Supplement evidence

060 / 575Vitamin form

Vitamin K2 (MK-4)

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The short answer

Pharmacologic MK-4 is used for osteoporosis in some countries; supplement doses are not equivalent.

Evidence and scope: Conditional or population-specific
This status does not grade the ingredient for every goal, outcome, or person.
Important limitation: Benefit depends on the population, formulation, baseline status, and objective; results should not be generalized.
Before deciding: Key concern: Do not combine with warfarin; do not imitate prescription dosing without medical supervision.

01 / PRACTICAL GUIDE

Dose, absorption, and combinations

These are indication-specific reference or studied ranges—not a personalized prescription. Start with the objective, then check the form, label, medicines, and health conditions.

Reference range by objective

Bone-health plan45 mg/day is a prescription-level Japanese regimen; consumer use requires clinician oversight

Reference or studied range—not a personalized prescription. The product label or a clinician may specify a different dose.

Dose source ↗

More is not automatically better. A clinician or product label may specify a different amount.

Absorption / solubilityFat-soluble / lipid-based

Fat-soluble or lipid-based. Absorption generally improves with a meal containing fat.

How it is commonly taken

Take with fat; formulation and regulatory status matter.

Do not combine casually

Do not combine with warfarin; do not imitate prescription dosing without medical supervision.

Dose and use source ↗

Dose and use links lead to primary or official source material. Search links are discovery tools, not proof that every returned paper applies.

02 / EVIDENCE

What the research says

We keep supportive, mixed, negative, safety, and contextual findings together. The headline never replaces the underlying papers.

4research papers in this ledger

4unique primary studies represented

1,052unique participants represented

These are audited counts for this JIVANA collection, not search-result totals. Participants are counted once when multiple papers use the same cohort; review papers are not added again to participant totals.

Open the research timelineResearch timeline

Entries are ordered by publication year. A study period appears only when the source reports it.

2023

Does not support the tested claimPMID 37338608 · NCT01232647

Vitamin K supplementation and bone outcomes in postmenopausal osteoporosis

MK-4 did not improve bone mineral density or bone-turnover markers. Modest geometry signals occurred only for vitamin K1 in per-protocol analyses, not for MK-4; the trial did not establish fewer fractures.

Published: 2023Duration: 18 monthsn=105 participants

Study design and methods

Design: Three-arm randomized, placebo-controlled add-on trial
Population: 105 postmenopausal women with osteoporosis and low vitamin K1 using bisphosphonate therapy
Intervention: Vitamin K1 1 mg/day, menaquinone-4 45 mg/day, or placebo alongside usual calcium with or without vitamin D
Outcome: Bone mineral density, bone-turnover markers, and bone geometry

Open research record ↗

2009

Does not support the tested claimPMID 19113922

Vitamin K supplementation in postmenopausal women with osteopenia

MK-4 reduced undercarboxylated osteocalcin but did not improve bone turnover, density, or geometry versus placebo. This directly separates vitamin-K biomarker change from measured skeletal benefit.

Published: 2009Duration: 12 monthsn=381 participants

Study design and methods

Design: Randomized, double-blind, placebo-controlled trial
Population: 381 healthy, nonosteoporotic postmenopausal North American women
Intervention: Vitamin K1 1 mg/day, menaquinone-4 45 mg/day, or placebo; all groups received calcium and vitamin D3
Outcome: Undercarboxylated osteocalcin, bone turnover, bone mineral density, and bone geometry

Open research record ↗

2007

Mixed or qualifiedPMID 17287908

Three-year low-dose menaquinone-4 supplementation helps maintain bone strength in healthy postmenopausal women

MK-4 did not improve DXA bone mineral density, although bone mineral content, femoral-neck width, and derived strength measures were maintained or favored MK-4. These surrogate geometry findings did not establish fracture prevention.

Published: 2007Duration: 3 yearsn=325 participants

Study design and methods

Design: Randomized, placebo-controlled trial
Population: 325 postmenopausal women
Intervention: Menaquinone-4 45 mg/day or placebo
Outcome: DXA bone mineral density, bone mineral content, femoral-neck width, and derived strength indices

Open research record ↗

2000

Mixed or qualifiedPMID 10750566

Vitamin K2 treatment for postmenopausal osteoporosis

Clinical fractures were less frequent and lumbar bone density was maintained rather than declining. The open-label design, untreated control, older setting, and prescription-scale 45 mg dose make this weak evidence for ordinary supplement-dose MK-4.

Published: 2000Duration: 24 monthsn=241 participants

Study design and methods

Design: Randomized, open-label trial with an untreated control
Population: 241 patients with osteoporosis
Intervention: Menaquinone-4 45 mg/day or no treatment
Outcome: Clinical fractures, lumbar bone mineral density, and bone-turnover markers

Open research record ↗

Unscreened discovery appendix—not evidence65 candidate publicationsSearch run: Aug 21, 2026

Complete for the displayed PubMed query at the search timestamp—not for all databases or every possible synonym. Candidates can be irrelevant, duplicate the same study, or report negative findings. They are never summed as evidence or participants until screened.

03 / SOURCES

Start with the source material

Official evidence overviewPubMed bounded human-evidence search Live PubMed discovery searchNational Library of Medicine

The live search is for discovery only. Search-result counts change and are not included in the audited totals above.

Recent PubMed discovery recordsDirect links to the first 12 records returned by the reproducible search. These are discovery candidates—not reviewed summaries or a count of supportive findings.

04 / EXPERT CONTEXT

Expert context—not evidence

Expert positions are dated context—not scientific evidence. They never raise the evidence status or become consensus by repetition.

No direct, source-verified endorsement is currently recorded. Research authorship or discussion alone is not treated as endorsement.