Vitamin K Deficiency

Vitamin K Deficiency Testing and health information

Excessive or unexpected bleeding usually leads to the discovery of vitamin K deficiency. The main lab tests to examine the bleeding are the prothrombin time (PT/INR) and the Vitamin K blood test for blood levels.

SEE BELOW THE LIST OF TESTS FOR MORE INFORMATION ABOUT Vitamin K Deficiency and Lab Tests


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Vitamin K is a required co-factor for the synthesis of factors 2, 7, 9, and 10 and proteins C and S. Deficiencies of vitamin K lead to bleeding. Coumadin® (warfarin) acts as an anticoagulant because it is a vitamin K antagonist

Vitamin K Deficiency Discovery Advanced Panel

  • CBC (includes Differential and Platelets)
  • Fibrinogen Activity, Clauss
  • Prothrombin Time (PT) with INR
  • Vitamin K

Vitamin K Deficiency Discovery Advanced Panel

  • CBC (includes Differential and Platelets)
  • D-Dimer, Quantitative
  • Fibrinogen Activity, Clauss
  • Prothrombin Time (PT) with INR
  • Vitamin K
  • von Willebrand Factor Antigen

Warfarin (Coumadin®) therapy is associated with significant complications because of its narrow therapeutic index and large interpatient dosage variation necessary to achieve an optimal therapeutic response. This variation is due to both genetic and environmental factors. A promoter variant (-1639 G?A) of the Vitamin K epoxide complex subunit 1 (VCR) accounts for 25%-44% of this variability and variants of the cytochrome P enzyme C (SPCA) account for 10%-15% of this variability. Identification of these warfarin sensitive variants of the VKORC1 and the CYP2C9 genes may allow a more individualized therapy and reduced risk of bleeding complications.

C4B is a complement binding protein that specifically binds 50% circulating protein S, a vitamin K dependent cofactor of protein C activation. Since C4B may be elevated in certain disease states, this may affect the available "free protein S" to engage in anticoagulant activity.

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The factor X assay is a blood test to measure the activity of factor X. This is one of the proteins in the body that helps the blood clot.


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Description: A Magnesium test is a blood test that measures magnesium levels in your blood’s serum and is useful in determining the cause of abnormal levels of magnesium, calcium, and or potassium, and is useful in the evaluation of a wide variety of disorders such as diabetes, kidney disease, and malabsorption.

Also Known As: Magnesium Serum Test, Mg Test, Mag Test

Collection Method: Blood Draw

Specimen Type: Serum

Test Preparation: No preparation required

When is a Magnesium test ordered?

Magnesium tests may be requested by health professionals as a follow-up to chronically low calcium and potassium levels in the blood. It may also be ordered if a person is experiencing muscle weakness, cramping, twitching, disorientation, seizures, or cardiac arrhythmias, which could be caused by a magnesium deficit.

As part of an evaluation of malabsorption, malnutrition, diarrhea, or alcoholism, a health practitioner may prescribe a magnesium level to check for a deficit. Testing may also be done if someone is taking drugs that cause the kidneys to excrete magnesium. When magnesium and/or calcium supplementation is required, the level of magnesium in the blood can be measured at regular intervals to ensure that the medication is working.

A magnesium test, along with kidney function tests such as a BUN and creatinine, may be given on a regular basis when someone has a kidney problem or uncontrolled diabetes to help monitor renal function and ensure that the person is not excreting or retaining excessive quantities of magnesium.

What does a Magnesium Serum test check for?

The magnesium test measures the amount of magnesium in your blood’s serum. Magnesium is a mineral that supports healthy bones, neuron function, muscle contraction and energy production. It enters the body through the diet and is then processed by the small intestine and colon. Tissues, cells, and bones all contain the element magnesium. It is challenging to determine the total magnesium content from blood tests alone since only 1% of the magnesium present in the body is accessible in the blood. However, this test is still useful for figuring out a person's magnesium levels.

Small levels of magnesium can be found in a range of meals, including green vegetables like spinach, whole grains, and nuts. Magnesium is commonly found in foods that contain dietary fiber. The body regulates how much magnesium it receives and excretes or conserves in the kidneys to keep its magnesium level stable.

