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What is vitamin K?
Vitamin K is a nutrient that the body requires in small, regular amounts. It is essential for the formation of several substances called coagulation factors as well as protein C and protein S that work together to clot the blood when injuries to blood vessels occur and to prevent excessive clotting. Insufficient vitamin K can lead to excessive bleeding and easy bruising. Vitamin K is also thought to play an important role in
the prevention of bone loss. Low blood levels of vitamin K have been associated with low bone density, and there is some evidence that adequate levels of vitamin K can improve bone health while reducing the risk of fractures.

There are three different types of vitamin K:
Vitamin K1 (phylloquinone or phytomenadione) is the natural from of vitamin K that comes from foods, especially green leafy vegetables but also dairy products and vegetable oils. K1 is considered as the "plant form" of vitamin K, but it is also produced commercially to treat some conditions associated with excess bleeding.

Vitamin K2 (menaquinones) is made by bacteria, the normal flora in the intestines. Bacteria in the intestines can also convert K1 into K2.
Vitamin K2 supplements K1 from the diet to meet the body's requirements.

Menadione is a non-natural, man-made chemical compound that is used in some countries as anutritional supplement because of its vitamin K activity. It is sometimes called K3.
Menadione supplements are currently banned in the U.S. because of their potential toxicity in human use. Since the body is not able to produce a sufficient amount of vitamin K, a certain amount must be taken in through the diet. It is present in a wide variety of foods, and the normal diet in the U.S. typically supplies enough. Examples of different foods that contain high amounts of vitamin K per serving, often more than the recommended Daily Allowance (RDA), include leafy green vegetables such as kale, collards, spinach, green leaf lettuce, and other vegetables such as broccoli, asparagus, brussels sprouts, and cabbage. Other sources include dairy products, cereals, vegetable oils, and soybeans. K1 and K2, the types provided by the diet and produced by the body, are both fat-soluble and are stored in the body's fat tissue and in the liver. An adult typically stores about a week's worth of vitamin K.

What are the causes for Vitamin K Deficiency?
The most common causes of vitamin K deficiency are insufficient dietary intake, inadequate absorption, and decreased storage of the vitamin due to liver disease, but it may also be caused by decreased production in the intestines.
In the India., dietary deficiency of vitamin K is rare in healthy individuals but is relatively common in those who are severely ill or who have certain chronic conditions. For example, it is often seen in patients with serious illnesses, including people with cancer who are receiving chemotherapy, chronic dialysis patients, and people who are at risk for malnutrition, such as those with a poor diet associated with alcoholism or drug abuse.
Malabsorption, especially impaired absorption of fats due to diseases such as cystic fibrosis, celiac disease, chronic pancreatitis or Crohns disease, may cause vitamin K deficiency.
Cholestatic liver diseases such as a bile duct obstruction or primary biliary cirrhosis can also lead to malabsorption and a deficiency in vitamin K.
Some medications, such as antibiotics, antacids, and anti-seizure medications can interfere with the absorption of vitamin K1, decrease the quantity of K2 produced in the intestines, or cause degradation of vitamin K.
High doses of aspirin may increase vitamin K requirements.
Newborns may be deficient in vitamin K because their intestines do not yet have normal flora, and breast milk does not provide them with much vitamin K. In addition, if the newborn's mother takes certain drugs during pregnancy, such as anti-seizure medications, then the infant may be vitamin K-deficient at birth.
Vitamin K deficiencies in newborns are associated with vitamin K deficiency bleeding or VKDB (also known as hemorrhagic disease of the newborn). This can cause excessive bleeding and bruising and, in severe cases, can lead to fatal bleeding into the brain. VKDB used to be a relatively common occurrence but it has become rare because of the practice of administering a vitamin K injection to all newborns shortly after birth, as recommended by the American Academy of Pediatrics. When surgeries are necessary, the infants may also be given vitamin K before the procedure to prevent excessive bleeding.
A common question is whether people who are treated with the anticoagulant drug warfarin should avoid eating foods that are rich in vitamin K and whether limiting these foods can cause an increased risk of vitamin K deficiency. Warfarin is prescribed for people with a variety of conditions such as deep vein thrombosis (DVT) and some cardiovascular diseases (CVD) to "thin" their blood and prevent inappropriate clotting. A healthcare practitioner will typically prescribe warfarin and measure how well that dose “thins” the blood using a test called PT/INR. The dose may be adjusted up or down depending on the result and to ensure the dose is sufficient in preventing clots without causing excessive bleeding.

