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Don’t worry if you can’t take metformin, other common supplements seem to do the same job of inhibiting the proliferation, calcification, and inflammation of VSMCs.
Inhibitors of VSMC Proliferation, Calcification, and Inflammation gleaned from the internet:
Vitamin K
Vitamin K is essential for the gamma-carboxylation and activation of matrix Gla protein (MGP), which is a potent inhibitor of vascular calcification (Deng et al., 2020).
By promoting MGP activation, vitamin K supplementation can inhibit the progression of vascular calcification.
The dosage of vitamin K supplementation used in studies is generally 100-500 mcg/day. Longer duration supplementation (6 months to 2 years) appears more effective than short-term.
Vitamin K supplementation is well tolerated at these dosages. The main caveat is that it can interfere with anticoagulation therapy in patients taking warfarin.
Magnesium
Magnesium inhibits VSMC calcification by reducing phosphate uptake and decreasing expression of osteogenic markers (Deng et al., 2020).
Magnesium supplementation at 300-600 mg/day for 4-6 months has been shown to attenuate vascular calcification progression in CKD patients.
Higher dosages for longer duration may be more effective, but may also increase risk of diarrhea or hypermagnesemia in susceptible patients.
Ascorbic Acid
Ascorbic acid (vitamin C) inhibits VSMC osteogenic differentiation and calcification in vitro (Deng et al., 2020).
Clinical evidence for vitamin C supplementation is lacking. Optimal dosage and duration is unknown.
High dose vitamin C may increase risk of kidney stones in susceptible individuals.
In summary, current evidence supports vitamin K, magnesium, and bisphosphonates as potential inhibitors of VSMC calcification. More research is needed to determine optimal dosing and duration for clinical efficacy.
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