Pomegranate juice, oxalate & kidney stone risk - a comment. *Vitamin K2 is a major topic in this post.

Short answer, pomegranate seems more protective than a risk for oxalate damage.

Mel’s comment: “Please write about the high oxalate levels in pomegranate juice. Upon reading how beneficial pomegranate is I bought juice and my husband started drinking it. Not a lot but a small juice glass full a day. I didn’t even think to check the oxalate levels. He ended up with an oxalate stone that also resulted in a bladder infection, a trip to the ER and a round of antibiotics.”

I am sorry that happened. Kidney stones can be extremely painful. and I failed to write that in my [*insensitive] reply:

That doesn't seem like it was just the pomegranate juice [*alone]. I am oxalate sensitive and I don't react to pomegranate juice, but I also don't drink much juice, about 2 ounces diluted. I really haven't noticed oxalate from the tea made with rind either though. Google search shows that pomegranate is considered high oxalate with 121 mg per 100 grams. However research with animals has found pomegranate juice to protect against oxalate damage.

"Crystal depositions were evident on day 7, and mild and severe crystallization were observed on day 15 and 45 in EG group, respectively. There was limited or no crystal formation in rats in both middle- and high-dose PJ groups when compared to low-dose PJ group. Crystal depositions, iNOS, p38-MAPK and p65-NF-kB activity, and oxidative stress markers were found to be decreased by middle- and high-dose PJ treatment. PJ was found to have inhibitory effects on renal tubular cell injury and oxidative stress caused by oxalate crystals by reducing ROS, iNOS, p38-MAPK, and NF-kB expression."

https://www.tandfonline.com/doi/full/10.1080/08860220902963871

Prickly pear cactus fruit are very in oxalate and I did use too much of that in some experiments with it. 152 mg in the fruit and 250 from the leaf. I only had problems when I used the peel like I was using pomegranate peel. https://ohf.org/fruit-oxalate/ Whoa, rhubarb, raw 1060 mg/100 gr. This reference says pomegranate seeds/juice have 78 mg/100 gr which would put it in the moderately high group instead of the High group. Rhubarb and prickly pear leaf (Nopal) would be in the Very High group. Star fruit is also Very High and cooking Rhubarb brings it down a little but is still quite high compared to the other fruits.

Having adequate calcium is important to help the body not make the sharp crystals instead of breaking it down but Vonu makes the excellent point that that won't work without vitamin K2. Supplements of vit K2 are ridiculously low. I get a higher dose supplement from Life Extension. Also being overly acidic is a controllable risk factor. Taking Mucinex daily was part of my risk as it is changed into uric acid before excretion. My high dose niacin was also adding to that. Gut microbiome can also be part of sensitivity as some species add to the oxalate load.

Vonu’s comment, 2 hrs ago:

“Calcium oxalate is a calcium salt of oxalic acid and calcium builds up in the body when someone has a deficiency of vitamin K2, which is explained in Vitamin K2 and the Calcium Paradox: How a Little-Known Vitamin Could Save Your Life by Kate Rheaume-Bleue.”

Vitamin K2 and the Calcium Paradox: How a Little-Known Vitamin Could Save Your Life, by Kate Rheaume-Bleue:

“The secret to avoiding calcium-related osteoporosis and atherosclerosis

While millions of people take calcium and Vitamin D supplements thinking they're helping their bones, the truth is, without the addition of Vitamin K2 , such a health regimen could prove dangerous. Without Vitamin K2, the body cannot direct calcium to the bones where it's needed; instead, the calcium resides in soft tissue (like the arteries)—leading to a combination of osteoporosis and atherosclerosis, or the dreaded "calcium paradox."

This is the first book to reveal how universal a Vitamin K2 deficiency is, and the risk (in the form of cancer and diabetes, among other ailments) the absence of Vitamin K2 poses. Written by Dr. Kate Rheaume-Bleue, a popular health expert on Canadian television and radio, Vitamin K2 and the Calcium Paradox sounds a warning about the popularity of the calcium and Vitamin D craze, while illustrating the enormous health benefits of Vitamin K2 in making the body less susceptible to dental cavities, heart disease, prostate cancer, liver cancer, diabetes, wrinkles, obesity, varicose veins, and other ailments. An essential book for anyone interested in bone health, or maintaining their overall health, Vitamin K2 and the Calcium Paradox is the guide to taking the right combination of supplements—and adding Vitamin K2 to a daily regimen. (*GoodReads)

Life Extension is having a sale on their ‘Mega’ K2. Standard supplement dosage seems like a psy op on learning more about it. A low dose of 45 mcg is a 1000 times less than the ‘Mega Vitamin K2’ dose of 45 mg.

(**Both products are on sale right now, I just got a flyer in the snail mail. Sale ends May 20, 2024. lifeextension.com the 40% off would be a better discount than you get through my Fullscript account (20% or 25% if it is a monthly autoship order). Fullscript has added a great new future where you can enter whatever supplements you take and it totals them all up into what you are getting overall for the day. Sign up link, Fill in your own supplements link - and then I could give feedback if you wanted me to look at it too. Free shipping on orders over $50 and it is very fast. Orthomolecular brand requires me to set up a plan for you but just ask, the system sends me a notice to set up a plan.)

