, Vitamin K, Arsenic, Boron, Chromium, Copper, Iodine, Iron, Manganese, Molybdenum, Nickel, Silicon, Vanadium, and Zinc,” 2002.
Shiraki, M. Journal of Bone and Mineral Research, 2000.
Cockayne, S. Archives of Internal Medicine, 2006.
Tamura, T. Archives of Internal Medicine, 2007.
© 2018 WebMD, LLC. All rights reserved. Tips for Taking Blood Thinners
Vitamin K Deficiency – Symptoms, Causes and Best Sources
Vitamin K refers to a group of structurally similar, fat-soluble vitamins that the body needs to produce a protein (prothrombin), which promotes blood clotting and regulates bone metabolism. In other words, it produces the necessary components without which the blood coagulation process would not work. Vitamin K naturally occurs in two forms:
- K1 or phylloquinone is mostly found in plant foods and occurs naturally in dark leafy green vegetables. However, the body has difficulty absorbing K1 from plant foods, because it is fat-soluble substance. That is why eating dietary fats, such as plant oils butter, may enhance the body’s absorption of K1 from plants.
- K2 or menaquinone is present in meat, dairy products and fermented foods. About 1/5 of necessary K vitamin levels we get from menaquinone. Our gut bacteria also produce K2, it can synthesize K1 into K2.
The body needs vitamin K for the carboxylation of glutamic acid (Gla), in other words for carbon binding. The presence of Gla in certain proteins also allows binding of calcium. Bone tissue consists several Gla-containing proteins, some of which play an important role in the regulation of bone growth and mineral deposition, but also in the elasticity of soft tissues.
Recent clinical studies have shown that taking vitamin K2 supplement could help reduce the bone loss that women suffer with age and could also improve cardiovascular health through the reduction of arterial stiffness.
Even more, taking vitamin K2 supplements could also help prevent the loss of elasticity in the skin and reduce varicose veins. That`s why it is nature’s unacknowledged anti-ageing supplement.
How do We Get this Vitamin – The Best Natural Sources
Our body absorbs vitamin K from the small intestine, after that it is transported to the lymph.
The lymphatic system stores it in the liver, but also in bone tissue, adipose tissue, the pancreas and the heart.
When looking at the supply of various fat soluble vitamins in the body, the total supply of vitamin K is quite modest. This is primarily due to the rapid effect of phylloquinone synthesis.
Therefore, it is very important to ensure a steady supply of this vitamin. As even a short period without the necessary sources will cause a rapid drain in your body vitamin stocks. Health problems such as poor absorption of fats directly affects the absorption of vitamin K, because without dietary fats, it cannot absorb properly.
The bioavailability of phylloquinone as the main synthesizer of vitamin K in food is approximately 1/10. Meaning, it is very low compared to the phylloquinone bioavailability in dietary supplements.
- The main sources of phylloquinones (K1) are dark green leafy vegetables, vegetable oils and fats. Also foods such as parsley and other herbs, nettle, Brussels sprouts, spinach, wheat germ, cauliflower, broccoli, rapeseed oil, cabbage, wheat bran, potatoes, oats and corn.
- Your body obtains menaquinones (K2) mainly from animal products such as meat and liver, soybean meals, egg yolk, fermented foods such as sauerkraut and dairy products.
Vitamin K Benefits
- Bones. Vitamin K is associated with bone mineralization, meaning that bone density maintains its normal state better when consuming adequate amounts of this vitamin. So it promotes healthy bone mineral density by carboxylation of osteocalcin, a protein that binds calcium to bones. It has also been found beneficial to combine this vitamin with calcium and vitamin D, which results in improved bone density.
- Heart. Vitamin K affects also your heart health, especially in terms of preventing heart conditions, lowering the risk of cardiovascular damage and improve overall health of the heart. It is inevitable that in old age calcification of the blood vessels can happen, which makes blood vessels less elastic and narrow. This can eventually lead to ischemic heart disease. Vitamin K has an indirect positive effect on the coronary arteries of the heart. Coronary arteries directly supply the heart with nutrients.