Magnesium deficiency can occur as a result of malnutrition, malabsorption-related disorders, or excessive magnesium loss via the kidneys. Magnesium overload can occur as a result of taking magnesium-containing antacids or a decrease in the kidneys' ability to eliminate magnesium.

There may be no or few nonspecific symptoms in someone with mild to severe magnesium insufficiency. Loss of appetite, nausea, muscle cramps, confusion, exhaustion, seizures, changes in heart rate, and tingling or numbness are all symptoms of persistent or severe deficits. They can also wreak havoc on calcium metabolism and worsen calcium deficiency. Muscle weakness, nausea, loss of hunger or cravings, and an erratic heart rate are some of the symptoms of excess magnesium, which are similar to those of deficiency.

Lab tests often ordered with a Magnesium test:

  • Complete Blood Count
  • Calcium
  • Iron Total and Total Iron binding capacity
  • Potassium
  • Comprehensive Metabolic Panel
  • Lipid Panel
  • Phosphorus
  • Parathyroid Hormone
  • Vitamin D
  • Glucose

Conditions where a Magnesium test is recommended:

  • Hypomagnesemia
  • Hypermagnesemia
  • Kidney Disease
  • Hypothyroidism
  • Diabetes
  • Alcoholism
  • Malnutrition
  • Malabsorption
  • Diarrhea
  • Dehydration
  • Parathyroid Diseases
  • Addison Disease
  • Adrenal Insufficiency

How does my health care provider use a Magnesium test?

Magnesium levels in the blood are measured with a magnesium test. Atypical magnesium levels are most frequently found in conditions or illnesses that result in insufficient or excessive renal excretion of magnesium or impaired intestinal absorption of magnesium. Magnesium levels can be measured to determine the severity of kidney issues, uncontrolled diabetes, as well as to diagnose gastrointestinal diseases.

Because a low magnesium blood level can lead to chronically low calcium and potassium levels over time, it may be tested to help diagnose calcium, phosphorus, potassium, and/or parathyroid hormone – another component of calcium regulation – problems.

Magnesium levels can be checked on a regular basis to monitor the response to oral or intravenous magnesium supplements, and calcium supplementation can be monitored using calcium and phosphorus tests.

What does my Magnesium test result mean?

Low magnesium levels in the blood can suggest that a person isn't getting enough magnesium or is excreting too much. Deficiencies are most commonly encountered in:

  • Low nutritional intake 
  • Gastrointestinal conditions
  • Diabetes that is uncontrolled
  • Hypoparathyroidism
  • Use of a diuretic for a long time
  • diarrhea that lasts for a long time
  • Following surgery
  • Burns that are severe
  • Pregnancy toxicity

Magnesium levels in the blood are rarely elevated as a result of food sources, but rather as a result of an excretion problem or excessive supplementation. Increased levels can be cause by:

  • Failure of the kidneys
  • Hyperparathyroidism
  • Hypothyroidism
  • Dehydration
  • Diabetic acidosis
  • Addison's disese
  • Use of antacids or laxatives containing magnesium

We advise having your results reviewed by a licensed medical healthcare professional for proper interpretation of your results.


Urinary magnesium concentrations often decline before serum concentrations. Adverse effects, such as cardiac arrhythmias, can be observed while serum concentrations are within range.

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Description: A Magnesium test is a blood test that measures magnesium levels in your blood’s serum and is useful in determining the cause of abnormal levels of magnesium, calcium, and or potassium, and is useful in the evaluation of a wide variety of disorders such as diabetes, kidney disease, and malabsorption.

Also Known As: Magnesium RBC Test, Magnesium Red Bood Cell Test, Mg Test, Mag test

Collection Method: Blood Draw

Specimen Type: Serum

Test Preparation: No preparation required

When is a Magnesium RBC test ordered?

Magnesium tests may be requested by health professionals as a follow-up to chronically low calcium and potassium levels in the blood. It may also be prescribed if a person exhibits symptoms of a magnesium deficiency, such as twitching, muscle weakness, cramping, disorientation, seizures, or cardiac arrhythmias.

