PKD DIET

Vitamin K

Vitamin K or pass the broccoli, hold the beef

Malabsorption of vitamin K can come about as a side effect from taking octreotide LAR, a treatment for Polycystic Liver Disease PLD. Most absorption of vitamin K happens within the intestines. Malabsorption is a known side effect of octreotide.

Some of us have both intestinal malabsorption as well as cystic organ disease. This can manifest by bruising and bleeding. These symptoms are caused by decreased Vitamin K absorption through the intestines. Sometimes with PLD our platelets are low, our bleeding time becomes prolonged, and our white blood cell count can become low. This is caused by pressure upon the splanchnic blood supply to the spleen from a huge PLD liver.

Vitamin K levels can be checked indirectly by a blood test for bleeding time and prothrombin time, also called a PT-INR test. Should you have a prolonged bleeding time a few dietary things to consider are prebiotics to increase Vitamin K levels.

Vitamin K produced in Intestines

Normally Vitamin K is produced by bacteria in the intestines. Adequate gut flora is necessary to produce Vitamin K1. Dark green vegetables are the best dietary source of vitamin K1. This is associated with the chlorophyll in the chloroplasts of green plants. Vitamin K comes in three forms: plant based vitamin K1 and pre-formed vitamin K2, and vitamin K3. The first two have no associated toxicity. Avoid using vitamin K3, the synthetic form, which can cause liver toxicity.

Vitamin K was discovered by Danish scientist Henrik Dam who named it the Koagulation vitamin. In 1920 he investigated the role of cholesterol by feeding chickens a cholesterol-depleted diet. After several weeks, the animals developed hemorrhages and started bleeding. These defects could not be restored by adding purified cholesterol to the diet. It appeared that together with the cholesterol a second compound had been extracted from the food, and this compound came to be called the Koagulation vitamin or vitamin K. The new vitamin received the letter K because the initial discoveries were reported in a German medical journal where coagulation is spelled with a K.

Food Sources of Vitamin K

Item VitaminK 100g Tablespoon(5g) Teaspoon(1g)
Basil 1714.5µg
(2143% DV)
85.7µg (107% DV) 17.2µg (21% DV)
Sage & Thyme (107% DV)
Fresh Parsley (82% DV)
Dried Coriander ((34% DV)
Chili powder 105.7µg (132% DV 8.5µg (11% DV) 3.2µg (4% DV)
Item VitaminK100g Cup ½ Cup
Kale 817µg (1021% DV) 1062.1µg (1328% DV) 531.1µg (664% DV)
Item VitaminK 100g Per cup (100g) Per Veg (15g)
Spring Onions/Scallions 207µg (259% DV) 207µg (259% DV) 31.1µg (39% DV)
Brussel sprouts 140.3µg (175% DV) 2218.9µg (274% DV) 29.5µg (37% DV

Vitamin K2 (menatetrenone) Bone Health

Very high pharmacological doses of the vitamin K2 (menatetrenone) has impressively been used to prevent further bone mineral loss and fracture risk in osteoporotic patients. According to one clinical trial, Menatetrenone is an effective and safe choice in the treatment of postmenopausal osteoporosis in Chinese women. They received menatetrenone 45 mg/day.

Some have said that high doses of vitamin D need to be taken with vitamin K2 (not K1). This has been tried with children to help retain bone mineral density if they were on long term glucocorticoid therapy. Vitamin K2 (menatetrenone) combined with alfacalcidol has preserved bone mineral density in children on long-term glucocorticoid therapy.

If one opts for commercial supplements of Vitamin K2, MK-7, menaquinone carefully check the ingredients. Avoid nattokinase, soy or natto with PLD liver disease.

Significant evidence suggests that humans require K2 in their diet to obtain and maintain optimal health. The strongest indication that humans require Vitamin K2 in the diet is that epidemiological and interventional studies show its superiority over K1. Intake of K2 is inversely associated with heart disease in humans while intake of K1 is not (Geleijnse et al., 2004, pp. 3100-3105), and Vitamin K2 is at least three times more effective than Vitamin K1 at activating proteins related to skeletal metabolism. (Schurgers et al., 2007).