- Cancer. Several experiments have shown that due to its antioxidant properties, vitamin K2 also has some anti-cancer effects. In addition, findings suggest that K2 may suppress genetic processes that lead to tumor growth.
- Diabetes. Maintaining a normal level of vitamin K can also alleviate inflammation and positively influence insulin regulation, thus helping prevent diabetes.
- Anxiety & depression. High blood glucose levels may increase a person’s risk of developing anxiety, depression, and cognitive impairment. According to a 2016 study which investigated the effects of vitamin K2 in rats, after 10 weeks treatment with vitamin K had normalized blood glucose and reduced symptoms of anxiety and depression.
- Elasticity. Helps to prevent the loss of elasticity in the skin and helps to reduce varicose veins.
According to a 2019 review, research suggests that the body absorbs 10 times more vitamin K2, in the form of MK-7, than vitamin K1. It has been found, that vitamin K from menaquinones, in particular all-trans MK-7, will give the best results. The MK-7 is preferred over both – phylloquinones and other menaquinones (such as MK-4), mainly because of its longer duration of action.
Therefore, the same amount will, at substantially the same time, do more work, thus having a much greater efficacy at the usual dose. It is important that, for example, before taking MK-7 supplements, you should determine that it is an all trans variant. This is what indicates that it is a bioactive product for example Ecosh Vitamin K2+D3+Ca+Mg.
Vitamin K2 Deficiency Symptoms
The first symptom of vitamin K deficiency is bleeding. It is especially dangerous for newborns, as they may have intracranial bleeding due to a deficiency of this vitamin.
The main risk of suffering from deficiency is due to inadequate absorption of this vitamin because of the use of antibiotics, blood thinners and parenteral nutrition.
Your daily diet can also be the cause of insufficient absorption. Because the absorption directly depends on the amount of consumed fats, so if your diet does not consist enough fats, vitamin K cannot absorb. At the same time, the fact that some persons cannot break down fats, can influence the absorption. For example, this can occur in case of removed bile.
Vitamin K2 deficiency can cause following health conditions:
- blood clotting problems;
- more prone to bruising and bleeding;
- increased risk of hemorrhage;
- inadequate bone mineralization, which can lead to osteoporosis.
Vitamin K Deficiency Risk Groups
- People with certain gastrointestinal disorders, such as ulcerative colitis, celiac disease or removed bile.
- People who take long courses of antibiotics, as antibiotics can kill the gut bacteria that produce vitamin K.
- Persons who take cholesterol-lowering medications, as some of these medications can also interfere with the body’s ability to absorb this vitamin.
- People who take blood thinners, such as warfarin, because it can interact dangerously with the vitamin.
It is extremely important for people taking these medications to consume the same amount of dietary vitamin K supplements each day. Also, it is vital to speak to a doctor before taking supplements or making any dietary changes.
Vitamin K – Required Amounts and Availability
There is no consensus on how much vitamin K should be consumed, because it is almost impossible to achieve clinical deficiency symptoms with poor nutrition. However, the estimated daily requirement is about 75µg. Our own microbiome also produces vitamin K2, but it is certainly not enough to maintain normal levels.
The recommended daily intake, regardless of age, is 1 µg / kg body weight.
The average amount of vitamin K in breast milk is 2.5 µg / l. However, this is too low, so newborns will get prophylactic injections of this vitamin to prevent both – brain and other bleeding.
In case of taking naturally sourced vitamin K, there has not yet been found upper limit or toxic amount, but that does not mean that it may not be. Therefore, you should not over-consume the recommended amount on your own initiative. However, the synthetic version of this vitamin can have a negative effect on the liver and hematopoiesis.
For conclusion, if you do not have a varied diet, it is worth to take vitamin K2 dietary supplements.
