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Vitamin K and VKORC1: What Your Genes May Mean for Bone and Blood Health

Vitamin K is a fat soluble vitamin that plays a key role in blood clotting, bone health, and tissue maintenance. It is found mainly as Vitamin K1 in leafy green vegetables and as Vitamin K2 in fermented foods and some animal products. The VKORC1 gene makes an enzyme that recycles vitamin K, converting the inactive form back to the active form so the body can reuse it. Variations in VKORC1 can change how efficiently this recycling happens, which can affect active vitamin K levels and, over time, influence bone mineral density and other vitamin K dependent processes.

How to read this page

  • The genetic interpretations below describe common genotypes at the VKORC1 rs7294 variant and what they may mean for vitamin K recycling.
  • Use the diet, supplement, lifestyle, and testing suggestions to support healthy vitamin K status. These are educational recommendations only.
  • PlexusDx does not provide medical advice. Always discuss genetic results and any changes to diet, supplements, or medications with your healthcare provider.

Quick overview of Vitamin K forms and sources

  • Vitamin K1 (phylloquinone): abundant in dark green leafy vegetables such as spinach, kale, collards, and broccoli.
  • Vitamin K2 (menaquinones): made by bacteria and found in fermented foods like natto, some cheeses, and in small amounts in animal products such as egg yolks and liver.
  • Vitamin K is fat soluble. Consuming food sources with a small amount of healthy fat improves absorption.

Genetic interpretations

Two effect alleles (TT) — reduced VKORC1 recycling efficiency

If your genotype is TT at rs7294, you carry two copies of the effect allele. This variant is associated with lower VKORC1 enzyme efficiency in recycling vitamin K. As a result, you may have lower circulating levels of active Vitamin K1, which is needed to activate proteins such as osteocalcin that support bone mineralization. Over time this pattern can be associated with lower bone mineral density compared to people with other genotypes. Clinical implications can vary based on diet, lifestyle, medications, and other genes.

Considerations for TT genotype

  • Prioritize regular dietary intake of Vitamin K1 and K2.
  • Discuss bone health monitoring with your provider, especially if you have other risk factors for osteoporosis.
  • Avoid abrupt changes to anticoagulant medications unless directed by your prescriber, as vitamin K status can interact with some blood thinners.
One effect allele (CT) — moderately reduced VKORC1 recycling efficiency

If your genotype is CT at rs7294, you carry one copy of the effect allele. This pattern is associated with somewhat reduced efficiency of VKORC1 mediated vitamin K recycling. You may have modestly lower levels of active vitamin K1 in blood plasma than people without the effect allele. This can influence activation of bone related proteins and may be associated with slightly lower bone mineral density, although the effect is generally smaller than with two effect alleles.

Considerations for CT genotype

  • Include daily servings of vitamin K rich foods, balancing K1 from leafy greens with K2 sources from fermented foods or certain cheeses.
  • Maintain routine bone healthy behaviors including weight bearing exercise and adequate calcium and vitamin D.
  • Review any medications with your clinician that interact with vitamin K.
Zero effect alleles (CC) — typical VKORC1 recycling efficiency

If your genotype is CC at rs7294, you carry two copies of the non effect allele. This genotype is associated with typical VKORC1 enzyme activity and normal vitamin K recycling. Your body is likely able to regenerate active vitamin K efficiently, supporting normal activation of clotting factors and bone proteins.

Considerations for CC genotype

  • Although genetic processing is typical, maintaining vitamin K rich eating patterns is still important for long term bone and cardiovascular health.
  • Keep up with bone supportive lifestyle measures and routine clinical screening as recommended by your provider.

Diet recommendations

  • Daily servings of dark green leafy vegetables: aim for a variety such as spinach, kale, Swiss chard, collard greens, and broccoli to supply Vitamin K1.
  • Include Vitamin K2 sources several times per week: fermented soy product natto is the richest source. Hard cheeses, soft cheeses, and some fermented dairy contain varying amounts of K2. Small amounts are present in egg yolks and organ meats.
  • Consume vitamin K rich foods with a source of dietary fat for better absorption, for example sauté greens in olive oil, add avocado to salads, or pair vegetables with a vinaigrette.
  • Balance vitamin K intake across days rather than making large sudden changes, especially if you use anticoagulant medications. Talk to your prescribing clinician about consistent dietary vitamin K patterns.

Supplement recommendations and safety

  • Supplementation may be considered if dietary intake is inadequate or if testing reveals low vitamin K status. Vitamin K supplements commonly come as K1 (phytonadione) or K2 (menaquinone-4 or menaquinone-7).
  • Discuss any supplement plan with your healthcare provider before starting. Supplements can affect blood clotting and can interact with medications such as warfarin and other anticoagulants.
  • If recommended by your clinician, K2 supplements are often preferred for bone health because some forms remain active longer in the body. Dose and form should be individualized.

Lifestyle recommendations

  • Weight bearing and resistance exercise: promote bone strength and bone mineral density. Aim for regular sessions each week tailored to your fitness level.
  • Adequate calcium and vitamin D: ensure sufficient dietary calcium and evaluate vitamin D status with your clinician. Both nutrients complement vitamin K for bone maintenance.
  • Avoid smoking and limit excessive alcohol, both of which impair bone health over time.
  • Maintain a balanced body weight. Being underweight and rapid weight loss increase risk for bone loss.

Blood tests and monitoring

  • Discuss bone density testing with your provider if you have risk factors for osteoporosis or if genetic results are one of several concerns.
  • Consider testing vitamin K dependent proteins or functional assays if suggested by your clinician to assess vitamin K status in specific clinical scenarios.
  • If you are on anticoagulant therapy, regular monitoring of clotting parameters is essential. Any dietary or supplement changes that affect vitamin K should be coordinated with your prescribing clinician.

Final notes and disclaimer

This information is educational and focused on how VKORC1 variants can influence vitamin K recycling, bone health, and related considerations. PlexusDx does not provide medical advice. Always consult with your healthcare provider or a qualified clinician before making changes to your diet, supplements, exercise, or medications. Your provider can help interpret genetic results in the context of your full medical history, current medications, laboratory testing, and other risk factors.