MenaQ7® (All-Trans Vitamin K2 MK-7)

Evidence Level
Moderate
3 Clinical Trials
5 Documented Benefits
3/5 Evidence Score

MenaQ7® (originally NattoPharma, now part of Gnosis/Lesaffre) is the original commercial all-trans menaquinone-7 (MK-7) ingredient, derived historically from a controlled natto fermentation process and now also available as a synthetically produced all-trans MK-7. Standardized for high all-trans isomer purity, MenaQ7® was used in a 3-year randomized, placebo-controlled trial in 244 healthy postmenopausal women that measured bone mineral density, arterial stiffness and matrix Gla protein activation. Nearly all of the human outcome evidence comes from that single trial and that single group of people, so it does not automatically apply to men, to younger women, or to people with existing disease. That trial found less age-related bone loss at the lumbar spine and femoral neck and better carotid-femoral pulse wave velocity (a measure of artery stiffness) than placebo. A separate 6-month trial of 360 mcg/day MK-7 in 68 people with type 2 diabetes and known heart disease did not succeed: it missed its main endpoint on CT scanning (P = 0.18), and on PET imaging the MK-7 group tended toward more active artery calcification than placebo (P = 0.06).

Studied Dose 180 mcg/day for 3 years in the postmenopausal bone and arterial stiffness trial. Products commonly supply 45 to 180 mcg/day. The trial that failed to reduce artery calcification used a higher dose, 360 mcg/day for 6 months.
Active Compound Menaquinone-7 (MK-7), all-trans isomer; from Bacillus subtilis natto fermentation or synthetic all-trans MK-7 of high isomeric purity.

Benefits

Long-term bone density support

In a 3-year randomized, double-blind, placebo-controlled trial in 244 healthy postmenopausal women, MenaQ7® at 180 mcg/day slowed the age-related decline in bone mineral content and bone mineral density at the lumbar spine and femoral neck compared with placebo. A 3-year placebo-controlled trial is unusually long for a supplement, which makes this the strongest evidence on this page. It was done only in postmenopausal women, so it says nothing about men or younger people. Effects are modest compared with pharmaceutical osteoporosis therapy but reached statistical significance over the multi-year window.

Arterial stiffness and vascular elasticity

In the same 3-year trial of 244 healthy postmenopausal women, MenaQ7® at 180 mcg/day improved carotid-femoral pulse wave velocity and stiffness index versus placebo, along with lower levels of inactive matrix Gla protein. That is real randomized evidence, but it is one trial in one narrow group. When MK-7 was tested directly against artery calcification it did not help: in 68 people with type 2 diabetes and existing heart disease, 360 mcg/day for 6 months missed the main endpoint on CT scanning (P = 0.18) and, on PET imaging, tended toward more active calcification than placebo (P = 0.06).

Activation of vitamin-K-dependent Gla proteins

MenaQ7® consistently lowers circulating inactive osteocalcin and inactive matrix Gla protein, which shows the body is using the vitamin K to switch these proteins on. These are laboratory markers, not health outcomes. The failed 6-month trial in people with diabetes shows why the difference matters: the blood marker improved while the imaging measure of artery calcification did not.

Long half-life and once-daily dosing

MK-7 has a plasma half-life of roughly 3 days versus about 1 hour for MK-4. In a blood-level study in healthy adults, MK-7 accumulated to 7 to 8 times its starting level with continued daily intake and held steadier levels than vitamin K1, so once-daily dosing is practical. This is a blood-level finding only, not evidence of a health benefit.

Original commercial all-trans MK-7

MenaQ7® was the first widely sold all-trans MK-7 and is the exact material used in the published 3-year postmenopausal trial, so a product listing MenaQ7® tells you which form was studied. Other MK-7 brands are not automatically covered by that trial, and being first to market is not itself evidence of a benefit.

Mechanism of action

1

Gamma-carboxylation of Gla-domain proteins

MK-7 is an essential cofactor for gamma-glutamyl carboxylase, which converts glutamate residues in Gla-domain proteins (osteocalcin, matrix Gla protein, GAS6, Protein S) to gamma-carboxyglutamate, enabling these proteins to bind calcium and perform their physiological functions.

2

Osteocalcin activation and bone matrix formation

Carboxylated osteocalcin binds hydroxyapatite (bone mineral) and helps incorporate calcium into the bone matrix. Inadequate K2 leaves osteocalcin undercarboxylated and impairs this binding, contributing to age-related bone loss that MK-7 supplementation may help mitigate.