Edited by Ecosh: Maria-Helena Loik
Pictures: Pexels.com, Pixabay.com
Vitamin K2 [K2+D3+Ca+Mg]
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Learn signs of vitamin K deficiency | Ada
Vitamin K is an essential fat-soluble vitamin which is important to bone and heart health, as well as blood clotting and brain function. A deficiency of vitamin K is rare in healthy adults due to its presence in a variety of common dietary sources, including green leafy vegetables, oils and grains.
While newborn babies are particularly at risk, people of any age can develop a vitamin K deficiency, which may be triggered by a number of factors, including liver disease, malnutrition and as a consequence of taking certain prescription drugs.
Vitamin K deficiency is quite rare in infants today, because vitamin K prophylaxis is routinely given to babies at birth in many parts of the world. The deficiency is more common in infants who are completely breastfed, as baby milk formula generally contains supplementary vitamin K.
The main symptoms of a vitamin K deficiency include bruising easily and excess bleeding.
A nutritionally balanced diet is normally sufficient to prevent vitamin K deficiency. If a deficiency of vitamin K does develop, it can usually be treated effectively if detected early.
Vitamin K deficiency symptoms
Signs and symptoms of a vitamin K deficiency include:
- Excessive bleeding, e.g. from a cut, wound, injection or puncture
- Easy bruising
- Heavy menstrual bleeding
If you think that you or a loved one might have signs of vitamin K deficiency, try using the Ada app to find out more about your symptoms.
Symptoms of vitamin K deficiency in infants
Infants are at an increased risk of developing a vitamin K deficiency until they begin to eat regular foods, which will usually be around four to six months after birth.
Signs and symptoms that could indicate vitamin K deficiency in babies include:
- Bruising, especially around the head or face
- Bleeding episodes, e.g. around the belly button, nose and mouth, penis if circumcised and at vaccination sites
- Paleness, which may be noticeable in the gums of darker-skinned infants
- Yellowing of the skin and eyes, occurring three or more weeks after birth, distinct from newborn jaundice, which typically clears by the time the baby is two weeks old
- Stool that is bloody, dark or sticky tar
- Blood in the urine or vomit
- Excessive tiredness or sleepiness
Good to know: If any of these signs and symptoms occur or there is any suspicion of a vitamin K deficiency, urgent medical attention should be sought.
Vitamin K deficiency bleeding (DB)
Infants with a vitamin K deficiency are susceptible to vitamin K deficiency bleeding (DB), also known as hemorrhagic disease of the newborn, a rare condition which stems from the blood being unable to clot.
The bleeding can occur anywhere in the body, including internally, for example in the gastrointestinal tract, and brain. Bleeding into the brain is particularly common with late-onset DB.
If bleeding is internal, it can be extremely difficult to notice and may lead to serious complications and even death. Signs are not always obvious and may be mistaken for other conditions.
DB is classified as one of three types according to when it develops:
- Early-onset DB, which develops within 24 hours of the infant being born
- Classic-onset DB, which develops within 2-7 days of the infant being born
- Late-onset DB, which develops between two weeks and six months after birth, most commonly in babies who have not been given a vitamin K shot
In addition to the symptoms listed above, signs of DB in babies may include:
- Poor feeding
- Low weight or difficulty gaining weight
Good to know: Brain bleeds may cause seizures and frequent vomiting in a baby. There may also be a lump on the head that was not there before.
If any unusual symptoms are present or vitamin K deficiency is suspected, a medical professional should be contacted immediately.
To help prevent DB and other potential complications of low vitamin K levels, vitamin K is routinely given by injection or orally to all infants at birth, in many parts of the world.
Risk factors for DB
Factors that increase an infant’s chances of developing DB include:
- Breastfeeding. Children who are exclusively breastfed are roughly 20 times more ly to experience DB. This is due to the low levels of vitamin K in breast milk compared to formula milk, as well as the low levels of bacteria that help the body synthesize vitamin K. However, breastfeeding has many other benefits, and concern about vitamin K deficiency is no reason not to do it, as the routine administration of vitamin K to newborns significantly reduces the risk of DB.
