Autoimmune Thyroid Disease

An Unfortunate and Lengthy Adventure in Misdiagnosis

Archive for July 2004

Vitamin K, warfarin and hypoglycaemia

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Vitamin K is a fat soluble vitamin. There are three main forms of vitamin K: vitamin K1 (Phylloquinone or phytonactone), which comes from plants; vitamin K2, a family of substances called menaquinones, which are made by intestinal bacteria and found in animal foods and fermented foods; and vitamin K3 (menadione), which is a synthetic substance.

Depleting Agents: Antibiotics, antiseizure medications, chemotherapy, x-rays, the freezing of foods, aspirin and salicylates, air pollution, mineral oil, high doses of vitamin E and A.

Vitamin K plays an important role in the intestines and aids in converting glucose into glycogen for storage in the liver.

You know, sometimes you just have an “oh” moment where everything just suddenly makes sense. I had that a couple of days ago. I felt like Fenchurch in the phone box in So Long and Thanks for all the Fish.

It was a big “oh”.

It was the kind of “oh” that expanded outwards in a ripple, triggering one memory after another that suddenly clicked and fitted and suddenly I understood, and I felt justified, and I hadn’t been going crazy in the hospital, and all of this pain and ill health and confusion and worry all made sense and was within my control to fix. I burst into tears.

Vitamin K plays an important role in the intestines and aids in converting glucose into glycogen for storage in the liver.

I had no idea. All of the reading on vitamin K that I’ve done (and I’ve done a lot) all suggested that vitamin K was used only for building bones and clotting blood. But no one studies vitamin K, it’s a neglected vitamin, so no one knows anything about it or what else it might do.

It was the warfarin all along. That’s why my hypoglycaemia got so much worse in hospital. I knew it. I knew it and I’ve been searching for the answer for the last year but I’ve never found a single study on warfarin and glycemic control. Somehow it has eluded me – how, I don’t know, because now when I type “vitamin K” + glycogen + glucose into google, I get about three thousand pages back.

Warfarin is a vitamin K antagonist. No wonder I couldn’t keep my blood sugar stable. No wonder I was hungry all the damned time, no wonder I thought I was going mad because I was so angry with every one and every thing. Warfarin causes reactive hypoglycaemia.

This makes total sense to me now. It was around day 4 of my stay in hospital that I woke up so weak and shaky I thought I was going to faint; the doctors had messed up my warfarin dose and my INR was something like 4.3 – way too high. I felt so confused all of the time I was in hospital, I was so panicky and fluttery I couldn’t sleep, and I had a couple of panic attacks that made the nurses scared I was having a pulmonary embolism. These things are to be expected under such circumstances, but how much of that psychology was actually biology?

What happens when you can’t store carbohydrate as glycogen? You don’t have a supply available to regulate your blood sugar levels in between meals. All that carbohydrate that I was eating that normally would have been converted to glycogen, was turned straight into fat instead. I was left on a rollercoaster, confused, emotional, and a complete hypochondriac.

This explains the interactions between warfarin and some diabetic medications that I could never find a scientific explanation for on the web.

I knew there was a connection, I knew it was the warfarin, I felt it (you might say with an ironic smile) in my bones. I can’t believe this, but it’s so bloody appropriate. The cure that kills! I could draw the history of my health as a diagram, and all the illness I’ve experienced go right back to one source: pharmaceuticals.

I go to the doctor, who puts me on the pill.

Which makes my breasts painful, and I get headaches and throw up on the first night of every month.

Which causes me to go back to the doctor.

Who puts me on the third generation pill.

Which causes me to develop deep vein thrombosis.

So I’m sent to hospital.

Where they give me warfarin.

Which gives me reactive hypoglycaemia. I put on weight and get really angry and stressed all the time. I question my sanity.

So I go back to the doctor, who tells me to eat lots of complex carbohydrates!

Thank god I broke the cycle and didn’t take that last piece of advice.

If I should ever have another DVT, I will not go on warfarin. Warfarin is not a natural substance, it’s a toxin that needs to be removed by the liver. Heparin, on the other hand, is a natural substance that exists normally in the human body. That’s not to say it’s harmless. I can tell you a harmless way of treating blood clots: tocopherols and cod liver oil!

The pancreas has the second highest amount of vitamin K in the body. This suggests the vitamin may have something to do with controlling blood sugar. In the first study of its kind, researchers in Japan looked at vitamin K’s effect on glucose and insulin. In a study on rats, they found that vitamin K deficiency initially impedes the clearance of glucose, then causes too much insulin to be released. This can be plotted on a graph that looks very similar to what occurs in diabetes. Lef.org

This is exactly what was happening to me. This is reactive hypoglycaemia. Thank you and bless you, Japanese vitamin K researchers!

