Vitamin K Deficiency

What is Vitamin K deficiency?

Vitamin K is a fat-soluble vitamin, i.e., it requires fat for its absorption in the human body. Vitamin K exists in two forms, viz. vitamin K1 (phylloquinone), which is available from a plant source and K2 (menaquinone), which is naturally synthesised in the intestine. Phylloquinones are the chief dietary source of vitamin K and is typically found in green leafy vegetables like spinach, broccoli and cabbage. Menaquinone is typically seen in certain animal foods and fermented foods. They are essentially produced by the bacteria that cause fermentation and are produced in the human gut in adequate quantities in most persons.

Vitamin K produces crucial proteins in the body, which are responsible for controlling bleeding. Vitamin K deficiency is a condition in which the body is unable to produce such crucial proteins rendering it to the risk of bleeding.

What are its main signs and symptoms?

Listed below are some signs and symptoms indicative of the deficiency:

• Excessive bleeding
• Easy bruising
• Bleeding in the nail beds
• Bleeding from any site of the alimentary tract
• Paleness and weakness
• Dark-coloured stools or bloody stools
• Blood in urine
• Bone weakening
• Rashes
• Rapid heartbeat

What are the main causes?

Vitamin K deficiency can occur at any age but newborns are more at risk. The other causes of vitamin K include

• Malnutrition
• Liver disease
• Insufficient dietary intake
• Fat malabsorption
• Medications that treat infections and anticoagulants

How is it diagnosed and treated?

history of the patient is noted to identify the possibility of vitamin K deficiency. A coagulation test is performed to identify the bleeding time. Other tests performed to assess the effects of a vitamin K deficiency are prothrombin time, bleeding time, clotting time and activated partial prothrombin time.

The treatment modes include

• Oral or injectable supplements of vitamin K
• Dietary intake of vitamin K-rich foods, such as green leafy vegetables, mustard, cabbage, and broccoli.

1. Marchili MR et al. Vitamin K deficiency: a case report and review of current guidelines. Ital J Pediatr. 2018 Mar 14;44(1):36 PMID: 29540231
2. Hathaway WE. Vitamin K deficiency. Southeast Asian J Trop Med Public Health. 1993;24 Suppl 1:5-9. PMID: 7886607
3. Omid Reza Zekavat et al. Acquired Vitamin K Deficiency as Unusual Cause of Bleeding Tendency in Adults: A Case Report of a Nonhospitalized Student Presenting with Severe Menorrhagia. Case Rep Obstet Gynecol. 2017; 2017: 4239148. PMID: 28928999
4. National Institutes of Health; Office of Dietary Supplements. [Internet]. U.S. Department of Health & Human Services; Vitamin K.
5. MedlinePlus Medical Encyclopedia: US National Library of Medicine; Vitamin K.
6. Linus Pauling Institute [Internet]. Oregon State University; Vitamin K.

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Dr. Anurag Shahi (AIIMS)