Updated Vitamin k protocol - copy and paste version

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Sorry, last attachment wouldn't open, so here is copy and paste version. Protocol is available on the vitamin K listserve in the files if you prefer a not so squashed up version.

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Page 1 of 4June 29, 2008Vitamin K ProtocolThis protocol focuses on the Fat Soluble Vitamins and the Macro Minerals (calcium,phosphorus, and magnesium); the purpose is to normalize calcium and phosphorusmetabolism, re-establish acid-base balance and renal anion exchange, re-balance theimmune system, and improve thyroid function. Most of the children appear to behypercalcemic and without sufficient levels of phosphorus or the fat soluble vitamins;thus they cannot control calcium, maintain acid-base balance, or mount an adequateimmune response. In addition their ability to maintain appropriate anion exchange in thekidneys and elsewhere is impaired due to loss of bicarbonates and many have thesymptoms of hypothyroidism.The children will receive robust, balanced doses of A, D, and the Omega-3 fatty acidDHA, and pharmacological doses of K2. They will also receive phosphorus andmagnesium (both macro minerals), iodide, sodium and chloride in the form of salt, andoral bicarbonates which include sodium and potassium. It is recommended that parentsstart with the High Vitamin Cod Liver Oil, which supplies Vitamin A, Vitamin D, DHA, andiodine, as most children tolerate cod liver oil. Magnesium and phosphorus should beadded next. DHA, Vitamin K2, iodide, and oral bicarbonate & salt can then be added inslowly. Most children will need more Vitamin D than is supplied in the cod liver oil.Circulating Vitamin D levels can be tested easily. Supplements and recommendeddoses are listed below._____________________Vitamin A: High-vitamin cod liver oil with natural, cod-derived Vitamin A is an excellentsource of Vitamins A and D. A recommended product is the high vitamin cod liver oil atwww.greenpasture.org. Recommended dosages for children with developmental issuesare:• Children age 3 months to 2 years: A dose of CLO that provides about 5,000 IUdaily.• Children 2 years to 10 years: A dose of CLO that provides between 5,000 IU and11,000 IU daily.• Children over 10 years and adults: A dose of CLO that provides between 5,000IU and 16,000 IU daily.• Pregnant and nursing women: A dose of CLO that provides about 20,000 IUdaily.Vitamin K2: Vitamin K2 is the form of Vitamin K found in the brain, the kidneys and thebones and is the most bioavailable form. The adult dose is 15 mg TID (three timesdaily). The weight-adjusted dose for children is one mg TID for each 10 pounds (4.5kilograms) of body weight, up to a maximum of 15 mg TID. This vitamin should bestarted initially at a much lower dose than the maximum, especially if the child has ahistory of seizures, because it is a powerful vitamin which takes effect slowly. ThorneResearch makes Vitamin K2 in a liquid dropper bottle. K2 is also available from variousmanufacturers in gelcap and capsule form.Regression of warfarin-induced elastocalcinosis by high intake of vitamin K in rats. Schurgers LJ, Spronk HM, SouteBA, Schiffers PM, Demey JG, Vermeer C. Blood. 2006 Nov 30 [Epub ahead of print].Page 2 of 4Vitamin D: Most children who do not live in the lowest one-third of the continentalUnited States and who do not receive regular year-round outdoor sun exposure will needmore Vitamin D than is found in the high-vitamin cod liver oil. The recommendedVitamin D dosage for this protocol is a total of 55 IU/pound/day from all sourcesincluding cod liver oil (120 IU/kilogram/day). Supplemental Vitamin D must be in theform of cholecalciferol, or Vitamin D3. Many supplement manufacturers make VitaminD3 in capsule form. Bio-D-Mulsion Forte by Biotics Research Corp. is emulsifiedVitamin D3 in a small dropper bottle that is easy to administer to children.Vitamin E: Large doses of Vitamin E will interfere with the clotting functions of VitaminK. A daily dose of no more than 200IU for children or 400IU for teens and adults isrecommended under this protocol.Note that serum levels of Vitamins A, D and E can be tested through LabCorp, allowingevaluation of fat-soluble vitamin levels. Vitamin A and D levels should be checkedregularly.Magnesium: Children with autism have been found to be severely depleted in serummagnesium. Magnesium is a coenzyme in phosphate transfer reactions and thus has arole in the transfer, storage and utilization of energy within the