Photo by Aswathy N on Unsplash

In a study with rabbits (Happy Easter! but poor bunnies…) and atherosclerosis risk, the doses of vitamin K2 (menatetrenone) used were in the milligrams, not micrograms; and they were per kg of body weight. The human equivalent would then be much higher than the amount a lightweight rabbit would get. A high cholesterol diet was used as a risk factor to promote arterial plaque. (Kawashima, et al., 1997)

“Vitamin K2 in daily doses of 1, 10 and 100 mg/kg was given with a 0.5% cholesterol diet for 10 weeks to 8 rabbits each.” (Kawashima, et al., 1997)

If a rabbit weighs about the same as a cat, then ten to 12 pounds would be about 5 kilograms and a daily dose of 5 mg or 50 mg or 500 mg of vitamin K2 would have been given. The 1 and 10 mg doses were effective at reducing lipid imbalance on the high cholesterol diet. The high doses were not a problem and even the 100 mg dose did not cause adverse effects. (Kawashima, et al., 1997)

“The plasma levels of total cholesterol in the vitamin K₂-treated groups were clearly lower than that of the hypercholesterolemic control group. The excessive dose of vitamin K₂, even at the high dose of 100 mg/kg/day for 10 weeks, did not accelerate the progression of atherosclerosis and did not promote the coagulative tendency in the rabbits. In contrast, the vitamin K₂ treatment (1 to 10 mg/kg/day) suppressed the progression of atherosclerotic plaques, intima-thickening and pulmonary atherosclerosis, the increase of ester-cholesterol deposition in the aorta, and both the elevation in plasma factor X level and increase in Hepaplastin ® test value in the rabbits. These results indicate that the pharmacological dose of vitamin K₂ prevents both the progression of atherosclerosis and the coagulative tendency by reducing the total-cholesterol, lipid peroxidation and factor X activity in plasma, and the ester-cholesterol deposition in the aorta in hypercholesterolemic rabbits.” (Kawashima, et al., 1997)

A human equivalent dose would be for a 70 Kg person ~ 150 pounds, either 70 mg or 700 mg to achieve the 1 mg/Kg or 10 mg/Kg dose. A 100 mg/Kg dose would be 7000 mg = 7 grams - so yes, that was a super duper mega dose. Yet for human supplement purchases, I can’t find a dose higher than Life Extension’s Mega Vitamin K2 product with 45 mg per capsule. Taking it twice a day would reach the 1 mg/Kg range but you would need to take 14 capsules to get near 700 mg/day. (LE sale price is $17.10 for a bottle of 30 capsule for the Mega K2 product.)

Developing a taste for the Japanese fermented soybean dish called Natto would net you both vitamin K2 and the biofilm disrupting nattokinase enzyme. Three ounces might provide 880 mg of vitamin K2. Which suggests that humans are safe to take that amount. It is fat soluble so having a larger amount occasionally may cover the body ‘s needs for a while. (Fact check needed)

https://www.vinatura.store/blogs/articles/nattokinase-and-vitamin-k2 Natto news to use via a comment by Nattering Naybob.

Vitamin K2 helps prevent excessive clotting rather than causing clotting to occur. It is used in clotting factors which other signals would induce.

Caution is used with vitamin K supplements when clotting is a risk and blood thinning medication is being used. “As Vitamin K interferes with the effect of anticoagulant drugs (like Coumadin), the concurrent use of these agents should be avoided.” - A liquid Thorne brand product that is recommending the 45 mg/day amount in 3 divided doses of 15 drops each. (That would be highly annoying to count out every day.) A NOW brand product suggests to us that 200 mcg is a high dose. I found a 600 mcg product (0.6 mg) and a 5 mg product by other brands.

…why did the rabbits do fine with the equivalent of 700 mg per day? and tolerated 7000 mg? Why aren’t humans being treated with even 70 mg per day instead of 15 mg x 3 or 45 mg/day? I don’t know. I haven’t seen the studies suggesting that be the recommended limit.

“Natto mazesoba,” Photo by 8-Low Ural on Unsplash

Disclaimer: Opinions are my own and the information is provided for educational purposes within the guidelines of Fair Use and is not intended to provide individual health guidance.

Reference List

(Kawashima, et al., 1997) Kawashima H, Nakajima Y, Matubara Y, Nakanowatari J, Fukuta T, Mizuno S, Takahashi S, Tajima T, Nakamura T. Effects of vitamin K2 (menatetrenone) on atherosclerosis and blood coagulation in hypercholesterolemic rabbits. Jpn J Pharmacol. 1997 Oct;75(2):135-43. doi: 10.1254/jjp.75.135. PMID: 9414028. https://www.jstage.jst.go.jp/article/jphs1951/75/2/75_2_135/_article