Even after I went on Atkins, I had strange episodes sometimes lasting a couple of days, and one lasting as much as a week, in which I was irritable and didn’t seem to be able to control my blood sugar at all. This is in spite of being very careful. During this week when I became ill, I was at my wits end, I just didn’t know what to do. I’d had a mild head cold for a couple of days and was having a few sinus headaches, but the lack of blood sugar control was far in excess of normal for a cold.

Then I read somewhere that salicylates like aspirin can affect blood sugar control, though there was no explanation given for why. I’d been using a Vick’s Inhaler all week in response to my sinus headaches – it contains methyl salicylate! I threw it away, and by the next day I’d recovered! Even the headaches were gone! I have noticed similar confusion and irritability after taking aspirin itself, I’ve even noticed a difference like this when taking anti-viral and anti-bacterial herbals like olive leaf extract, echinacea and goldenseal root. They must contain salicylates or something else that has the same effect on vitamin K. Now I know that salicylates and aspirin contraindicate vitamin K I feel sure that this was the mechanism that caused me to lose control of my blood sugar again!*

Furthermore, I had episodes of uncontrollable blood sugar that I could not associate with any pharmaceutical, which I categorised at the time as general illness – these bouts of hypoglycaemia seemed to be associated with constipation, bloating, or less frequently, diarrhoea. As a large portion of vitamin K is absorbed from the intestines, I believe these episodes of poor intestinal health to be the cause of these bouts of hypoglycaemia.** I attribute my slightly improved glycemic control of recent months in part to following the advice of The Weston A. Price Foundation, and eating live cultured yoghurt every day.

Not long ago, I went through a rough patch just after the aspartame/MSG incidents.*** I was very irritable for a couple of weeks. At the time I was due to be flying in and out of the country, so I had been taking 1000iu of vitamin E every day in preparation. It was working, as I developed one or two bruises on my legs. I don’t normally take such a high dose of vitamin E for an extended period, unfortunately they were the only capsules I had with me in France (whose Nazi anti-vitamin laws preclude me from buying anything in a useful dose over here). At high doses, vitamin E acts as a vitamin K antagonist, that is partly how it thins the blood. Was this also an episode of relative vitamin K deficiency?

Vitamin A also antagonises vitamin K at high doses, and something similar happened a few weeks later when I developed a chest infection and began taking a high dose of cod liver oil to combat it; I had a rapid heartbeat, panicky feelings, and I was swinging between loss of appetite and constant hunger… I can’t separate these symptoms from the infection itself, but at the time they felt like a loss of blood sugar control. More relative vitamin K deficiency?

You know what else? Warfarin also screws up your brain. It gives you Alzheimer’s!

[Osteocalcin is] one of the calcium-grabbing proteins in bone. But bone is not its only location. It’s also found in the brain, along with other vitamin K-dependent proteins. People with the E4 protein [a dysfunctional protein] have undercarboxylated osteocalcin not only in their bone, but also in their brains. Kohlmeier believes that people with E4 clear vitamin K too fast from their bodies. This leaves too little vitamin K for the brain proteins. Calcium can’t be regulated properly and may cause some of the damage seen in [Alzheimer’s Disease]. Studies show that AD patients have severely dysregulated calcium in their brains. Kohlmeier believes that this has to do with their lack of vitamin K – the vitamin necessary for controlling calcium in both the brain and bone. Lef.org

AD begins slowly. At first, the only symptom may be mild forgetfulness. People with AD may have trouble remembering recent events, activities, or the names of familiar people or things. Simple math problems may become hard to solve. Such difficulties may be a bother, but usually they are not serious enough to cause alarm.

However, as the disease goes on, symptoms are more easily noticed and become serious enough to cause people with AD or their family members to seek medical help. For example, people in the later stages of AD may forget how to do simple tasks, like brushing their teeth or combing their hair. They can no longer think clearly. They begin to have problems speaking, understanding, reading, or writing. Later on, people with AD may become anxious or aggressive, or wander away from home. Eventually, patients need total care. [Alzheimers.org]

  1. The seven warning signs of Alzheimer’s disease are:
  2. Asking the same question over and over again.
  3. Repeating the same story, word for word, again and again.
  4. Forgetting how to cook, or how to make repairs, or how to play cards — activities that were previously done with ease and regularity.
  5. Losing one’s ability to pay bills or balance one’s checkbook.
  6. Getting lost in familiar surroundings, or misplacing household objects.
  7. Neglecting to bathe, or wearing the same clothes over and over again, while insisting that they have taken a bath or that their clothes are still clean.
  8. Relying on someone else, such as a spouse, to make decisions or answer questions they previously would have handled themselves. [Alzheimers.org]

Hell, I was forgetful, repetitive, confused, and unable to program or do simple sums… I was a mental basket case… I blamed all of these symptoms on the hypoglycaemia itself, but now I wonder if maybe something more was going on than just that! If a vitamin K deficiency damages the brain as well as the body, then considering what it has done to my body, I dread to think what damage it has done to my brain, what it’s changed, reprogrammed, taken away, destroyed, and what it has made me more vulnerable to in later life.