3

Matrix Gla protein activation and vascular protection

Carboxylated matrix Gla protein is the body's primary inhibitor of vascular calcification, binding calcium ions in vessel walls and limiting calcium phosphate deposition. Low vitamin K leaves MGP inactive, and low activation has been linked with more arterial calcification in observational data. That is an association, not proof, and the one randomized trial that imaged calcification directly found no benefit from MK-7 and a trend in the wrong direction.

4

Long-chain menaquinone tissue distribution

Compared with shorter menaquinones, MK-7's longer isoprenoid side chain supports efficient incorporation into circulating lipoproteins and extra-hepatic tissue delivery — explaining its disproportionate effect on extra-hepatic Gla proteins like osteocalcin and MGP relative to MK-4.

Clinical trials

1
MenaQ7® (180 mcg/day) for Bone Mineral Density in Postmenopausal Women — 3-Year RCT

Randomized, double-blind, placebo-controlled trial of MenaQ7® MK-7 (180 mcg/day) vs placebo in 244 healthy postmenopausal women over 3 years. Outcomes: bone mineral density at lumbar spine and femoral neck, osteocalcin carboxylation status. Published in Osteoporosis International.

244 healthy postmenopausal women; 3-year intervention.

MenaQ7® MK-7 significantly improved osteocalcin carboxylation and reduced age-related decline in bone mineral content and bone mineral density at the lumbar spine and femoral neck vs placebo. Effects were modest in magnitude compared with pharmaceutical osteoporosis therapy but reached statistical significance over the 3-year window.

2
MenaQ7® (180 mcg/day) and Arterial Stiffness — 3-Year RCT

Randomized, double-blind, placebo-controlled trial of MenaQ7® MK-7 (180 mcg/day) vs placebo in 244 healthy postmenopausal women over 3 years. Outcomes: carotid–femoral pulse wave velocity, stiffness index, circulating inactive matrix Gla protein. Published in Thrombosis and Haemostasis.

244 healthy postmenopausal women; 3-year intervention.

Three years of MenaQ7® improved carotid-femoral pulse wave velocity and stiffness index versus placebo, along with significant reductions in inactive matrix Gla protein. This is the same 244-woman trial listed above reported in a second paper, not an independent study. A different randomized trial (68 people with type 2 diabetes and known cardiovascular disease, 360 mcg/day MK-7 for 6 months) did not meet its primary endpoint: no effect on vascular calcification by CT (P = 0.18), and on 18F-NaF PET the MK-7 group tended to increase active calcification versus placebo (P = 0.06). Only the blood marker improved in that trial.

3
MK-7 pharmacokinetics vs phylloquinone — Blood

Pharmacokinetic study comparing synthetic vitamin K1 (phylloquinone) and natto-derived MK-7 supplementation in healthy adults to characterize plasma kinetics, half-life, and accumulation. Published in Blood.

Healthy adult volunteers; pharmacokinetic study.

MK-7 demonstrated a very long plasma half-life and far more stable serum levels than phylloquinone, with 7- to 8-fold accumulation during prolonged intake. This supports once-daily dosing. It is a blood-level comparison in healthy volunteers, not a trial of bone, heart or any other health outcome.

Side effects and drug interactions

Common Potential side effects

Well tolerated at typical doses (45 to 180 mcg/day) in published trials.
No clinically significant side effects were reported in the 3-year MenaQ7® trial. Separately, in a 6-month trial in people with type 2 diabetes and existing heart disease, the MK-7 group showed a non-significant trend toward more active artery calcification on PET scanning (P = 0.06). This has not been confirmed or explained, but it is worth knowing.
Mild GI discomfort possible with very high doses or in sensitive individuals.
Not extensively studied in pregnancy beyond dietary intake levels; consult clinician.
No tolerable upper intake limit established by most regulatory authorities for MK-7.

Important Drug interactions

Warfarin and other vitamin K antagonists — MK-7 directly opposes the drug's mechanism; coordinate carefully with anticoagulation clinic.
Direct oral anticoagulants (DOACs) — limited interaction data, but maintain consistent vitamin K intake.
Broad-spectrum antibiotics — may reduce intestinal K2 production; supplemental K2 may become more important.
Bile acid sequestrants and orlistat — may reduce absorption of fat-soluble vitamins including K2.

Frequently asked questions about MenaQ7® (All-Trans Vitamin K2 MK-7)

What is MenaQ7?

MenaQ7® (originally NattoPharma, now part of Gnosis/Lesaffre) is the original commercial all-trans menaquinone-7 (MK-7) ingredient, derived historically from a controlled natto fermentation process and now also available as a synthetically produced all-trans MK-7.

What is MenaQ7 used for?

