By Yvonne England Dip Raw and Robert Verkerk PhD

It was no great surprise to read the results of the latest analysis within the huge EPIC study published in the journal Heart on 23rd May evaluating the role of calcium supplements in heart disease risk. The study confirms what has been found in many other studies; that heart attack risk increases slightly for those taking high dose calcium supplements – and not a lot else!  The authors of the study from the Institute of Social and Preventive Medicine, University of Zurich, indicated: “The more pronounced increase was seen among calcium supplement only users, suggesting that this adverse effect is mainly from calcium supplements themselves”. 

As we indicated back in 2010, calcium supplements are frequently prescribed or recommended by medical doctors. In clinical nutrition circles, it has been known for some years that regular calcium supplements, especially those based on inorganic salts of calcium such as calcium carbonate (chalk) are harmful at high doses — and that dietary intakes of calcium in the average diet are already more than sufficient. It is the lack of other minerals and vitamins – and hence the imbalance in micronutritional intakes — that is at the heart (excuse the pun) of the problem.  

Arteriosclerosis: Calcium build up in an artery

Given that calcium supplements (more recently with vitamin D) are a popular mainstream/allopathic preventative measure deemed to treat or prevent osteoporosis, this has resulted in much confusion, and sensational headlines in the press. 

Vitamin D is only part of the story

It should also be unsurprising that Vitamin D, despite its wealth of benefits, is only part of the story in getting calcium into bones rather into plaques within arteries and blood vessels. And the calcium and vitamin D only ‘combo’ is by no means ‘off the hook’ as far as increasing the risk of CHD among women before old-age. 

Vitamins K2, D and A, and the minerals magnesium and potassium are all crucial for calcium absorption, and they ensure efficient utilisation of dietary calcium. Also important are zinc, manganese, boron, vitamin C, B6 and folates and weight bearing exercise. Diets high in protein and low in vitamin K2, such as grain-fed, as opposed to grass-fed, animal protein is another risk factor. 

The difficulty with allopathic measures is they continue to hunt for ‘magic bullets’ — and as demonstrated many times over, answers rarely lie in a single element, nutrient or ingredient. Animal life has evolved to rely on synergistic combinations, which is why randomised controlled trials (RCTs) are largely an inadequate tool for any health strategy involving a diversity of dietary and lifestyle approaches — while they do provide valuable information when the trial seeks only to measure the effect of a single variable, such as the addition of a drug to a given study population.  In any case, there’s no money in nutritional combinations. Sadly then, we may face a predictable knee-jerk withdrawal by the mainstream from natural solutions to a basic problem. 

Grassfed beef cattle: the exception rather than the rule today

Weston Price and the mysterious ‘Activator X’

Inappropriate calcium metabolism and mass ‘misdirection’ of calcium are significant factors in diseases such as osteoporosis, cardiovascular disease, and dementia. It turns out that the likely solution to the calcium overload problem was under our collective noses all along. Nearly 70 years ago, a dentist by the name of Weston Price did some immensely valuable research with traditional people who had healthy mouths and no need for dentists. He discovered a ‘vitamin-like’ activator that was key in the utilisation of calcium, protection against heart disease, and brain function. It was present in the fat and organs of grass-fed animals— but absent in the grain fed animals of modern day farming. He called it Activator X, and he noted a huge synergistic effect when it was in the diet along with vitamins A and D. Decades later, it was realised that Activator X was in fact vitamin K2, and that modern life has left us largely deficient.

Vitamin K2: underestimated and misunderstood

Vitamin K2 was discovered in the 1930s, and its importance was underestimated for decades, and still is, by many. Along with its sister molecule, vitamin K1 (essential for clotting and found in green vegetables), the two forms were simply known as vitamin K. It was wrongly assumed that no vitamin K1 or K2 deficiency was present if blood clotting was normal. Grass fed animals convert vitamin K1 into K2, and the yellow buttermilk and yellow meat fats are excellent sources, if you can find them. Alternative sources are ‘natto’ and fermented cheeses. Confusion between K1 and K2 persists today. 

Vitamin K2: An essential and long overlooked nutrient

Research has shown that a form of vitamin K2 known as menaquinone-4 is highly effective at reducing bone loss. In this form, and with a 45mg dose, it outperformed various osteoporosis drugs and parathyroid hormone with a 60% risk reduction for vertebrae, a 73% risk reduction for the hip, and a whopping 81% risk reduction for all nonvertebral fractures. Yet the longer chain forms, the bioavailable MK-7 in particular, are generally recognised to be even more effective, due to their ability to remain longer in the bloodstream.

Spinal column of senior man with osteoporosis

There is also a wealth of evidence to back up various further benefits of this apparently essential, but long overlooked nutrient, including its role in preventing heart disease and dementia. 

A popular therapy for 2 decades

Nutritional, orthomolecular, and functional medicine doctors and practitioners, the world over, have been using nutrient combinations including vitamin K2 for bone strength for over two decades. In the UK, vitamin K2 and other important nutrients have been included in the leading supplement brands used by nutritional therapists for bone health since the 1990s. Calcium supplementation per se seems to be favoured mainly by allopathic physicians and dieticians. How ironic then, that the calcium findings are being used to criticise those who generally know better that to use calcium alone!  

