Vitamin
    Moderate Evidence

    Vitamin K1

    Phylloquinone

    TL;DR

    K1 is the form that runs blood clotting and is abundant in leafy greens; the bone and arterial claims people attach to "vitamin K" mostly come from K2 trials, and K1 supplementation has largely failed to reduce fractures.

    Ideal For

    • People with fat malabsorption or very low vegetable intake
    • Newborns, via standard prophylactic injection

    Avoid If

    • You take warfarin and have not discussed it with your prescriber
    • You are specifically seeking bone or arterial benefit — that evidence belongs to K2

    Frequently Asked Questions

    Overview

    Phylloquinone is the vitamin K found in green vegetables, and it is the form your liver preferentially takes up to gamma-carboxylate clotting factors II, VII, IX and X. Frank deficiency is rare outside malabsorption, newborns and long-term antibiotic use, which is why the newborn K1 injection remains one of the most cost-effective preventive interventions in medicine. Where the picture gets muddled is bone and vascular health. Osteocalcin and matrix Gla protein also require vitamin K, but they are extrahepatic, and menaquinones (K2, especially MK-7) persist in circulation far longer and reach those tissues better. Trials reflect this: the ECKO trial gave 5 mg/day of K1 to 440 postmenopausal women for two to four years and found no improvement in bone mineral density, while K2 trials have shown more consistent, if still debated, fracture signals. K1 is also the reason warfarin users are told to keep leafy-green intake steady rather than avoid it.

    How It Works

    • Cofactor for gamma-glutamyl carboxylase, activating clotting factors II, VII, IX, X
    • Carboxylates osteocalcin, though less efficiently in bone than menaquinones
    • Recycled through the vitamin K epoxide reductase cycle that warfarin blocks

    Quick Facts

    • One cup of cooked kale supplies many times the daily adequate intake
    • ECKO trial: 5 mg/day K1 for up to 4 years did not improve bone density
    • Warfarin patients need consistent, not zero, vitamin K intake

    Benefits & Outcomes

    No linked outcomes yet. Research is ongoing.

    Supporting Research
    14 studies

    Vitamin K supplementation and vascular calcification in people with type 2 diabetes and chronic kidney disease: a randomized controlled trial

    Score: 8/10
    2019
    rct
    n=68

    Zwakenberg SR, de Jong PA, Bartstra JW +3 more

    Vitamin K status improved markedly but there was no difference in femoral artery or coronary calcification progression versus placebo.

    View source

    Vitamin K2 supplementation does not influence bone loss in early menopausal women: a randomised double-blind placebo-controlled trial

    Score: 8/10
    2010
    rct
    n=334

    Emaus N, Gjesdal CG, Almås B +5 more

    No significant difference in bone mineral density change at any measured site despite improved vitamin K status markers.

    View source

    Vitamin K2 and bone health: a systematic review

    Score: 5/10
    2006
    systematic_review

    Iwamoto, I., Kosha, S., Noguchi, S.

    Review of vitamin K2 (menaquinone) trials, dominated by Japanese studies of high-dose MK-4 (45 mg/day), reported improved bone mineral density maintenance and reduced vertebral and non-vertebral fracture rates in postmenopausal and osteoporotic women, with effects on bone quality via osteocalcin carboxylation rather than density alone.

    View source

    Evaluation of the clinical efficacy and safety of an eye counter pad containing caffeine and vitamin K in emulsified Emu oil triglycerides

    Score: 5/10
    2015
    rct
    n=22

    Ahmadraji F, Shatalebi MA

    Significant reduction in infraorbital pigmentation and wrinkle depth versus baseline and control side.

    View source

    Accelerated resolution of laser-induced bruising with topical 20% arnica: a rater-blinded randomized controlled trial

    Score: 5/10
    2010
    rct
    n=22

    Leu S, Havey J, White LE +4 more

    Topical 20% arnica ointment reduced laser-induced bruising more than white petrolatum and 1% vitamin K formulations.

