Vitamin K Deficiency Treatment and Toxicity

ID-10042016Deficiency of vitamin K

Deficiency of vitamin K is mostly seen in infants. In adults the deficiency of vitamin K is not common. The causes of vitamin K deficiency in infants and adults are different.

In adults the deficiency of vitamin K is mainly due to chronic small intestinal disease like celiac disease, Crohn’s disease, in patients with obstruction of biliary tract or due to resection of small intestine. Treatment with broad spectrum antibiotics like tetracycline, chloramphenicol etc. can lead to aggravation of vitamin K deficiency by reducing the intestinal flora which synthesize menaquinones, and by inhibiting the metabolism of vitamin K. In patients with warfarin (an anti coagulant) therapy, the hypoloipidemic drug Orlistat can lead to INR (international normalized ratio) changes due to vitamin K mal absorption.

The diagnosis of vitamin K deficiency is usually made on the basis of an increased prothrombin time, reduced clotting factors and also by directly measuring vitamin K level in blood.

Treatment of vitamin K deficiency:

Vitamin K deficiency is treated by administering 10 mg of vitamin K parenteral dose. Patients of chronic mal absorption should receive oral dose of 1–2 mg/day of vitamin K or 1-2 mg parenteral dose of vitamin K every week. Patients with liver disease may have an elevated prothrombin time because of liver cell destruction as well as vitamin K deficiency. So if an elevated prothrombin time does not improve on vitamin K therapy, it can be said that it is not due to vitamin K deficiency.

In infants the deficiency of vitamin K is usually due to loss of blood, low fat stores and liver immaturity (both are stores of vitamin K); low breast milk levels (15 mcg/liter) of vitamin K, sterility of the infantile intestinal tract and no or very small number of intestinal flora which synthesize menaquinones, and poor placental transport.

Deficiency of vitamin K in infants can lead to intracranial bleeding, gastrointestinal bleeding and skin bleeding in 1–7 days after birth. To prevent these problems infants should be administered vitamin K (1 mg IM) prophylaxis at the time of delivery.

Toxicity of vitamin K:

Vitamin K toxicity is not seen due to excess dietary consumption of vitamin K (phylloquinones and menaquinones). But high doses of vitamin K can impair the actions of oral anticoagulants like warfarin.

 

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