Thiamine (Benfotiamine) vs Vitamin K2 (MK-7)

Mechanism

Benfotiamine is a lipophilic S-acyl derivative of thiamine with 5x greater bioavailability than water-soluble thiamine. Once absorbed, it is converted to thiamine pyrophosphate (TPP), the active coenzyme for pyruvate dehydrogenase (linking glycolysis to Krebs cycle), alpha-ketoglutarate dehydrogenase (Krebs cycle), branched-chain alpha-ketoacid dehydrogenase (BCAA metabolism), and transketolase (pentose phosphate pathway). Benfotiamine specifically activates transketolase, shunting glucose metabolites away from damaging AGE (advanced glycation end-product) formation pathways, hexosamine pathway, and PKC activation — the three major pathways of hyperglycemic damage.

Standard Dosing

150-300mg benfotiamine daily

Timing

With meals. Divide higher doses.

Cycle Duration

ongoing

Side Effects

• Generally very well tolerated
• Mild GI upset (rare)
• Skin rash (very rare)
• Garlic-like body odor at very high doses

Contraindications

• Rare thiamine allergy (more relevant to parenteral administration)

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Mechanism

Vitamin K2 (menaquinone-7) activates vitamin K-dependent proteins via gamma-carboxylation of glutamic acid residues. Key targets: osteocalcin (directs calcium into bone matrix), matrix Gla protein (MGP, inhibits arterial calcification), Gas6 (cell signaling, neuroprotection), and protein S (anticoagulant). MK-7 has a long half-life (~72 hours vs 1-2 hours for K1) enabling consistent carboxylation activity with once-daily dosing. It works synergistically with Vitamin D3 to regulate calcium metabolism — D3 increases calcium absorption while K2 directs its deposition.

Standard Dosing

100-200 mcg MK-7 daily

Timing

With fat-containing meal alongside Vitamin D3.

Cycle Duration

ongoing (mandatory co-supplement with Vitamin D3)

Side Effects

• Generally very well tolerated
• Rare: mild GI discomfort
• Theoretical thrombotic risk in deficiency-rebound scenario (unproven)

Contraindications

• Warfarin/coumarin anticoagulant therapy (unless specifically directed by physician with INR monitoring)

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