As part of an evaluation of malabsorption, malnutrition, diarrhea, or alcoholism, a health practitioner may prescribe a magnesium level to check for a deficit. Testing may also be done if someone is taking drugs that cause the kidneys to excrete magnesium. When magnesium and/or calcium supplementation is required, the level of magnesium in the blood can be measured at regular intervals to ensure that the medication is working.

A magnesium test, along with kidney function tests such as a BUN and creatinine, may be given on a regular basis when someone has a kidney problem or uncontrolled diabetes to help monitor renal function and ensure that the person is not excreting or retaining excessive quantities of magnesium.

What does a Magnesium RBC test check for?

The magnesium test measures the amount of magnesium in your blood’s serum. Magnesium is a mineral that supports healthy bones, muscle contraction, neuron function, and energy production. It enters the body through the diet and is then absorbed by the small intestine and colon. Bones, cells, and tissues all contain the element magnesium. It is challenging to determine the total magnesium content from blood tests alone since only 1% of the magnesium present in the body is accessible in the blood. However, this test is still useful for figuring out a person's magnesium levels.

Small levels of magnesium can be found in a range of meals, including green vegetables like spinach, whole grains, and nuts. Magnesium is commonly found in foods that contain dietary fiber. The body regulates how much magnesium it receives and excretes or conserves in the kidneys to keep its magnesium level stable.

Magnesium deficiency can occur as a result of malnutrition, malabsorption-related disorders, or excessive magnesium loss via the kidneys. Magnesium overload can occur as a result of taking magnesium-containing antacids or a decrease in the kidneys' ability to eliminate magnesium.

There may be no or few nonspecific symptoms in someone with mild to severe magnesium insufficiency. Nausea, loss of appetite, exhaustion, confusion, muscle cramps, seizures, changes in heart rate, and numbness or tingling are all symptoms of persistent or severe deficits. They can also wreak havoc on calcium metabolism and worsen calcium deficiency. Nausea, muscle weakness, loss of appetite, and an erratic heart rate are some of the symptoms of excess magnesium, which are similar to those of deficiency.

Lab tests often ordered with a Magnesium RBC test:

  • Complete Blood Count
  • Calcium
  • Iron Total and Total Iron binding capacity
  • Potassium
  • Comprehensive Metabolic Panel
  • Lipid Panel
  • Phosphorus
  • Parathyroid Hormone
  • Vitamin D
  • Glucose

Conditions where a Magnesium RBC test is recommended:

  • Kidney Disease
  • Hypothyroidism
  • Diabetes
  • Alcoholism
  • Malnutrition
  • Malabsorption
  • Diarrhea
  • Dehydration
  • Parathyroid Diseases
  • Addison Disease
  • Adrenal Insufficiency

How does my health care provider use a Magnesium RBC test?

Magnesium levels in the blood are measured with a magnesium test. Atypical magnesium levels are most frequently found in conditions or illnesses that result in insufficient or excessive renal excretion of magnesium or impaired intestinal absorption of magnesium. Magnesium levels can be measured to determine the severity of kidney issues, uncontrolled diabetes, and/or uncontrolled diabetes as well as to diagnose gastrointestinal diseases.

Because a low magnesium blood level can lead to chronically low calcium and potassium levels over time, it may be tested to help diagnose calcium, phosphorus, potassium, and/or parathyroid hormone – another component of calcium regulation – problems.

Magnesium levels can be checked on a regular basis to monitor the response to oral or intravenous magnesium supplements, and calcium supplementation can be monitored using calcium and phosphorus tests.

What does my Magnesium RBC test result mean?