Food Sources Vitamin K2

Vegan food sources are from fermented grains, beans such as natto (fermented soy or chickpeas dish popular in Japan), red beans, all of these contain substantial amounts of Vitamin K2. Natto is typically fermented by using a healthy bacteria called bacillus subtilus that may also serve as a probiotic. Natto contains the highest concentration of K2 of any food measured; nearly all of it is MK-7, which research has shown to be in a highly effective form. A recent study demonstrated that MK-7 increased the percentage of osteocalcin in humans three times more powerfully than did Vitamin K1. (Schurgers & Vermeer, 2000, pp. 298-307). Fermented foods, like natto, typically have the highest concentration of Vitamin K in the human diet. Levels of Vitamin K found in natto (K2) have been shown to far exceed those amounts found in dark green vegetables (K1). Not sure if all fermented vegetables contain Vitamin K2. One would have to experiment and see. Certain cultured dairy products are also said to contain Vitamin K2.

Warfarin (Coumadin®) is a frequently prescribed anticoagulant drug that inhibits normal Vitamin K function in the body. The alarming result of Vitamin K impairment is rapid development of osteoporosis and arterial calcification.

Other Non-Vegan Food Sources Vitamin K2

Fois gras
Animal Glands
This is because animals, not humans, can manufacture Vitamin K2 and it is stored in animal glands. Winston Price from Nourishing Traditions tested many forms of butter. He found that among all the many butter samples he tested, (Activator X) Vitamin K2 was only present when the animals were grazing on rapidly growing green grass. In most regions, this occurred in the spring and early fall. Butter that is made from cows that eat the new spring blades of grass has a totally different taste to other butters lacking Vitamin K2.

Prebiotics

Prebiotics are non-digestible food ingredients that stimulate the growth of bacteria in the digestive system. Prebiotics were first identified and named by Marcel Roberfroid in 1995. As a functional food component, prebiotics, are conceptually intermediate between foods and drugs. Some food sources considered to be prebiotics are Jerusalem artichoke, jicama, and chicory root), raw oats, unrefined spelt, unrefined barley are oligosaccharides that naturally occur in breast milk. These are believed to play an important role in the development of a healthy immune system in infants. While there is no broad consensus on an ideal daily serving of prebiotics, recommendations typically range from 4-8g for general digestive health, to 15g or more for those with active digestive disorders. Given an average 6g serving, below are the amounts of prebiotic foods required to achieve a daily serving of prebiotic fiber:

Food 6g serving prebiotics
Raw Chicory Root 9.3 g    (about 1/3 oz)
Raw Jerusalem Artichoke 19g (about 3/4 oz)
Raw dandelion greens 24.7g (just under 1 oz)
Raw Garlic 34.3 g (about 1.2 oz)
Raw Leek 51.3g (about 1.8 oz)
Cooked Onion 120g (about 1/4 lb)
Raw Asparagus 120 g (about 1/4 lb
Raw Spelt Bran 120g (about 1/4 lb)
Whole Grain Spelt Flour cooked 125g (about 1/4 lb)
Raw Banana 600g (about 1.3 lb)

There are differences between short-chain, long-chain, and full-spectrum prebiotics. "short-chain" prebiotics, e.g. oligofructose, contain 2-8 links per saccharide molecule, are typically fermented more quickly the colon providing nourishment to the bacteria in the right side of the colon. Longer-chain prebiotics, e.g. Inulin, contain 9-64 links per saccharide molecule, and tend to be fermented more slowly, nourishing bacteria predominantly in the left-side colon. Full-spectrum prebiotics provide the full range of molecular link-lengths from 2-64 links per molecule, and nourish bacteria throughout the colon, e.g. Oligofructose-Enriched Inulin (OEI). The majority of research done on prebiotics is based on full-spectrum prebiotics, typically using OEI as the research substance.

We are  sharing our experiences with PKD/PLD Diet, an adjunct diet envisioning it complementing a physician's prescribed medical therapy. Consider testing this with your doctor's prior knowledge, who can  adjust it according to your own uniqueness by adding it to your current  treatment.

Medical Disclaimer