In the 2024 review article “Zinc, Magnesium and Vitamin K Supplementation in Vitamin D Deficiency: Pathophysiological Background and Implications for Clinical Practice,” Andrius Bleizgys explores the interconnected roles of zinc, magnesium, and vitamin K in human health, particularly concerning their influence on vitamin D metabolism and activity.

Magnesium (Mg):

Magnesium is vital for numerous bodily functions, including acting as a cofactor in enzymatic processes related to vitamin D metabolism. It aids in the synthesis of 25-hydroxyvitamin D and calcitriol (the active form of vitamin D), as well as in the expression of vitamin D receptors. A deficiency in magnesium can impair these processes, potentially leading to suboptimal vitamin D activity. Conversely, adequate magnesium levels support effective vitamin D function, highlighting the importance of ensuring sufficient magnesium intake in individuals with or at risk of vitamin D deficiency.

Zinc (Zn):

Zinc plays a crucial role in immune function, protein synthesis, and cell division. It also interacts with vitamin D metabolism; for instance, zinc is involved in the regulation of vitamin D receptor expression and may influence the activity of enzymes that metabolize vitamin D. Zinc deficiency could therefore compromise vitamin D function, suggesting that zinc supplementation might be beneficial in managing vitamin D deficiency.

Vitamin K:

Vitamin K is essential for blood clotting and bone metabolism. It works synergistically with vitamin D to regulate calcium homeostasis and bone health. Vitamin K activates proteins that help bind calcium to the bone matrix, while vitamin D enhances calcium absorption. A deficiency in vitamin K can lead to improper calcium utilization, potentially resulting in vascular calcification and osteoporosis. Therefore, adequate vitamin K levels are important for individuals supplementing with vitamin D to ensure proper calcium metabolism and bone health.

Clinical Implications:

Bleizgys emphasizes that deficiencies in magnesium, zinc, and vitamin K are common and often underdiagnosed. These deficiencies can exacerbate or contribute to various health issues, including those related to vitamin D deficiency. The review suggests that assessing and correcting these nutrient deficiencies is crucial in clinical practice, especially when addressing vitamin D deficiency. Supplementation with magnesium, zinc, and vitamin K, alongside vitamin D, may enhance therapeutic outcomes by supporting the metabolic pathways and physiological functions that these nutrients collectively influence.