Other causes of Vitamin K deficiency.
Warfarin works by reducing the liver’s ability to use vitamin K to make blood clotting factors. Thus, warfarin and vitamin K are antagonists—they work against each other. Significant increases or decreases in the amount of vitamin K a person consumes can affect how well their dose of warfarin works in preventing blood clots without causing excess bleeding. So rather than avoiding foods rich in vitamin K, it is more important for people taking warfarin to consume a consistent amount of those foods each day. These individuals can get the vitamin K they need as long as they are consistent about the amount they consume.

What are the symptoms of Vitamin K Deficiency?
The signs and symptoms associated with vitamin K deficiency may include:
Easy bruising
Oozing from nose or gums
Excessive bleeding from wounds, punctures, and injection or surgical sites
Heavy menstrual periods
Bleeding from the gastrointestinal (GI) tract
Blood in the urine and/or stool
Increased prothrombin time (PT/INR)
In vitamin K deficiency bleeding in newborns, signs and symptoms may be similar to those listed above but, in more serious cases, may also involve bleeding within the skull (intracranial).
A deficiency of vitamin K may be suspected when symptoms listed above appear in someone who is at an increased risk, such as:
Those who have a chronic condition associated with malnutrition or malabsorption
Those who have been on long-term treatment with antibiotics; the antibiotics can kill the bacteria that aid in the production of vitamin K2 in the small intestine.
Seriously ill patients such as cancer or dialysis patients

मॅग्नेशियमची कमतरता

मॅग्नेशियमची कमतरता लक्षण
खालील वैशिष्ट्ये मॅग्नेशियमची कमतरता दर्शवितात:
- भूक न लागणे
- मळमळ
- उलट्या
- थकवा
- अशक्तपणा
मॅग्नेशियमची कमतरता कोणतीही शारीरिक लक्षणे दर्शवत नसेल तरीही रुग्णांमध्ये उपस्थित राहू शकतो.

मॅग्नेशियमची कमतरता चे साधारण कारण
मॅग्नेशियमची कमतरता चे साधारण कारणे खालीलप्रमाणे आहेत:
- अपर्याप्त आहार
- अल्कोहोल दुरुपयोग
- तीव्र ताण
- खराब नियंत्रित मधुमेह
- तीव्र उलट्या

चांगल्या आरोग्यासाठी मॅग्नेशियम योग्य प्रमाणात शरीरात गेले पाहिजे; पण तज्ज्ञांच्या मते आपल्या आहारात मॅग्नेशियमयुक्त पदार्थांची कमतरता आहे. त्यामुळे आपल्या शरीराला योग्य त्या प्रमाणात मॅग्नेशियम मिळत नाही. शरीरातील मॅग्नेशियमचे कमी प्रमाण अनेक रोगांना आमंत्रण ठरू शकते. जे लोक मॅग्नेशियम आणि इतर खनिजांचा समावेश असलेले पदार्थ आहारात घेतात, त्यांचा रक्तदाब नियंत्रित राहतो, असा ब्रिटनमध्ये प्रसिद्ध होणार्‍या जर्नलमधल्या निबंधात म्हटले आहे.