Low magnesium levels in the blood can suggest that a person isn't getting enough magnesium or is excreting too much. Deficiencies are most commonly encountered in:

  • Low nutritional intake 
  • Gastrointestinal conditions
  • Diabetes that is uncontrolled
  • Hypoparathyroidism
  • Use of a diuretic for a long time
  • diarrhea that lasts for a long time
  • Following surgery
  • Burns that are severe
  • Pregnancy toxicity

Magnesium levels in the blood are rarely elevated as a result of food sources, but rather as a result of an excretion problem or excessive supplementation. Increased levels can be cause by:

  • Failure of the kidneys
  • Hyperparathyroidism
  • Hypothyroidism
  • Dehydration
  • Diabetic acidosis
  • Addison's disese
  • Use of antacids or laxatives containing magnesium

We advise having your results reviewed by a licensed medical healthcare professional for proper interpretation of your results.


Aids in diagnosis of decreased activity of Protein C characterized by recurrent venous thrombosis. Acquired deficiencies associated with Protein C include: oral anticoagulant therapy, liver disease, vitamin K deficiency, malignancy, consumptive DIC, surgery, trauma, antibodies to Protein C and hepatic immaturity of the newborn.

In the presence of low Protein C Activity, Protein C Antigen is useful in classifying the deficiency as Type I or II.

Aids in diagnosis of congenital deficiencies characterized by recurrent venous thrombosis. Acquired deficiencies associated with Protein C include: oral anticoagulant therapy, liver disease, vitamin K deficiency, malignancy, consumptive DIC, surgery, trauma, antibodies to Protein C and hepatic immaturity of the newborn.

Description: A Prothrombin Time test will measure the speed of which your blood clots. This test can be used to detect a bleeding or clotting disorder or to determine in your blood is clotting too fast or too slow.

Also Known As: Pro Time with INR Test, Prothrombin Time and International Normalized Ratio test, Prothrombin Time PT with INR Test, Prothrombin Time with INR Test, Prothrombin with INR, Protime with INR, PT Test

Collection Method: Blood draw

Specimen Type: Whole Blood

Test Preparation: No preparation required

When is a Prothrombin Time with INR test ordered?

When a person takes the anticoagulant medicine warfarin, a PT and INR are ordered on a regular basis to confirm that the prescription is working effectively and that the PT/INR is adequately extended. A doctor will prescribe them frequently enough to ensure that the treatment is having the desired effect, namely, boosting the person's clotting time to a therapeutic level while minimizing the danger of excessive bleeding or bruising.

When a person who isn't taking anticoagulants exhibits signs or symptoms of excessive bleeding or clotting, a PT may be ordered when they are experiencing:

  • Bleeding that isn't explained or bruises that isn't easy to get rid of
  • Nosebleeds
  • Gums that are bleeding
  • A blood clot in an artery or vein
  • Disseminated intravascular coagulation
  • A persistent disorder that affects hemostasis, such as severe liver disease

PT and PTT may be prescribed prior to surgery when there is a high risk of blood loss associated with the procedure and/or when the patient has a clinical history of bleeding, such as frequent or severe nosebleeds and easy bruising, which may indicate the presence of a bleeding problem.

What does a Prothrombin Time with INR blood test check for?

The prothrombin time is a test that determines a person's capacity to make blood clots properly. The international normalized ratio, or INR, is a calculation based on the results of a PT that is used to track people who are taking the blood thinner warfarin.

After chemicals are added to a person's blood sample, a PT measures how long it takes for a clot to develop. The PT is frequently used with a partial thromboplastin time to measure the number and function of proteins known as coagulation factors, which are essential for optimal blood clot formation.

When an injury develops in the body and bleeding ensues, the clotting process known as hemostasis begins. This process is aided by a series of chemical events known as the coagulation cascade, in which coagulation or "clotting" components are activated one by one, leading to the development of a clot. In order for normal clotting to occur, each coagulation factor must be present in appropriate quantities and operate effectively. Excessive bleeding can result from too little, while excessive clotting can result from too much.

There are two "pathways" that can trigger clotting in a test tube during a laboratory test, the extrinsic and intrinsic pathways. Both of these pathways subsequently converge to finish the clotting process. The PT test assesses how well all coagulation factors in the extrinsic and common routes of the coagulation cascade cooperate. Factors I, II, V, VII, and X are included. The PTT test examines the protein factors XII, XI, IX, VIII, X, V, II, and I, as well as prekallikrein and high molecular weight kininogen, which are all part of the intrinsic and common pathways. The PT and PTT examine the overall ability to generate a clot in a fair period of time, and the test results will be delayed if any of these elements are insufficient in quantity or are not operating effectively.