Calls to action

  1.  If you have been prescribed calcium supplements alone by your doctor, question on what evidence the prescription has been made?
  2. If you have osteoporosis or are concerned about bone health, consider getting advice from a qualified and experienced nutritional practitioner so that dietary, supplement and physical activity protocols can be optimised for your individual situation 

Further reading:

Vitamin K2 and the Calcium Paradox’ by Kate Rheaume-Bleue, BSc, ND 



  1. Hi there I’d like to thank you for the work you do. I currently live in South Africa, and we’ve just heard the Medicines Control Council are implementing some of the Codex rulings here, no date given yet. Take care Wray

  2. This really is a very old story indeed.

    US homoeopath James Tyler Kent was saying over a century ago that people who have a calcium deficiency do so because of a failure to absorb calcium and the treatment of deficiencies by bombarding the body with the thing deficient in without treating the inability to absorb is a recipe for disaster.

    Yet another example of the homoeopaths being right and the rest of us taking a century to catch up. Bearing in mind that another great homoeopath well over a century ago warned of the dangers of vaccination, I wonder how long we should wait for the self evident truth on that topic finally to sink in.

  3. Having in the past advised many people (including a pharmacist!) about the inadequacies of calcium carbonate supplementation (so favoured by standard pharma medicine), I was astounded to see the latest adverse findings spun in the tabloid press as attack on nutritional medicine.

    It’s an utter disgrace.

  4. Thank you so much for this very complete and clear article – the best I have seen on this subject. It needs to be read by many – or at least the information. I will do my best to circulate it.
    Many blessings on all that you do – so important!
    Heather Wolfe
    Ireland and USA

  5. I have been taking something (prescribed by GP) called CacitD3, 500 mg/440IU D3 (it’s a dissolvable powder) once day for quite a few years. Was given due to arthritic and osteopeona problems. However, I have discovered Vit D3 in a liquid form with higher potency and started taking around 6 months ago. Now learning about K2 (I cannot eat a lot of dairy, except goats) and bit confused as to amounts to take. The K2 is Solgar and is 100mg per day which seems the general recommendation. I don’t want to over medicate, so what is the general advice between, D3, K2 and Calcium (unfortunately I notice the Cacit is Carbonate) Many thanks.

  6. Hi Gillian

    As an NGO we don’t give out patient-specific information as there can be a range of factors that affect the requirement for given nutrients including age, gender, life stage, activity level, ethnicity, diet, genetic polymorphisms, etc. However, we think you mean 100 mcg rather than 100 mg as a typical dosage – this level being in line with the average requirement set by authorities such as the National Institutes of Health in the USA, that says the requirement for men is 120 mcg/day and for women it is 90 mcg/day. See

  7. I think there is some confusion on recommended intakes of vitamin K2. The current US dietary guidelines for intakes of vitamin K are 90 and 120 µg/day (that is micrograms) for women and men, respectively, and do not distinguish between vitamin K1 and K2. Most research studies done on K2 effects on osteoporosis have used a 45 mg/day (that is milligrams) of MK-4, and the link above from ANH Admin links to the report of a meta-study based on these research studies that used 45mg/day. 45mg/day is roughly 50 times what the US dietary guidelines recommend. The US guidelines are probably too low but it is worth noting that 45 mg/day is a dose that would be very difficult to achieve through diet. One serving of natto (highest dietary source) has about 1 mg, as does foie gras and blood sausage, 3.5 oz of hard cheese another great source of K2 has less than 0.1 mg. It is important to note that the research using 45 mg/day used MK-4 which lasts only hours in the body and the 45 mg/day dose was split in thirds and taken three times per day. If you are using an MK-7 source of K2, studies have shown that MK-7 last up to 3 days in the body so 45mg/day could result in an accumulation in the body of three times that amount. Since this is way beyond anything you could hope to get through diet I think caution is needed with with supplement doses of this amount. The best research I have seen recommends supplement doses on the order of 200 µg/day (that is micrograms) and that seems reasonable to me given what one could hope to get in a diet high in K2.

  8. K2 dosage recommendations are different, depending on the type of K2 you are taking (mk4 versus mk7).

    K2 MK7 only requires around 100 mcg (that’s MICRO GRAMS). Some people have reported issues with insomnia and even having bad reactions issues with MK7, especially at higher dosages. Whereas K2 MK4 can be taken in much larger doses, upwards of 45mg (that’s MILLIGRAMS) or more.

    Although there have been some dietary studies (mostly in Japan between populations eating/not eating natto) on the effectiveness of K2 MK7 ability to lower the incidence of both cardiovascular disease (CVD/CHD) and osteoporosis, only K2 MK4 has been shown in clinical double blind studies to actually reverse osteoporosis, and lower the incidence of liver cancer in hepatitis C patients when taken at what are referred to as “therapeutic dosages” of 15mg x 3 times per day.

    From all the information I have read on both versions of K2, I think that the MK7 version is safer at lower dosages of <=100 mcg per day, and could be used more as a “preventative” over the long haul. Because MK7 serum levels build up and last over a few days, I suspect that (most of) the body probably doesn’t use it “directly” like it can with MK4, but probably converts it to MK4 via the liver. Although their is some evidence that MK7 is directly effective on certain brain tissues. MK7 would probably be the safer form to take if you are on the rat poison (aka warfarin). K2 MK4 on the other hand is in and out of the body in a matter of a few hours, and can be used in large therapeutic dosages to actually reverse problems caused by a lifetime of low K2 levels (i.e., you have a fractured hip and don’t want the side effects of taking Fosamax or Boniva). MK4 is also the only version of K2 that has been shown to actually activate gene expression that generates certain enzymes (MGP) that are needed for properly directing calcium into or out of the appropriate tissues. This is the one thing in particular that makes me think that the MK7 version is not able to “reverse” already existing calcium problems. With either form of K2, you also need the proper levels of D3, A, magnesium, and potassium, especially if taking larger therapeutic dosages of MK4. Also, both forms MUST be taken with animal fats to be absorbed by the body (i.e. it is a FAT SOLUBLE vitamin)….

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