body. Magnesium is alsoa natural calcium channel blocker that stops the movement of calcium into the nervecells, thereby allowing the neurons to rest instead of firing continuously. Magnesiumshould be given generously; the recommended dose is 500-1,000 mg daily. Somechildren do not tolerate magnesium citrate.Magnesium profile in autism. Strambi M, Longini M, Hayek J, Berni S, Macucci F, Scalacci E, Vezzosi P. Biol TraceElem Res. 2006 Feb;109(2):97-104.The Biological Chemistry of Magnesium. Cowan JA (ed). VCH Publishers, Inc., New York, 1995.Phosphorus: Phosphorus is used by the kidneys to maintain acid-base balance; it isalso needed for bone and cell wall structure, energy storage, and oxygen transport.Carlson Labs Complexed Phosphorus tablets or Angstrom Minerals liquid phosphoruswww.elementalresearchllc.com are the only recommended forms. Initial dose,depending on age/size, is 100-250mg phosphorus if using Carlson tablets or 30-80mgphosphorus if using Angstrom Minerals liquid. Dose may reduced by about 25% after 2months. Increase the dose temporarily to counter the effects of microbial die-off.The essentials of calcium, magnesium and phosphate metabolism: Part I. Physiology. Baker SB, Worthley LIG.Critical Care and Resuscitation, 2002; 4:301-6.The essentials of calcium, magnesium and phosphate metabolism: Part II. Disorders. Baker SB, Worthley LIG.Critical Care and Resuscitation, 2002; 4:307-15.Potassium Iodide: Iodide, another element that is deficient in children with autism, isused by the thyroid to produce hormones and is a very important part of this protocol.Supplemental iodide will improve thyroid activity and supply non-thyroidal tissues andorgans with iodide. Potassium iodide is the recommended form of iodine; theinformation under “Improving Thyroid Function with Iodide†contains dosing instructions.Analyses of toxic metals and essential minerals in the hair of Arizona children with autism and associated conditions,and their mothers. JB, Holloway CE, F, Quig D. Biol Trace Elem Res.Oral Bicarbonate and Salt: Bicarbonate is vital for proper anion exchange and tocorrect renal and/or metabolic acidosis. Renal anion exchanger proteins are dependentupon sodium and chloride, which are supplied by salt. A total daily bicarbonate dose ofPage 3 of 4one-quarter to three-quarters of a teaspoon, depending on the size and tolerance of thechild, should be given between meals in divided doses. One-eighth to one-quarterteaspoon salt should be given with each dose of bicarbonate. Either sodium bicarbonate(baking soda) or sodium/potassium bicarbonate (Klaire Laboratories Bi-Carb Formulacapsules) may be used. Once supplemental phosphorus is initiated, oral bicarbonateand salt can be phased out over a period of approximately three months. ElaineGottschall’s electrolyte recipe can be found atwww.breakingtheviciouscycle.info/knowledge_base/kb/electrolyte_drink.htm.Pink Disease and Primary Renal Tubular Acidosis. A Common Cause. MacGregor ME, Rayner PH. Lancet. 1964Nov 21;2:1083-85.SLC26 chloride/base exchangers in the kidney in health and disease. Soleimani M, Xu J. Semin Nephrol. 2006Sep;26(5):375-85.Metabolic acidosis regulates rat renal Na-Si cotransport activity. Puttaparthi K, Markovich D, Halaihel N, P,Zajicek HK, Wang H, Biber J, Murer H, T, Levi M. Am J Physiol. 1999 Jun;276(6 Pt 1):C1398-404.VSL#3 probiotic: This probiotic is very helpful in alleviating the intestinal distressexperienced with high doses of magnesium. The lactic acid bacteria strains, especiallythe bifidobacterium strains, are also able to break down oxalic acid as it is secreted intothe intestines for disposal. Oxalic acid is a strong acid that can irritate and inflame theintestines if it is not degraded by bacteria. VSL#3 works well as a yogurt starter as wellas a probiotic. It is available at www.vsl3.com.Reduction of oxaluria after an oral course of lactic acid bacteria at high concentration. Campieri C, Campieri M,Bertuzzi V, Swennen E, Matteuzzi D, Stefoni S, Pirovano F, Centi C, Ulisse S, Famularo G, De Simone C. KidneyInternational, Vol. 60 (2001), pp 1097-1105.DHA, an Omega-3 Essential Fatty Acid: DHA, an Omega-3 EFA, supplements weakVitamin A signaling and improves cell functioning. Approximately ½ to 2 grams DHA ormore should be given daily, depending on body size and response. The DHA formulaswill also include EPA; no particular ratio of DHA-to-EPA is necessary, so the dose ofEPA will be whatever is included with the DHA supplement.Docosahexaenoic acid, a ligand for the retinoid X receptor in mouse brain. de Urquiza AM, Liu S, Sjöberg M,Zetterström RH, Griffiths W, Sjövall J, Perlmann T. Science. 