The PT test is normally done in seconds and the results are compared to a normal range that represents PT levels in healthy people. Because the reagents used to conduct the PT test vary from one laboratory to the next and even within the same laboratory over time, the normal ranges will change. The Internationalized Normalized Ratio, which is computed based on the PT test result, was developed and recommended for use by a World Health Organization committee to standardize results across various laboratories in the United States and around the globe for people taking the anticoagulant warfarin.

The INR is a formula that accounts for variations in PT reagents and enables for comparison of findings from different laboratories. When a PT test is performed, most laboratories report both PT and INR readings. However, the INR should only be used by people who are taking the blood thinner warfarin.

Lab tests often ordered with a Prothrombin Time with INR test:

  • Partial Thromboplastin Time
  • Fibrinogen Activity
  • Platelet Count
  • Complete Blood Count (CBC)
  • Coagulation Factors
  • Warfarin Sensitivity testing

Conditions where a Prothrombin Time with INR test is recommended:

  • Bleeding Disorders
  • Excessive Clotting Disorders
  • Vitamin K Deficiency
  • Liver Disease
  • DIC

How does my health care provider use a Prothrombin Time with INR test?

The prothrombin time is used to diagnose the origin of unexplained bleeding or abnormal blood clots, generally in conjunction with a partial thromboplastin time. The international normalized ratio is a calculation based on the results of a PT that is used to monitor people on the blood thinner warfarin.

Coagulation factors are proteins that are involved in the body's process of forming blood clots to assist stop bleeding. When an injury occurs and bleeding begins, coagulation factors are triggered in a series of events that finally assist in the formation of a clot. In order for normal clotting to occur, each coagulation factor must be present in appropriate quantities and operate effectively. Excessive bleeding can result from too little, while excessive clotting can result from too much.

The PT and INR are used to monitor the anticoagulant warfarin's efficacy. This medication influences the coagulation cascade's function and aids in the prevention of blood clots. It is given to those who have a history of recurrent abnormal blood clotting on a long-term basis. Warfarin therapy's purpose is to strike a balance between preventing blood clots and causing excessive bleeding. This equilibrium must be carefully monitored. The INR can be used to change a person's medication dosage in order to get their PT into the ideal range for them and their condition.

What do my PT and INR test results mean?

Most laboratories report PT findings that have been corrected to the INR for persons taking warfarin. For basic "blood-thinning" needs, these persons should have an INR of 2.0 to 3.0. Some people with a high risk of blood clot require a higher INR, about 2.5 to 3.5.

The outcome of a PT test is determined by the method utilized, with results measured in seconds and compared to a normal range defined and maintained by the laboratory that administers the test. This normal range is based on the average value of healthy persons in the area, and it will differ somewhat from test to lab. Someone who isn't on warfarin would compare their PT test result to the usual range provided by the laboratory that conducted the test.

A prolonged PT indicates that the blood is taking an excessive amount of time to clot. This can be caused by liver illness, vitamin K inadequacy, or a coagulation factor shortage, among other things. The PT result is frequently combined with the PTT result to determine what condition is present.

We advise having your results reviewed by a licensed medical healthcare professional for proper interpretation of your results.


Description: PTH is a hormone that is used to help maintain levels of calcium in the blood. A PTH test will measure the amount of PTH in the blood and can be used to make sure that the feedback loop is working correctly. 

Also Known As: Parathyroid hormone Intact test, Intact PTH test, Parathormone test

Collection Method: Blood Draw

Specimen Type: Plasma

Test Preparation: No preparation required

When is a PTH test ordered?

When a calcium test is abnormal, a PTH test may be requested. When someone shows signs of hypercalcemia or hypocalcemia, it may be prescribed.

