Vitamin K2 (MK-4)

Vitaminfat-solubleModerate dose evidence

Also known as: menatetrenone, menaquinone-4, MK-4, MK4

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Menaquinone-4 is the short-chain vitamin K2 that the body itself makes from phylloquinone and the form present in meat, eggs, and dairy. As a supplement it is synthetic. It clears from blood faster than MK-7, so it is dosed more often or at higher amounts. In Japan a 45 mg per day menatetrenone drug has been studied for osteoporosis, and meta-analyses of those trials underpin its bone reputation; dietary supplements use far smaller microgram amounts, typically 100 to 1,500 mcg.

Research summary

Cofactor for gamma-glutamyl carboxylase activating osteocalcin and matrix Gla protein; also acts on the SXR/PXR nuclear receptor in bone cells.

Dosage

Daily amounts, of compound.

Lowest studiedTypical rangeHighest studiedUpper limit
45 mcg100–1,500 mcg45,000 mcg

Doses are mcg MK-4. Adequate Intake for vitamin K is 120 mcg men, 90 mcg women; DV 120 mcg; no UL. Supplement products commonly range from 100 to 1,500 mcg, while the Japanese osteoporosis protocol reviewed in meta-analyses uses 45 mg (45,000 mcg) per day as a prescription drug in divided doses; that amount is a medical regimen, not a supplement level. Short half-life, so split across meals. Fat-soluble; take with food.

Standardization: ≥97% menatetrenone; supplied neat or as 1% to 5% dilutions

Source material: synthetic

As supplied: Available neat (oil) or as 1% to 5% dry dilutions; 0.1 mg per mcg assumes a 1% grade and is supplier dependent. For mg-level doses using neat material, set raw material to 0.001 mg per mcg.

Forms of Vitamin K

FormTypical doseElement %FormatsPrice
Vitamin K2 (MK-4)100–1,500 mcgCapsule, Softgel, Tablet, Powder, Liquidmid
Vitamin K2 (MK-7)90–200 mcgCapsule, Softgel, Tablet, Gummy, Liquid, Powdermid
Vitamin K1 (Phylloquinone)90–200 mcgCapsule, Tablet, Powder, Softgel, Gummy, Liquidlow

Format suitability

  • Capsule
  • Powder
  • Tablet
  • Softgel
  • Gummy
  • Liquid

Light-sensitive; protect from UV. Neat MK-4 is an oil and suits softgels; dry dilutions suit tablets and capsules.

Formulation notes

Antagonizes warfarin and related anticoagulants; label caution required. Often combined with vitamin D3 and calcium.

  • Notable drug interactions

Sources

  1. Vitamin K — Health Professional Fact SheetNIH ODS
  2. The efficacy and safety of menatetrenone in the management of osteoporosis: a systematic review and meta-analysis of randomized controlled trials. (Su S, 2019)PubMed
  3. Efficacy of menatetrenone (vitamin K2) against non-vertebral and hip fractures in patients with neurological diseases: meta-analysis of three randomized, controlled trials. (Iwamoto J, 2009)PubMed

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