- Pharmaceuticals. Certain medication taken by the mother can increase the chances of an infant developing DB. These include rifampicin, isoniazid, anticoagulants and anticonvulsant agents.
- Warm environments. Extended exposure to a warm environment can make late-developing DB more ly. Late-developing DB usually peaks at around 3-8 weeks.
- Liver disease. There is increased risk if an infant has an unsuspected liver disease, especially alpha-1-antitrypsin deficiency.
- Malabsorption. An inability to absorb vitamins due to factors and conditions such as cystic fibrosis, celiac disease and long-lasting diarrhea.
Prevention and treatment of DB in infants
A vitamin K supplement should be given to the infant as soon as DB is suspected. In severe cases, fresh frozen plasma, a blood product containing coagulating properties, may also be administered. If an infant has lost a large amount of blood, a blood transfusion may also be necessary.
To help prevent DB from occurring, a vitamin K supplement in the form of phytonadione is routinely given, with parental permission, to infants after birth in many parts of the world, including the United States and United Kingdom. It is sometimes called “the vitamin K shot”, but may be administered orally. The procedure is considered safe by healthcare professionals.
Vitamin K deficiency causes and risk factors
A vitamin K deficiency can occur in people of any age, but newborn infants are particularly at risk. Vitamin K deficiency is most ly to result from a lack of vitamin K reaching the fetus before birth and the lack of vitamin K in breast milk.
Other risk factors for a vitamin K deficiency include:
- Liver disease
- Conditions that affect the body’s ability to absorb vitamin K, such as celiac disease, Crohn’s disease and tropical sprue
- Biliary tract disease
- Certain drugs, such as coumarin anticoagulants, cholestyramine, salicylates, rifampin and barbiturates
It should be emphasized that a vitamin K deficiency in healthy adults is rare due to the vitamin’s presence in a variety of food sources, notably green leafy vegetables, oils and grains.
Vitamin K deficiency diagnosis
Diagnosing a deficiency of vitamin K will typically begin with a physical examination by a doctor.
If a deficiency is suspected, the next stage of diagnosis will normally be blood tests. A blood test can reveal the level of prothrombin, a clotting agent in the blood, which will be lower than average in the case of a vitamin K deficiency.
However, as low levels of prothrombin can also be symptomatic of other conditions, the diagnosis will generally be confirmed with a vitamin K injection. If symptoms subside following the injection, the diagnosis of vitamin K deficiency can be confirmed.
If you think that you or a loved one might have a vitamin K deficiency, start a free symptom assessment using the Ada app.
Vitamin K deficiency prevention
Most healthy adults are able to prevent a deficiency of vitamin K by maintaining a diet containing foodstuffs which are rich in the vitamin, such as:
- Green leafy vegetables, such as kale, chard, watercress and spinach
- Oils, such as olive, cottonseed and soya bean
- Grains, such as rye grain, spelt and buckwheat
In some cases, a vitamin K supplement may be recommended for those at risk of developing a vitamin K deficiency.
Vitamin K deficiency treatment
The appropriate treatment method for a vitamin K deficiency depends on the severity of the condition, particularly the severity of the associated bleeding, and its underlying cause.
If bleeding reaches life-threatening levels, fresh frozen plasma will be administered. In other cases, or after fresh frozen plasma has been administered, a vitamin K supplement will be administered to the person, usually intravenously or into the muscle.
Vitamin K deficiency FAQs
Q: What does vitamin K do?
A: Vitamin K plays an important role in keeping the bones, heart and brain healthy. It is also essential for normal blood clotting, known as coagulation; low levels of vitamin K can cause a person to bleed excessively. For this reason, it is sometimes called “the blood clotting vitamin”.
Q: What is the most common cause of vitamin K deficiency?
A: Vitamin K deficiency is most ly to occur in newborn infants, as a result of low levels of the vitamin being transferred from the mother to the baby during pregnancy, naturally low levels in breast milk, and the baby’s body experiencing difficulty making the vitamin on its own.