When someone has been treated for an illness or condition that affects calcium control, such as the elimination of a parathyroid tumor, or when a person has a long - term condition like renal disease, a health practitioner may prescribe a PTH test along with a calcium test at intervals.

When someone with hyperparathyroidism is undergoing surgery to remove abnormal parathyroid tissue, an intraoperative PTH test may be done to confirm that all of the abnormal glands are removed, which can vary in number and position.

What does a PTH blood test check for?

The hormone parathyroid aids in the body's ability to keep calcium levels in the blood at a constant level. Calcium, PTH, vitamin D, and, to a lesser extent, phosphorus and magnesium are all part of a feedback loop. Conditions and disorders that disturb this feedback loop can lead to abnormal increases or declines in calcium and PTH levels, as well as hypercalcemia and hypocalcemia symptoms. This test determines how much PTH is present in the blood.

PTH is generated by four parathyroid glands, which are positioned behind the thyroid gland in the neck and are the size of a button. PTH is secreted into the bloodstream by these glands in reaction to low blood calcium levels. To help restore normal blood calcium levels, the hormone functions in three ways:

  • PTH encourages calcium to be released from the bones into the bloodstream.
  • It encourages the kidneys to convert vitamin D from inactive to active form, which enhances calcium absorption from food in the intestines.
  • It works on the kidneys to reduce calcium excretion in the urine while increasing phosphorus excretion.

PTH generally declines as calcium levels in the blood begin to rise.

The parathyroid hormone is made up of 84 amino acids. The parathyroid gland contains both intact and fragmented hormone, which it secretes. The intact hormone makes up a lesser percentage of the total, but its proportion rises when calcium levels are low and falls when calcium levels are high.

PTH has a relatively short half-life once released into the bloodstream; absorption and cleavage in the liver and kidneys cause levels to drop by 50% in less than 5 minutes. The pieces are known as C-terminal fragments, and they range in size from 6 amino acids to more than half of the molecule's N-terminal region. C-terminal fragments have a longer half-life, are found in higher concentrations, and are eventually eliminated by the kidneys. Although the C-terminal fragments were assumed to be inactive at first, it now appears that some of them may have biologic actions that are able to counteract those of whole PTH.

Lab tests often ordered with a PTH test:

  • Calcium
  • Phosphorus
  • Vitamin D

Conditions where a PTH test is recommended:

  • Parathyroid Disease
  • Kidney Disease
  • Hypercalcemia
  • Hypocalcemia

How does my health care provider use a PTH test?

The most commonly requested parathyroid hormone test is intact PTH. It's utilized to figure out what's causing a low or high calcium level, as well as to distinguish between parathyroid and non-parathyroid reasons. When a person has a parathyroid-related ailment, it can also be utilized to track the effectiveness of treatment. People with chronic renal disease or who are on dialysis have their PTH levels checked on a regular basis.

Almost always, a calcium test is ordered in conjunction with a PTH test. It's not just the calcium level in the blood that matters, but also the calcium-PTH balance and the parathyroid glands' response to fluctuating calcium levels. Typically, health professionals are concerned about severe calcium regulation imbalances that may necessitate medical intervention or recurring imbalances that signal an underlying disease.

PTH levels can be used to track persons who have chronic calcium imbalances due to illnesses or diseases, as well as those who have had surgery or another procedure for a parathyroid tumor.

What do my PTH test results mean?

A health professional will look at both calcium and PTH findings to see if they're in the right range and in balance. If both PTH and calcium levels are normal, the body's calcium regulating mechanism is likely to be in good working order.

Low levels of PTH can be caused by hypercalcemia or a defect in PTH generation, resulting in hypoparathyroidism. Hyperparathyroidism, which is most commonly caused by a benign parathyroid tumor, can produce excessive PTH secretion. Cancer may be the reason in some cases.

If calcium levels are low and PTH levels are high, the parathyroid glands are responding properly and producing enough PTH. A health practitioner may examine a low calcium level further by analyzing vitamin D, phosphorus, and magnesium levels, depending on the degree of hypocalcemia.