2000 Dec 15;290(5499):2140-4.Dietary fatty acid supplementation modulates the urinary excretion of calcium and oxalate in the rat. Baggio B,Budakovic A, Priante G, Gambaro G, Manzato E, Khan S. Nephron 2002;91:486-491.Phosphatidylcholine and Phosphatidylserine: Both phosphatidylcholine andphosphatidylserine will reduce inflammatory cytokines, and phosphatidylcholine workssynergistically with Vitamin A to reduce inflammation and neuronal activation. Both areavailable in oral form. Phosphatidylcholine may be given IV.Phosphatidylserine and phosphatidylcholine-containing liposomes inhibit amyloid beta and interferon gamma-inducedmicroglial activation. Hashioka S, Han YH, Fujii S, Kato T, Monji A, Utsumi H, Sawada M, Nakanishi H, Kanba S.Free Radic Biol Med. 2007 Apr 1;42(7):945-54.Ligands for the peroxisome proliferator-activated receptor-gamma and the retinoic X receptor exert additive antiinflammatoryeffects in experimental autoimmune encephalomyelitis. Diab A, Hussain RX, Lvett-Racke AE, ChavisJA, Drew PD, Racke MK. J Neuroimmunol. 2004 Mar;148(1-2):116-26.Melatonin: Melatonin in high doses acts as an anti-inflammatory, has been shown toreduce GI pain in Crohn’s disease patients, and increases the movement of oxalate intothe intestines for disposal. Higher doses do not affect waking patterns. Start with 1 mgat night (1/2 mg for small children) and increase the dose slowly. A target dose isapproximately 2 mg for small children, 5-6 mg for larger children, and up to 10 mg forteens. Doses of 20 mg have been used successfully to treat sarcoidosis in adults.Page 4 of 4Melatonin is a safe and effective treatment for chronic pulmonary and extrapulmonary sarcoidosis. Pignone AM,Rosso AD, Fiori G, Matucci-Cerinic M, Becucci A, Tempestini A, Livi R, Generini S, Gramigna L, Benvenuti C,Carossino AM, Conforti ML, Perfetto F. J Pineal Res. 2006 Sep;41(2):95-100.Melatonin improves abdominal pain in irritable bowel syndrome patients who have sleep disturbances: a randomised,double blind, placebo controlled study. Song GH, Leng PH, Gwee KA, Moochhala SM, Ho KY. Gut. 2005Oct;54(10):1402-7. Epub 2005 May 24. Comment in: Gut. 2005 Oct;54(10):1353-4.Baking Soda Baths: It cannot be emphasized enough how helpful a baking soda bathcan be in calming a child. Use approximately 8 cups baking soda per bath.Glutathione: Any kind. IV is great if possible. Glutathione shifts the cell environment toan anti-oxidative state and allows the cells to release excess intracellular calcium.Glutathione also improves the body’s ability to synthesize the biologically active forms ofVitamin A.Supplements to Minimize or Avoid:Supplemental Calcium: Most of the children who have reported their testing on theVitamin K listserve are hypercalcemic, and supplemental calcium adds to the problembecause it is absorbed so quickly and easily. Moreover, calcium given withoutphosphorus may lead to an imbalance in phosphorus levels. Under no circumstancesshould supplemental calcium be used to “mop up†intestinal oxalate. Dietary calciumshould be obtained from food, not from supplements.Antibiotics and Herbal or “Natural†Anti-Microbials: All of these will kill off the veryexpensive VSL#3 lactic acid bacteria, leading to diarrhea caused by the outflow ofoxalates.Other Vitamin, Minerals and Supplements:This list is not meant to exclude other vitamins, minerals, or supplements that arebeneficial. It is important that the children receive B vitamins, Vitamin C, and traceminerals including selenium and zinc. Other supplements may be continued as desired.The supplements on this list are intended to improve Vitamin A signaling, correct fatsolublevitamin deficiencies, reduce ionized calcium, restore renal anion exchange andthyroid function, and encourage the excretion of organic acids including oxalic acid.DietThe Specific Carbohydrate Diet eliminates sugar and grains and utilizes fermented andaged dairy products, thereby improving phosphorus availability and absorption, and forthat reason it is the diet recommended in this protocol. In his seminal work on nutritionand health, Dr. Weston Price wrote eloquently about the need for a high daily intake ofthe macro minerals including phosphorus. Children with autism require high andbalanced amounts of the macro minerals calcium, phosphorus and magnesium.Sources of information on diet:• Breaking the Vicious Cycle: Intestinal Health Through Diet, by Elaine Gottschall.• Nutrition and Physical Degeneration, 6th edition, by Weston A. Price, D.D.S.