Vitamin K2 in Osteoporosis Treatment

Corina Adelina Zah 1  and Paul Grama 1
  • 1 “Iuliu Haţieganu” University of Medicine and Pharmacy, , Cluj-Napoca


Osteoporosis is represented by loss of bone mass with consequent bone fragility and increased risk of fractures. Current treatment options include several classes of drugs and adjuvant use of vitamin D and calcium. The aim of this review is to study whether vitamin K2 could be of use to the actual treatment schemes as it is directly implicated in the normal metabolism of bone tissue. After consulting the current literature, we have found that vitamin K2 is able to reduce the risk of fracture in osteoporotic patients, increase osteocalcin and diminish levels of undercarboxylated osteocalcin. In conclusion, vitamin K2 has the capability of improving the outcome and evolution of osteoporosis with minimal to no adverse effects and possibly achieving higher treatment compliance.

If the inline PDF is not rendering correctly, you can download the PDF file here.

  • 1. Consensus development conference: Diagnosis, prophylaxis, and treatment of osteoporosis, The American Journal of Medicine. 1993;94(6):646-650.

  • 2. Kanis JA, Cooper C, Rizzoli R, Reginster JY. Executive summary of the European guidance for the diagnosis and management of osteoporosis in postmenopausal women. Calcif Tissue Int. 2019;104(3):235–8.

  • 3. Butler L. March 19, 1960 NATURE. 1960;17(4716):4716.

  • 4. Ebina K, Noguchi T, Hirao M, Kaneshiro S, Tsukamoto Y, Yoshikawa H. Comparison of the effects of 12 months of monthly minodronate monotherapy and monthly minodronate combination therapy with vitamin K2 or eldecalcitol in patients with primary osteoporosis. J Bone Miner Metab. 2016;34(3):243–50.

  • 5. Douglas AS, Robins SP, Hutchison JD, Porter RW, Stewart A, Reid DM. Carboxylation of osteocalcin in post-menopausal osteoporotic women following vitamin K and D supplementation. Bone. 1995;17(1):15–20.

  • 6. Iwamoto J, Takeda T, Ichimura S. Effect of combined administration of vitamin D3 and vitamin K2 on bone mineral density of the lumbar spine in postmenopausal women with osteoporosis. J Orthop Sci. 2000;5(6):546–51.

  • 7. Shiraki M, Shiraki Y, Aoki C, Miura M. Vitamin K2 (Menatetrenone) Effectively Prevents Fractures and Sustains Lumbar Bone Mineral Density in Osteoporosis. J Bone Miner Res. 2010;15(3):515–21.

  • 8. Iwamoto J, Takeda T, Ichimura S. Effect of menatetrenone on bone mineral density and incidence of vertebral fractures in postmenopausal women with osteoporosis: A comparison with the effect of etidronate. J Orthop Sci. 2001;6(6):487–92.

  • 9. Ishida Y, Kawai S. Comparative efficacy of hormone replacement therapy, etidronate, calcitonin, alfacalcidol, and vitamin K in postmenopausal women with osteoporosis: The Yamaguchi Osteoporosis Prevention Study. Am J Med. 2004;117(8):549–55.

  • 10. Tanaka S, Miyazaki T, Uemura Y, Miyakawa N, Gorai I, Nakamura T, et al. Comparison of concurrent treatment with vitamin K2 and risedronate compared with treatment with risedronate alone in patients with osteoporosis: Japanese Osteoporosis Intervention Trial-03. J Bone Miner Metab. 2017;35(4):385–95.

  • 11. Kasukawa Y, Miyakoshi N, Ebina T, Aizawa T, Hongo M, Nozaka K, et al. Effects of risedronate alone or combined with vitamin K2on serum undercarboxylated osteocalcin and osteocalcin levels in postmenopausal osteoporosis. J Bone Miner Metab. 2014;32(3):290–7.

  • 12. Miki T, Nakatsuka K, Naka H, Kitatani K, Saito S, Masaki H, et al. Vitamin K2 (menaquinone 4) reduces serum undercarboxylated osteocalcin level as early as 2 weeks in elderly women with established osteoporosis. J Bone Miner Metab. 2003;21(3):161–5.

  • 13. Shiraki M, Itabashi A. Short-term menatetrenone therapy increases gamma-carboxylation of osteocalcin with a moderate increase of bone turnover in postmenopausal osteoporosis: A randomized prospective study. J Bone Miner Metab. 2009;27(3):333–40.

  • 14. Inoue T, Fujita T, Kishimoto H, Makino T, Nakamura T, Nakamura T, et al. Randomized controlled study on the prevention of osteoporotic fractures (OF study): A phase IV clinical study of 15-mg menatetrenone capsules. J Bone Miner Metab. 2009;27(1):66–75.


Journal + Issues