However, most newborns are given a vitamin K supplement after birth to avoid complications. Vitamin K deficiency is rare in adults, but can be caused by malnutrition, certain prescription medication and conditions that lead to malabsorption. For more information, see the section on causes above.
Q: Why is vitamin K deficiency rare in adults?
A: Low levels of vitamin K are rare in healthy adults because it is easy to obtain sufficient quantities of the vitamin by eating a balanced diet, and the body is able to produce some vitamin K on its own.
Q: What foods are high in vitamin K?
A: Examples of good sources of vitamin K include:
- Green leafy vegetables spinach, kale and lettuce
- Other vegetables brussels sprouts, cabbage and broccoli
Q: Does vitamin K deficiency cause bruising?
A: Vitamin K deficiency can cause a person to bruise easily. However, there may be other causes of bruising. Vitamin K deficiency can also cause heavy bleeding.
If you think that you or a loved one might have signs of vitamin K deficiency, try using the Ada app to find out more about your symptoms.
Q: Can vitamin K deficiency cause anemia?
A: Vitamin K deficiency in itself does not cause anemia. However, the heavy bleeding that can be a symptom of the deficiency, may sometimes be associated with anemia. Read more about Anemia ».
Q: Can vitamin K deficiency cause hair loss?
A: Hair loss is not a symptom of a lack of vitamin K. However, hair loss may sometimes be a symptom of anemia or a deficiency of another vitamin, such as vitamin D. Read more about Vitamin D Deficiency ».
Q: How is vitamin K deficiency treated?
A: Low levels of vitamin K in adults can often be treated with dietary changes to include more leafy green and other vegetables. Sometimes, a doctor may recommend vitamin K supplements, typically in the form of phytonadione tablets or injections. Newborn babies will usually receive a vitamin K shot to prevent deficiency.
Other terms associated with vitamin K deficiency
- Low vitamin K
- Hemorrhagic disease of the newborn
What is Vitamin K Deficiency Bleeding? | CDC
- Vitamins are substances our bodies need, which we get from either the foods we eat or from a multivitamin.
- Vitamins are normally stored in the body. A person without enough of a vitamin stored in the body is “vitamin deficient” or has a “vitamin deficiency”.
Vitamin K is a substance that our body needs to form clots and to stop bleeding. We get vitamin K from the food we eat. Some vitamin K is also made by the good bacteria that live in our intestines.
Babies are born with very small amounts of vitamin K stored in their bodies, which can lead to serious bleeding problems if not supplemented.
What is Vitamin K Deficiency Bleeding or DB?
Vitamin K deficiency bleeding or DB, occurs when babies cannot stop bleeding because their blood does not have enough Vitamin K to form a clot. The bleeding can occur anywhere on the inside or outside of the body. When the bleeding occurs inside the body, it can be difficult to notice.
Commonly, a baby with DB will bleed into his or her intestines, or into the brain, which can lead to brain damage and even death. Infants who do not receive the vitamin K shot at birth can develop DB at any time up to 6 months of age. There are three types of DB, the age of the baby when the bleeding problems start: early, classical and late.
More information about these types is included below.
Why are babies more ly to have vitamin K deficiency and to get DB?
All infants, regardless of sex, race, or ethnic background, are at higher risk for DB until they start eating regular foods, usually at age 4-6 months, and until the normal intestinal bacteria start making vitamin K. This is because:
- At birth, babies have very little vitamin K stored in their bodies because only small amounts pass to them through the placenta from their mothers.
- The good bacteria that produce vitamin K are not yet present in the newborn’s intestines.
- Breast milk contains low amounts of vitamin K, so exclusively breastfed babies don’t get enough vitamin K from the breast milk, alone.
What can I do to prevent my baby from getting vitamin K deficiency and DB?
The good news is that DB is easily prevented by giving babies a vitamin K shot into a muscle in the thigh. One shot given just after birth will protect your baby from DB. In order to provide for immediate bonding and contact between the newborn and mother, giving the vitamin K shot can be delayed up to 6 hours after birth.
Is the Vitamin K shot safe?