A lack of vitamin K is implicated in calcium deposits in the arteries, because vitamin K drives calcium into the bones where it belongs. Arthritis can be associated with calcium deposits in the joints, soft tissues and connective tissues, so vitamin K deficiency may also be implicated here. No wonder, when I asked the hospital nurse “how long will it take for my DVT to dissolve?” she answered. “We don’t know. Sometimes it calcifies.” The goddamned warfarin is the cause of the calcification!

A lack of vitamin K, and vitamin K therapy are also indicated in certain types of cancer. It’s a mega antioxidant, and as well as regulating the blood’s ability to clot, it also prevents blood clots by preventing platelet aggregation and producing anti-clotting factors as well as clotting factors, and in fact warfarin knocks both on the head, starting with the anti-clotting factors. This is why a period of hypercoagulability may occur in patients when they begin warfarin therapy. Incidentally… patients with Factor V Leiden are more susceptible to this risk due to the nature of the factors involved. Typical. Vitamin K is depleted by chemotherapy, yet chemotherapy actually makes the blood more likely to clot.

Towards the end of her life, my paternal grandmother didn’t eat properly, she ate like a bird and even then the wrong kind of food. She became forgetful. She developed Alzheimer’s Disease. She also developed osteoporosis. Then she developed breast cancer. She was given oral chemotherapy drugs. On these, she developed Deep Vein Thrombosis and died of a Pulmonary Embolism. As far as we are aware, she did not have my defective clotting gene – I inherited that from my maternal grandfather. This all makes perfect sense to me. Every one of my grandmother’s problems was associated with a vitamin K deficiency.

It is so ironic to me to think that I have taken megadoses of every single vitamin, mineral and nutrient that is indicated in blood sugar control. Vitamin K is not in the literature, alternative practitioners just don’t know about it yet, the information on the internet is patchy and sparse. The Japanese studies exposing vitamin K’s role in blood sugar control were done in the year 2000, which goes to show just how fast information doesn’t filter through the medical community or leaps across continents.

It’s even more ironic that I’ve been taking high doses of vitamin E to antagonise vitamin K, it means I may have been prolonging my own ill health through attempts to keep myself healthy. Vitamin K was the one vitamin I was afraid to take, and it may be the one vitamin that I needed all along!****

To clarify the roles of vitamin K (VK) in the pancreas, twice oral, glucose tolerance tests were examined in 12 healthy young male volunteers before and after 1 week of VK tablet intake. Blood were collected by venipucture at 0, 30 and 120 min after 75 g oral glucose loading. They then took VK tablets (90 mg/d of menaquinone-4) for 1 week, and the second glucose tolerance test was examined. The subjects were divided into three groups by serum descarboxy prothrombin (DP) levels; four of lowest DP (L-DP), middle of DP (M-DP) and highest DP (H-DP) levels. They were compared by one-factor analysis of variance and Scheffe’s F (group differences) and paired t -test (the effects of 1 week of VK intake). Age, body mass index and glucose status [plasma glucose (PG) and immunoreactive insulin (IRI), hemoglobin-Alc, fructosamine] of all groups were almost the same, but the IRI of the H-DP group was higher than that of the other groups at 120 min after the glucose loading (mean+/-SEM; L; 10.6+/-0.9, M-; 17.5+/-4.2, H-; 40.4+/-6.0 microU/ml). One week of VK intake tended to decrease the plasma DP levels of all groups and significantly reduced IRI of the H-DP at 120 min by half (before; 40.4+/-6.0 vs after: 18.4+/-4.6 microU/ml). The IRI/pG ratio in areas under the curve (AUC) of H-DP from 0 to 120 min after the loading was significantly decreased by 1 week of VK tablet intake (before: 31.0+/-7.4 vs after: 20/1+/-3.8 microU/g). These results suggested that there may be some relationship between pharmacological dose of vitamin K and insulin response. Copyright 2000 Harcourt Publishers Ltd. Possible effects of one week vitamin K (menaquinone-4) tablets intake on glucose tolerance in healthy young male volunteers with different descarboxy prothrombin levels.