MenaQ7 is researched primarily for Bone Health and Cardiovascular. In a 3-year randomized, double-blind, placebo-controlled trial in 244 healthy postmenopausal women, MenaQ7® at 180 mcg/day slowed the age-related decline in bone mineral content and bone mineral density at the lumbar spine and femoral neck…

What is the recommended dosage of MenaQ7?

The clinically studied dose is 180 mcg/day for 3 years in the postmenopausal bone and arterial stiffness trial. Products commonly supply 45 to 180 mcg/day. The trial that failed to reduce artery calcification used a higher dose, 360 mcg/day for 6 months. Always follow the product label and check with a healthcare provider for personal advice.

Is MenaQ7 safe, and does it have side effects?

For most healthy adults, MenaQ7 is well tolerated at studied doses. Reported effects can include: Well tolerated at typical doses (45 to 180 mcg/day) in published trials. No clinically significant side effects were reported in the 3-year MenaQ7® trial. It may also interact with some medications. MenaQ7 is not right for everyone, so check with a healthcare provider first if you are pregnant or breastfeeding, have a medical condition, or take prescription medication.

Does MenaQ7 interact with any medications?

Possible interactions include: Warfarin and other vitamin K antagonists — MK-7 directly opposes the drug's mechanism; coordinate carefully with anticoagulation clinic. Direct oral anticoagulants (DOACs) — limited interaction data, but maintain consistent vitamin K intake. If you take prescription medication, check with a pharmacist or doctor before using it.

How strong is the scientific evidence for MenaQ7?

NutraSmarts rates the evidence for MenaQ7 as Moderate (3 out of 5). It is backed by 3 clinical trials and 4 cited references summarized on this page. A higher rating reflects more, larger, and better-designed human studies.

References(4 citations)

Evidence ratings on NutraSmarts are based on the totality of human clinical research, with emphasis on randomized controlled trials, meta-analyses, and systematic reviews. The references below directly support claims made throughout this page.

  1. Knapen MH, Drummen NE, Smit E, Vermeer C, Theuwissen E. Three-year low-dose menaquinone-7 supplementation helps decrease bone loss in healthy postmenopausal women. Osteoporos Int. 2013;24(9):2499-507. doi: 10.1007/s00198-013-2325-6.PubMedUsed to support: 3-year RCT in 244 healthy postmenopausal women — MenaQ7® MK-7 (180 mcg/day) significantly improved vitamin K status and decreased age-related decline in bone mineral content and bone mineral density at the lumbar spine and femoral neck vs placebo.
  2. Knapen MH, Braam LA, Drummen NE, Bekers O, Hoeks AP, Vermeer C. Menaquinone-7 supplementation improves arterial stiffness in healthy postmenopausal women. A double-blind randomised clinical trial. Thromb Haemost. 2015;113(5):1135-44. doi: 10.1160/TH14-08-0675.PubMedUsed to support: 3-year RCT in 244 healthy postmenopausal women — MenaQ7® MK-7 (180 mcg/day) significantly improved carotid–femoral pulse wave velocity and stiffness index and reduced inactive matrix Gla protein vs placebo, supporting MK-7's cardiovascular role.
  3. Schurgers LJ, Teunissen KJ, Hamulyak K, Knapen MH, Vik H, Vermeer C. Vitamin K-containing dietary supplements: comparison of synthetic vitamin K1 and natto-derived menaquinone-7. Blood. 2007;109(8):3279-83. doi: 10.1182/blood-2006-08-040709.PubMedUsed to support: Pharmacokinetic comparison showing MK-7 has a much longer plasma half-life than phylloquinone, with stable serum levels and 7–8-fold accumulation during prolonged intake — mechanistic basis for once-daily MenaQ7® dosing and extra-hepatic Gla-protein activation.
  4. Zwakenberg SR, de Jong PA, Bartstra JW, van Asperen R, Westerink J, de Valk H, et al. The effect of menaquinone-7 supplementation on vascular calcification in patients with diabetes: a randomized, double-blind, placebo-controlled trial. Am J Clin Nutr. 2019;110(4):883-890. doi: 10.1093/ajcn/nqz147.PubMedUsed to support: This citation is not a review. It is a randomized, double-blind, placebo-controlled trial that did not meet its primary endpoint. In 68 people with type 2 diabetes and known cardiovascular disease, 360 mcg/day MK-7 for 6 months did not reduce vascular calcification on CT scanning (P = 0.18), and on 18F-NaF PET imaging the MK-7 group tended to increase active calcification compared with placebo (P = 0.06). Only the blood marker dp-ucMGP improved. This reference does not support a cardiovascular benefit.