Yes. Many studies have shown that vitamin K is safe when given to newborns. For more information about the safety of the vitamin K shot, please see our FAQ’s.
What might cause babies to be deficient in vitamin K and have bleeding problems?
Some things can put infants at a higher risk for developing DB. Babies at greater risk include:
- Babies who do not receive a vitamin K shot at birth. The risk is even higher if they are exclusively breastfed.
- Babies whose mothers used certain medications, isoniazid or medicines to treat seizures. These drugs interfere with how the body uses vitamin K.
- Babies who have liver disease; often they cannot use the vitamin K their body stores.
- Babies who have diarrhea, celiac disease, or cystic fibrosis often have trouble absorbing vitamins, including vitamin K, from the foods they eat.
How often are babies affected with vitamin K deficiency bleeding?
Since babies can be affected until they are 6 months old, healthcare providers divide DB into three types; early, classical and late. The chart below helps explain these three different types.
- Early and classical DB are more common, occurring in 1 in 60 to 1 in 250 newborns, although the risk is much higher for early DB among those infants whose mothers used certain medications during the pregnancy.
- Late DB is rarer, occurring in 1 in 14,000 to 1 in 25,000 infants (1–3).
- Infants who do not receive a vitamin K shot at birth are 81 times more ly to develop late DB than infants who do receive a vitamin K shot at birth. (4)
|Early||0-24 hours after birth|
|Classical||1-7 days after birth|
|Late||2-12 weeks after birth is typical, but can occur up to 6 months of age in previously healthy infants|
What things should I look for in my baby if I think he or she might have DB?
Unfortunately, in the majority of cases of DB, there are NO WARNING SIGNS before a life-threatening event starts. Babies with DB might develop any of the following signs:
- Bruises, especially around the baby’s head and face
- Bleeding from the nose or umbilical cord
- Skin color that is paler than before. For darker skinned babies, the gums may appear pale
- After the first 3 weeks of life, the white parts of your baby’s eyes may turn yellow.
- Stool that has blood in it, is black or dark and sticky (also called ‘tarry’), or vomiting blood
- Irritability, seizures, excessive sleepiness, or a lot of vomiting may all be signs of bleeding in the brain
1. Zipursky A. Prevention of vitamin K deficiency bleeding in newborns. Br J Haematol 1999;104:430–7.
2. Sutor AH, Kries R, Cornelissen EAM, McNinch AW, Andrew M. Vitamin K deficiency bleeding (DB) in infancy. Thromb Haemost 1999;81:456–61.
3. American Academy of Pediatrics, Vitamin K Ad Hoc Task Force. Controversies concerning vitamin K and the newborn. Pediatrics 1993;91:1001–3.
4. McNinch AW, Tripp JH. Haemorrhagic disease of the newborn in the British Isles: two year prospective study. BMJ 1991;303:1105–9.
Vitamin K deficiency: Causes and symptoms
Vitamin K deficiency in adults is rare but does occur in infants. The main symptom of a vitamin K deficiency is excessive bleeding caused by an inability to form blood clots.
In this article, we look at the function of vitamin K in the body, as well as the symptoms and treatments for a vitamin K deficiency.
Share on PinterestVitamin K is found in some plant foods, such as leafy green vegetables, and is also produced by the body.
Vitamin K comes in two forms.
The first type is known as vitamin K-1 or phylloquinone and can be found in plants, such as spinach and kale.
The second is known as vitamin K-2 or menaquinone and is found in the body and created naturally in the intestinal tract.
Both vitamin K-1 and vitamin K-2 produce proteins that help the blood to clot. Blood clotting or coagulation prevents excessive bleeding internally and externally.
While vitamin K deficiency is rare, it means a person’s body cannot produce enough of these proteins, increasing the risk of excessive bleeding.
Most adults obtain an adequate supply of vitamin K through the foods they eat and through what their body naturally produces.
Certain medications and medical conditions can reduce vitamin K production and inhibit absorption, meaning adults can become deficient.