To evaluate the effects of vitamin K (VK) on pancreatic function, especially on acute insulin response, 25 healthy young male volunteers were given an oral load of 75 g of glucose, and their mean daily VK intake was estimated by a one-week food check list. After excluding low (<20) and high (> or =25) body mass index (BMI) subjects, the remaining 16 participants were divided into three semi-equal groups according to VK intake. Blood VK status of the low VK intake group tended to be poorer than that of the high intake group (median of 5 samples: prothrombin time; 12.5 vs 12.2s and protein-induced VK absence-factor-II; 23 vs 15 mAU/ml), but fasting plasma glucose status was not markedly different between both groups: [plasma glucose (PG); 87 vs 86 mg/dl, immunoreactive insulin (IRI); 6.7 vs 5.3 microU/ml, HbA1c; 4.8 vs 4.9%]. However, at 30 min after glucose loading, PG of the low VK intake group tended to be higher than those of the high intake group (160 vs 145 mg/dl) and IRI was lower (36.1 vs 52.3 microU/ml). Insulinogenic index (incremental IRI/incremental PG, 0-30 min) of the low VK intake group was significantly lower than that of the high intake group (0.4 vs 0.9). These results suggested that VK may play an important role on the acute insulin response in glucose tolerance. Relationship between acute insulin response and vitamin K intake in healthy young male volunteers.

To investigate the effects of vitamin K (VK) on pancreatic function, intravenous glucose tolerance tests were performed in rats fed with and without low VK diet (including less than 20% required vitamin K1). Plasma glucose and immuno-reactive insulin (IRI) were determined. It was found that at 0 min., plasma glucose and IRI levels in low VK group were slightly less than in the control (glucose, 204.5 +/- 21.7 vs. 229 +/- 19.6 mg/dl, IRI, 6.6 +/- 1.3 vs. 9.3 +/- 1.8 ng/ml mean +/- SEM). At 3 min. after glucose administration, plasma glucose was higher (391.8 +/- 25.6 vs. 371.8 +/- 18.7 mg/dl) and IRI, lower (11.8 +/- 2.1 vs. 18.2 +/- 3.6 ng/ml) in the low VK group. The disappearance rate of plasma glucose in the low VK group at 5-10 min. was significantly less than in the control (6.7 +/- 2.2 vs. 11.9 +/- 1.8 mg/dl/min.). Incremental IRI area at 0 to 5 min. in the low VK group is less than in the control (15.2 +/- 4.4 vs. 25.0 +/- 9.1 ng/ml/min.), but at 5-60 min. and 0-60 min., it was found to be significantly higher compared to the control (210.3 +/- 55.2 vs. 32.5 +/- 47.1 ng/ml/min. at 5-60 min.). Dietary low VK intake would thus appear to induce a tendency of poor early insulin response, and late hyperinsulinemia to the glucose load in rats. Low vitamin K intake effects on glucose tolerance in rats.

Notes from October 2007

* Even at this very early stage, I knew salicylates were part of the problem. What I didn’t know was that fruit and vegetables contain salicylates too!

** I should have examined my diet more closely at the time – I believe during these periods of intestinal ill health I was exposing myself to more food chemicals than usual.

*** Vitamin K also protects against glutamate toxicity.

**** I believed that I needed to stop taking vitamin E and start taking vitamin K, so I did that as soon as I got back to the UK. The only supplements of vitamin K that were available at the time were Solgar 100ug phytonadione tablets. I started taking a couple of those every day.

However, within a month of being back in the UK I was overcome with fibromyalgia symptoms – I couldn’t think, I was exhausted, I had constant brain fog, and my dermatitis which had previously completely disappeared, came back with avengence. By autumn, my skin was so bad that I was ashamed to leave the apartment.

My response to this was to start using lots of fermented foods and organ meats – rich sources of vitamin K. I ate yoghurt every day, I ate kefir every day, I ate sauerkraut, I ate kimchi. I tried eating liver every day for a week – a total disaster.

More recently I have tried megadosing vitamin K2 supplements on several occasions. It is good at giving me pain in my DVT leg. It calms me down. It helps my skin a bit. Thus far it has not proven to be a cure.

As a smug aside

Yes. I really did write this over three years ago, long before the Weston A. Price Foundation declared vitamin K to be Price’s activator X and renewed their promotion of fermented foods for this reason. In fact, what I didn’t really understand about WAPF’s output back in 2004 was the emphasis on vitamins A and D for bone health, and the lack of any dialogue on their site about vitamin K and bone health. I thought – surely it wasn’t possible that activator X was vitamin K, because they must have already examined vitamin K and dismissed it! It just shows you that you can’t let other people do your thinking for you. My sign-in name on yahoo has been “vitaminkgirl” for many years now.

Written by alienrobotgirl

24 July, 2004 at 12:02 pm

Posted in My History

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