    View source

    Three-year low-dose menaquinone-7 supplementation helps decrease bone loss in healthy postmenopausal women

    Score: 8/10
    2013
    rct
    n=244

    Knapen MH, Drummen NE, Smit E +2 more

    MK-7 improved vitamin K status, decreased age-related decline in lumbar spine and femoral neck bone mineral density and reduced vertebral height loss.

    View source

    Dietary intake of menaquinone is associated with a reduced risk of coronary heart disease: the Rotterdam Study

    Score: 6/10
    2004
    cohort
    n=4807

    Geleijnse JM, Vermeer C, Grobbee DE +5 more

    Highest tertile of menaquinone intake was associated with reduced coronary heart disease mortality, all-cause mortality and severe aortic calcification; phylloquinone intake showed no association.

    View source

    Effect of vitamin K supplementation on bone loss in elderly men and women

    Score: 9/10
    2008
    rct
    n=452

    Booth SL, Dallal G, Shea MK +3 more

    Phylloquinone reduced undercarboxylated osteocalcin but produced no difference in bone mineral density.

    View source

    Daily vitamin K supplementation improves anticoagulant stability

    Score: 7/10
    2007
    rct
    n=200

    Rombouts EK, Rosendaal FR, van der Meer FJ

    Daily supplementation with 100 microgram of vitamin K improved the stability of anticoagulation in patients with unstable control.

    View source

    Does vitamin K cream reduce laser-induced purpura?

    Score: 6/10
    2002
    rct
    n=22

    Shah NS, Lazarus MC, Bugdodel R

    Topical vitamin K after laser modestly reduced purpura severity.

    View source

    Vitamin K supplementation in postmenopausal women with osteopenia (ECKO trial): a randomized controlled trial

    Score: 9/10
    2008
    rct
    n=440

    Cheung AM, Tile L, Lee Y +3 more

    Daily 5 mg vitamin K1 did not protect against bone mineral density loss in postmenopausal women with osteopenia.

    View source

    Effect of vitamin K on bone mineral density and fractures in adults: an updated systematic review and meta-analysis of randomised controlled trials

    Score: 10/10
    2019
    meta_analysis
    n=11112

    Mott A, Bradley T, Wright K +5 more

    No consistent effect of vitamin K on bone mineral density; fracture reductions were confined to lower-quality trials.

    View source

    Vitamin K supplementation and progression of coronary artery calcium in older men and women

    Score: 8/10
    2009
    rct
    n=388

    Shea MK, O'Donnell CJ, Hoffmann U +6 more

    Vitamin K1 did not slow coronary artery calcium progression in the intention-to-treat analysis.

    View source

    Vitamin K and the prevention of fractures: systematic review and meta-analysis of randomized controlled trials

    Score: 7/10
    2006
    meta_analysis
    n=3000

    Cockayne S, Adamson J, Lanham-New S +3 more

    Vitamin K supplementation was associated with improved bone density in all but one trial.

    View source

    Safety Information

    Potential Side Effects

    Very well tolerated. No established toxicity for oral phylloquinone.

    Contraindications

    Anyone on warfarin or other vitamin K antagonists must not change intake without clinician guidance — K1 directly opposes the drug.

    Drug Interactions

    • Warfarin and other vitamin K antagonists
    • Orlistat and bile acid sequestrants reduce absorption

    Pregnancy & Breastfeeding

    Pregnancy: likely_safe

    Breastfeeding: likely_safe

    Dosage Guidelines

    Dosage Used in Studies

    Consult healthcare provider

    Best Time to Take

    With the largest meal of the day

    Best Form

    Dietary leafy greens; supplement only for documented need

    Bioavailability

    Poorly absorbed from raw vegetables (roughly 5-10%); much better from oil-based supplements or cooked greens with fat

    Forms Compared

    Plant form; hepatic priority, short half-life

    Different tissue distribution; where most bone and arterial evidence sits

    Food & Timing

    With a fat-containing meal

    Medical Disclaimer

    The information provided on this website is for educational and informational purposes only and is not intended as a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition or before starting any supplement regimen.

    Individual results may vary. The statements on this website have not been evaluated by the Food and Drug Administration. Products and information are not intended to diagnose, treat, cure, or prevent any disease.