रक्तदाबाच्या नियंत्रणासाठी आणि मधुमेहाच्या दुसर्‍या प्रकारात मॅग्नेशियम उपयोगी पडू शकते का, याविषयी अधिक संशोधन सुरू आहे. गर्भवती महिलेला जर दम्याचा आणि आकडीचा जोरदार झटका आल्यास मॅग्नेशियमचे इंजेक्शन दिले जाते. शरीरात मॅग्नेशियमची कमतरता, ही दुर्मीळ बाब आहे; मात्र काही आजारांत जसे मूत्रपिंडाचे आजार, पचनशक्तीचे आजार, पॅराथायरॉईडची समस्या, मधुमेह किंवा कॅन्सरमध्ये घेतली जाणारी प्रतिजैविके किंवा अतिमद्यपान करणार्‍या व्यक्तीत मॅग्नेशियमची कमतरता जाणवू शकते.

गरज किती? : सगळ्यांना मॅग्नेशियमची आवश्यकता असते. महिलांना 270 मिलिग्रॅम प्रतिदिन आणि पुरुषांना 300 मिलिग्रॅम प्रतिदिन इतक्या प्रमाणात मॅग्नेशियमची गरज असते; पण तेच प्रमाण जर 400 मिलिग्रॅमपेक्षा जास्त झाले, तर जुलाब होण्याची शक्यता असते. मॅग्नेशियम जास्त सेवनही धोकादायक ठरते. त्याचे प्रमाण जास्त झाल्यास उलट्या, जुलाब, कमी रक्तदाब, स्नायूंचा थकवा यासारखी लक्षणे दिसतात आणि अतिप्रमाण झाल्यास जीवाला धोकाही उत्पन्न होऊ शकतो.

दुष्परिणाम :
वर सांगितलेले दुष्परिणाम वगळता जे लोक मूत्रपिंडाचे आजार, हृदयविकार यासारख्या आजारांसाठी प्रतिजैविके घेत असतील, त्यांना मॅग्नेशियमचे पूरक औषध घेणे धोक्याचे असते. त्यामुळे मूत्रपिंडाचे आजार, मधुमेह, हृदयविकाराच्या रुग्णांनी डॉक्टरांच्या सल्ल्याशिवाय मॅग्नेशियमचा पूरक डोस घेऊ नये.

शांत झोप : झोपण्याआधी मॅग्नेशियमचे पूरक औषध घेतल्यास आराम मिळतो. ते घेणार्‍या व्यक्तीला शांत झोप लागते. रात्री आठ वाजण्याआधी जर याचे पूरक औषध घेतले, तर दिवसभर याचा फायदा जाणवतो.

मॅग्नेशियम असलेले पदार्थ
पालक - 157 मिलिग्रॅम/एक कप
रसपालक - 154 मिलिग्रॅम/एक कप
भोपळ्याच्या बिया - एक कप बियांचा आठवा भाग - 92 मिलिग्रॅम
दही - 50 मिलिग्रॅम/एक कप
बदाम - 80 मिलिग्रॅम/एक कप
काळा घेवडा - 120 मिलिग्रॅम/एक कप
एव्हाकॅडो - एक मध्यम आकाराचे फळ 58 मिलिग्रॅम
अंजीर - 100 मिलिग्रॅम/एक कप
डार्क चॉकलेट - एक तुकड्यातून 95 मिलिग्रॅम
केळे - एक मध्यम आकाराचे 32 मिलिग्रॅम
या सगळ्या पदार्थांचे नियमित सेवन केल्यास तुम्हाला शरीराच्या गरजेइतके मॅग्नेशियम नक्कीच मिळेल. त्याच्या कमतरतेमुळे होणारे रोगही टाळता येतील.

Dr. Pooja Hemnani
Dr. Pooja Hemnani
MPTh, Cardiovascular And Pulmonary Physiotherapist Neuro Physiotherapist, 1 yrs, Pune
Dr. Manna  Varghese
Dr. Manna Varghese
BAMS, Ayurveda, 4 yrs, Pune
Dr. Minal Sapate
Dr. Minal Sapate
BDS, Dentist Cosmetic and Aesthetic Dentist, 15 yrs, Pune
Dr. Tushar Shivaji Ghode
Dr. Tushar Shivaji Ghode
BDS, Dentist, 6 yrs, Pune
Dr. Dr.Rajendra  Chavat
Dr. Dr.Rajendra Chavat
MBBS, Family Physician, 35 yrs, Pune