The COMB Study and Vitamin K2 for Bone Health

April 08, 2013

The Comb Study: Combination of Micronutrients and Bone Density 

Reference: Journal of Environmental and Public Health, Volume 2012 

 Ok, now we get serious about some implications with K2 and its effectiveness.  Let’s teach you how to CURE osteoporosis.  I said cure, and I mean it.   No drugs.  Here goes.  The COMB study comes out of Edmonton, Canada, and was published last year.  It’s the first study that looks at K2 and bone density that I could find. The authors found some 77 folks who didn’t want to take bisphonates and wanted a natural treatment of their bone density problems.  Some had failed bisphonate therapy.  They were followed for a year.   Those who didn’t take the supplements on a daily basis were excluded if they dropped below 50%.   It was not randomized, placebo-controlled.  Hence that makes it an observational study and not quite to the standard of modern science.  We probably need a randomized trial to see if this is duplicated.  

But the results are pretty impressive nevertheless.  And I can still argue that we have yet to do a randomized placebo-controlled trial of the effectiveness of parachutes on people jumping out of planes. Their protocol was:   Vitamin D3 2,000 IU a day,  Fish Oil (DHA) 250 mg a day,  Strontium citrate 680 mg a day,  magnesium 25 mg a day, and Vitamin K2 100 mcg a day.  In addition, they encouraged dietary sources of calcium and daily exercise. Sounds easy!  You can buy the strontium cheaply on the internet or at health food stores.  It is below calcium on the periodic table and is known to increase bone density.   

Each of the ingredients listed is literature-based as improving bone density individually.  You could add some others. Boron, copper, manganese, silica, B6, B12, folate are all other useful micronutrients that weren’t included in this study.  But K2 is the new player in town. I would probably add a bit more Vitamin A too. What happened in this observational study?  Well, the folks who took it every day had a 4% increase in the femoral neck, an 8% increase in the lowest spine site…read the study and look at tables 3-5 and look at the Figures.  The data is just very powerful.  Folks who had not improved with bisphonates showed 3-8% improvement in just one year with this combination of micronutrients.   

And no side effects.  Can I repeat that?  No side effects.  The cost was also minimal.  The total cost of all these supplements will be on the order of $ 200 a year if you find the expensive stuff.   This improvement is double the usual rate of improvement from bisphonates, and you don’t need to get a prescription. This should be a clarion call.  The more we publicize this study, the more the PR departments of major pharma will be gearing up to try and downplay the significance.  The best way to attack is to claim that we need a randomized, controlled trial to prove that it works.  My response to that is “Hogwash”.  You need RCTS when you are giving dangerous drugs that have toxicity.  This stuff is all food.  Don’t need an RCT for food.  You just need a caring mother and a natural table.  Lacking that, you need some supplements and persistence. 

 WWW.  What will work for me?  I will be using this protocol with every patient I see now.  It will be the standard of care in my practice and in my personal life.  I will be taking K2 the rest of my life, along with my D.   And until we see big pharma fund an RCT on parachutes, you need your own parachute to protect you from the free fall of osteoporosis.  It’s called K2.  100 mcg-200 mcg a day.  This observational study is just plain common sense.  Listen to it and enjoy the triumph of reason. 

Pop Quiz 

 1.  COMB stands for the C-ombination O-f M-icronutrients for B-one density.  T or F                 Answer:   True 

 2.  Each of the ingredients is a natural food product:  K2, D3, DHA, strontium, Magnesium and calcium  T or F                         Answer:  False.  It's actually hard to get strontium in food.  It's a natural element that acts like calcium, but that's all it is.  And you only get D from sunshine or from supplemented foods. 

 3.  There are other supplements you could add.  Name two or three.                       Answer:  Boron, copper, Vitamin A, manganese, B12, folate, .... 

 4.   Bone density in compliant volunteers improved at double the rate of bisphonates with no side effects in 12 months.                          Answer:  Yup.  That's it in a nutshell.  

5.  The beneficial effect is not proven, this is an observational study.   T or F                      Answer:  Yes again.  Most of medicine is based on empiric observations.  Something this obvious just needs to be done.

This column was written by John E Whitcomb, MD, Brookfield Longevity, Brookfield, WI.