However, vitamin K deficiency is much more ly to occur in infants. When it does, it is known as vitamin K deficiency bleeding or DB.
Adults are at an increased risk of vitamin K deficiency and the associated symptoms if they:
- take anticoagulants that prevent blood clots but inhibit vitamin K activation
- take antibiotics that interfere with vitamin K production and absorption
- do not get enough vitamin K from the foods they eat
- take extremely high doses of vitamin A or E
Other people who may be diagnosed with vitamin K deficiency have a condition that results in the body being unable to absorb fat properly. This is known as fat malabsorption.
People who have problems absorbing fat may have an associated condition, such as:
There are several reasons why newborn babies are more prone to vitamin K deficiency. These are:
- drinking breast milk that is low in vitamin K
- vitamin K does not transfer well from a mother’s placenta to her baby
- a newborn baby’s liver is unable to use vitamin K efficiently
- a newborn’s gut cannot produce vitamin K-2 in the first few days of life
Dieticians and nutrition experts recommend that adult males consume at least 120 micrograms (mcg) per day of vitamin K and women consume 90 mcg per day.
Foods that are high in vitamin K include green, leafy vegetables, prunes, and fermented dairy products.
Share on PinterestA person with vitamin K deficiency may bruise easily.
There are several symptoms associated with vitamin K deficiency, but the main one is excessive bleeding. Excessive bleeding may not be immediately evident, as it may only occur if a person is cut or wounded.
Additional signs of excessive bleeding can also include:
- bruising easily
- small blood clots appearing under the nails
- bleeds in mucous membranes that line areas inside the body
- stool that is dark black, tar-, or contains blood
When looking for signs of vitamin K deficiency in newborn babies and infants, doctors will also look for:
- bleeding from the area where the umbilical cord has been removed
- bleeding in the skin, nose, gastrointestinal tract, or other areas
- bleeding at the penis if the baby has been circumcised
- sudden brain bleeds, which are deemed severe and potentially life-threatening
To diagnose a vitamin K deficiency, a doctor will ask about a person’s medical history to see if they have any risk factors.
The doctor may use a coagulation test called the prothrombin time or PT test. This test draws blood using a small needle. Chemicals are added to the blood, which is then observed to see how long it takes to clot.
If a person’s blood takes longer than 13.5 seconds to clot, the doctor may suspect a vitamin K deficiency.
Certain foods have high levels of vitamin K and should not be eaten before a test. These include some liver products, cauliflower, broccoli, chickpeas, kale, green tea, and soybeans.
If a person is diagnosed with vitamin K deficiency, they will be given a vitamin K supplement called phytonadione.
Phytonadione is usually taken orally, though it can also be given as an injection if a person has difficulty absorbing the oral supplement.
The dosage given depends on the age and health of the individual. The usual dose of phytonadione for adults ranges from 1 to 25 mcg.
A doctor will also consider whether a person is taking anticoagulants, as these can interact with vitamin K.
Share on PinterestNewborn babies may need a vitamin K supplement.
Vitamin K administered at birth can prevent a deficiency occurring in newborn babies. It is usually given as a shot.
The American Academy of Pediatrics recommend that newborns receive a single shot of 0.5 to 1 mcg of vitamin K-1 at birth.
A vitamin K shot is especially important for newborns under certain conditions. Risk factors for vitamin K deficiency bleeding include:
- babies that are born prematurely
- babies with mothers taking anti-seizure drugs, anticoagulants, or drugs for tuberculosis
- babies who have fat malabsorption due to gastrointestinal or liver disease
- newborns not given vitamin K at birth, breast-fed exclusively and exposed to antibiotics
It is up to the parents to decide whether or not their baby receives a vitamin K injection, although it is usually recommended.
Vitamin K deficiency in adults is very rare. However, if a deficiency is left untreated, it may result in excessive bleeding.
In infants, it is essential to administer vitamin K at birth to prevent poor outcomes from excessive bleeding, such as intracranial hemorrhage, brain damage, and infant death.