If calcium levels are low and PTH levels are normal or low, PTH isn't working properly, and the person being tested is most likely hypoparathyroid. The failure of the parathyroid glands to produce enough PTH causes hypoparathyroidism. It could be caused by a variety of factors and could be chronic, progressive, or transitory. An autoimmune problem, parathyroid injury or removal during surgery, a hereditary condition, or a serious sickness are all possible causes. PTH levels will be low, calcium levels will be low, and phosphorus levels will be high in those who are impacted.

If your calcium levels are high and your PTH levels are high, your parathyroid glands are producing too much PTH. To help diagnose the origin and severity of hyperparathyroidism, a health practitioner may order X-rays or other imaging procedures. Primary, secondary, and tertiary hyperparathyroidism are three types of hyperparathyroidism characterized by an excess of PTH produced by the parathyroid glands.

If calcium levels are high and PTH levels are low, the parathyroid glands are functioning normally. However, a health practitioner will likely conduct additional tests to rule out non-parathyroid causes for the elevated calcium, such as genetic variants in calcium receptors or tumors that secrete a peptide with PTH-like activity, which increases calcium concentration while decreasing PTH.

We advise having your results reviewed by a licensed medical healthcare professional for proper interpretation of your results.



Diagnosing Vitamin K Deficiency; the body requires small regular amounts of Vitamin K. This nutrient is important in the formation of coagulation factors, protein S, and protein C. When blood vessels are injured, all these substances help in the blood’s clotting. They also ensure excessive clotting is prevented. Easy bruising and extreme bleeding can be caused by inadequate vitamin K. Also, this nutrient has an important role when it comes to bone loss prevention. Low bone density has been associated with low levels of vitamin K within the blood. There is some evidence suggesting that enough vitamin K levels lead to bone health improvement. Such levels also reduce fracture risks.

Vitamin K exists in three different types:

  • Vitamin K1 comes from foods. It also goes by the name phylloquinone or phytomenadione. Green leafy vegetables, vegetable oils, and dairy products are the source of vitamin K1. It is regarded as vitamin K’s “plant form.” The commercial production of K1 is also done for the treatment of conditions linked to excess bleeding.  
  • Bacteria are used in the production of vitamin K2 (menaquinones). It is produced by the intestines’ normal flora. The conversion of K1 into K2 is made possible by intestinal bacteria. The body’s requirements are met when the diet is supplemented by vitamin K2.    
  • K3 (menadione) is a synthetic chemical compound that is non-natural. This nutritional supplement is used in some countries due to its vitamin K activity. Menadione supplements aren’t allowed for human use in the US due to their potential toxicity. The body must take in a certain amount of vitamin K through the diet since enough amounts of this nutrient aren’t produced by the body. This vitamin is present within many food varieties. It is normally supplied in enough levels in the regular diet in the USA.

Various foods contain high levels of vitamin K per serving. They usually exceed the Recommended Daily Allowance (RDA). These foods consist of leafy green vegetables, including spinach, kale, green leaf lettuce, and collards. Other vegetables such as asparagus, broccoli, cabbage, and brussels sprouts also fall under this category. Dairy products, soybeans, cereals, and vegetable oils also add up as other sources. Both K1 and K2 are fat-soluble. They are stored in the fat tissue and liver of the body. Vitamin K that’s worth a week is typically stored by an adult.

Factors That Result in Vitamin K Deficiency          

Insufficient dietary intake, decreased vitamin K storage because of liver disease, and inadequate absorption are the common causes that result in vitamin K deficiency. A decrease in its production within the intestines may also lead to its deficiency.

Healthy individuals in the US rarely experience dietary deficiency of vitamin K. This is, however, relatively common with individuals that have certain chronic conditions or are severely ill. For instance, it is commonly witnessed in patients suffering from serious illnesses such as cancer patients who are undergoing chemotherapy and chronic dialysis patients. It can also be seen in individuals at risk for malnutrition, such as those that have poor dietary habits that are linked to drug abuse or alcoholism.

