SIBO Patients Should Consider K2 Supplements, Italian Doctors Recommend

Italian researchers have proposed that vitamin K2 supplementation may be of great therapeutic value for patients diagnosed with small intestinal bacterial overgrowth (SIBO) by linking subclinical atherosclerosis to SIBO via vitamin K2-dependent mechanisms. The results of this important observational study have recently been published in the World Journal of Gastroenterology.1

Patients with SIBO suffer from the presence of excessive bacteria in the small intestine, and also from unintentional weight loss, nutritional deficiencies, and osteoporosis. This disease is frequently blamed for causing chronic diarrhea and malabsorption. Moreover, recent studies have highlighted that patients with SIBO have low circulating levels of vitamin K2.2 Several maladies of the gastrointestinal tract, wherein gut bacteria act in a pathogenic capacity, are associated with vascular dysfunction and increase the risk of atherosclerosis in the host.

The aim of this study was to investigate the rate of MGP carboxylation (the protein that helps prevent calcium from accumulating in arterial walls) in patients with SIBO and to decipher its association with the risk of developing subclinical atherosclerosis. To that end, researchers enrolled 39 patients into the study, and 12 of them were diagnosed with SIBO (30.8%). Vascular assessment was carried out by ultrasound examination. Plasma levels of the inactive form of MGP (dp-ucMGP) were measured in blood and vitamin K2 intake was estimated using a food frequency questionnaire.

SIBO patients presented with a higher concentration of inactive form of MGP and arterial stiffness was elevated in this group. This phenomenon was reported to correlate linearly with the levels of inactive MGP. Carotid intima-media thickness and arterial calcifications were not observed to be significantly elevated as compared to controls.

“Assessing vitamin K2 status may be particularly valid for patients with small intestinal bacterial overgrowth (SIBO), since they are more prone to subclinical atherosclerosis due to reduced MGP activation and arterial stiffening,” says Dr. Katarzyna Maresz, president of the International Science and Health Foundation. “Such early detection enables a novel therapeutic approach of supplementing patients affected by SIBO with vitamin K2, which may be very beneficial in the treatment of this intestinal dysbiosis.”


1 Ponziani FR, Pompili M, Di Stasio E, Zocco MA, Gasbarrini A, Flore R. Subclinical atherosclerosis is linked to small intestinal bacterial overgrowth via vitamin K2-dependent mechanisms. World Journal of Gastroenterology. 2017;23(7):1241-1249. doi:10.3748/wjg.v23.i7.1241.

2 Giuliano V, Bassotti G, Mourvaki E, Castellani D, Filippucci E, Sabatino G, Gizzi S, Palmerini F, Galli F, Morelli O, Baldoni M, Morelli A, Iorio A. Small intestinal bacterial overgrowth and warfarin dose requirement variability. Thromb Res 2010; 126:12-17 [PMID: 20051286 DOI: 10.1016/j.thromres.2009.11.032]


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