Skip to main content
ARS Home » Northeast Area » Boston, Massachusetts » Jean Mayer Human Nutrition Research Center On Aging » Research » Publications at this Location » Publication #169070
Title: EFFECT OF VITAMIN E SUPPLEMENTATION ON VITAMIN K STATUS IN ADULTS WITH NORMAL COAGULATION STATUS

Author
item BOOTH, SARAH - TUFTS/HNRCA
item GOLLY, INES - UNIVERSITY OF MUNICH
item SACHECK, JENNIFER - TUFTS/HNRCA
item ROUBENOFF, RONENN - TUFTS/HNRCA
item DALLAL, GERARD - TUFTS/HNRCA
item HAMADA, KOICHIRO - TUFTS/HNRCA
item BLUMBERG, JEFFREY - TUFTS/HNRCA

Submitted to: The American Journal of Clinical Nutrition
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 12/19/2003
Publication Date: 7/1/2004
Citation: Booth, S.L., Golly, I., Sacheck, J.M., Roubenoff, R., Dallal, G.E., Hamada, K., Blumberg, J.B. 2004. Effect of vitamin E supplementation on vitamin K status in adults with normal coagulation status. American Journal of Clinical Nutrition. 80:143-148.

Interpretive Summary: Cases of enhanced anticoagulant effect have been reported among patients taking oral anticoagulants in response to high dose vitamin E supplementation. Although a vitamin E-vitamin K interaction has been proposed to underlie this effect, it has not been systematically investigated in adults with normal coagulation. The objective of this study was to examine the effect of 12-week supplementation with high doses of vitamin E on measures of vitamin K status in men and women not taking oral anticoagulants. Vitamin K status was determined in 38 men and women with rheumatoid arthritis (Study A) and 32 healthy men (Study B) participating in two independent 12-week long studies employing vitamin E supplementation at doses of 1000 international units per day. One measure of vitamin K status, PIVKA-II, significantly increased in response to 12-week of vitamin E supplementation. An increase in PIVKA-II is indicative of poor vitamin K status. In contrast, other measures of vitamin K status did not change in response to the supplementation. In conclusion, high dose vitamin E supplementation reduced the function of the vitamin K-dependent proteins involved in normal coagulation. The clinical significance of these changes warrants further investigation, but it is possible that high doses of vitamin E antagonize vitamin K. Whether such an interaction is potentially beneficial or harmful remains to be determined.

Technical Abstract: Cases of enhanced anticoagulant effect have been reported among patients taking oral anticoagulants in response to high dose vitamin E supplementation. Although a vitamin E-vitamin K interaction has been proposed to underlie this effect, it has not been systematically investigated in adults with normal baseline coagulation status. The objective of this study was to examine the effect of 12-wk supplementation with 1000 IU/d /RRR/-a-tocopherol on biochemical measures of vitamin K status in men and women not taking oral anticoagulants. Vitamin K status, assessed by plasma phylloquinone and the degree of under g-carboxylation of the vitamin K-dependent proteins prothrombin (PIVKA-II) and osteocalcin (%ucOC), was determined in 38 men and women with rheumatoid arthritis (Study A) and 32 healthy men (Study B) participating in two independent 12-wk long randomized clinical trials employing vitamin E supplementation at 1000 IU/d. PIVKA-II (mean+/-SD) increased from 1.7+/-1.7 to 11.9+/-16.1 ng/mL (P<0.001) (Study A) and from 1.8+/-0.6 to 5.3+/-3.9 ng/mL (P<0.001) (Study B) in response to 12-wk of vitamin E supplementation. An increase in PIVKA-II is indicative of poor vitamin K status. In contrast, plasma phylloquinone and %ucOC, other measures of vitamin K status, did not change in response to the supplementation. In conclusion, high dose vitamin E supplementation reduced the g-carboxylation of the vitamin K-dependent protein prothrombin among adults not receiving oral anticoagulant therapy. The clinical significance of these changes warrants further investigation, but it is possible that high doses of vitamin E antagonize vitamin K. Whether such an interaction is potentially beneficial or harmful remains to be determined.