Malabsorption can result in vitamin K deficiency. This can more so be caused by impaired fat absorption due to conditions such as celiac disease, Crohn’s disease or chronic pancreatitis, and cystic fibrosis. Malabsorption can also be caused by cholestatic liver diseases such as primary biliary cirrhosis or bile duct obstruction. This results in vitamin K deficiency. The absorption of vitamin K can be affected by medications such as antacids, antibiotics, as well as anti-seizure drugs. These medications can also affect the amount of K2 produced within the intestines or even lead to vitamin K’s degradation. Vitamin K requirements may be increased through the consumption of high aspirin doses.

Insufficient normal flora within the intestines of newborns can result in vitamin K deficiency. Vitamin K may also not be present in enough levels from breast milk. Also, vitamin K deficiency may occur once the infant is born if the infant’s mother was on certain medications such as anti-seizure medications while pregnant. These incidents are usually linked to vitamin K deficiency bleeding or VKDB. It is also referred to as hemorrhagic disease of the newborn. It can result in extreme bleeding and bruising. Severe cases may result in fatal brain bleeding.

VKDB was a relatively common occurrence in the past. Luckily, it has subsided since the introduction of the vitamin K injection that’s administered shortly after newborns are delivered. The American Academy of Pediatrics recommends its administration. Vitamin K may also be administered to help with excessive infant bleeding in instances where surgeries are required.   

A frequent question asked is if individuals that have used the anticoagulant drug warfarin in their treatment shouldn’t eat foods rich in vitamin K. It is also common for people to query whether the risk of vitamin K deficiency is heightened by limiting such foods after being treated with Coumadin®.

Individuals with various conditions, including cardiovascular diseases (CVD) and deep vein thrombosis (DVT), are prescribed with warfarin. It helps “thin” their blood. Inappropriate clotting is prevented using this drug. A test termed as PT/INR is usually done to determine how effective the dose “thins” the blood after the prescription of warfarin by a healthcare practitioner. The adjustment of this dose is determined by the test results. This adjustment ensures excessive bleeding is prevented through the prescription of the right amount of the dose.

The ability of the liver to use vitamin K in the production of blood-clotting factors is reduced by taking warfarin. This implies that an antagonism exists between warfarin and vitamin K. They counteract each other. The success of warfarin in the prevention of blood clots without resulting in excess bleeding is dependent on the significant decreases or increases in the vitamin K amounts consumed by an individual. Individuals who are under warfarin prescriptions need to take in a consistent amount of foods rich in vitamin K every day rather than avoid them. Through consistency in the food amount that’s consumed, these individuals can get their much-needed vitamin K.    

Signs and Symptoms

Vitamin K deficiency can be associated with the following signs and symptoms:

  • An increase in prothrombin time (PT/INR)
  • Intense menstrual periods
  • Urine and/or stool that contains blood
  • Easy bruising
  • Oozing from either gums or nose
  • Extreme bleeding from punctures, wounds, and surgical or injection sites
  • Bleeding from the GI (gastrointestinal) tract

The signs and symptoms mentioned above may be similar in vitamin K deficiency bleeding involving newborns. More serious cases in newborns involve intracranial hemorrhage. 

Questions may be raised on whether one is vitamin K deficient if the symptoms mentioned above are observed in an individual with an increased risk, say:

  • Individuals with chronic conditions linked to malabsorption or malnutrition
  • Individuals who’ve been undergoing treatment for a long-time using antibiotics; the medications act by killing the bacteria responsible for vitamin K2 production in the small intestine.
  • Severely sick patients such as dialysis or cancer patients

Tests      

Excessive or unexpected bleeding usually leads to the discovery of vitamin K deficiency. The principal laboratory test that’s conducted to examine the bleeding in such cases is the prothrombin time (PT/INR). The administration of vitamin K by injection is done if it is suspected that the bleeding may have been as a result of low vitamin K levels. An assumption is made that a vitamin K deficiency caused the bleeding if it stops, and the PT is normalized.

Occasionally, other coagulation tests may be performed to an individual with excessive bleeding and bruising symptoms. They include thrombin time, partial thromboplastin time (PTT), platelet function tests, platelet countfibrinogend-dimer, coagulation factor tests, and von Willebrand factor.