Nattokinase is a fibrinolytic enzyme derived from Japanese Natto, a fermented soy food. Accumulating research identifies nattokinase as a potent anti-fibrinolytic and anti-thrombotic agent, serving as a potential treatment for: cardiovascular disease, hypertension, myocarditis, chronic kidney disease and beyond.
A 2022 study involving 1,062 heart disease patients in China found high doses of nattokinase significantly reduced carotid artery intima-media size, and carotid plaque. These improvements ranged from 66.5-95.4%. Additionally, significant reductions in blood lipids were observed. The study was completed after 1 year on the nattokinase therapy. The dosage used in the study was 10,800 F.U. (fibrinolytic units) daily (1).
Nattokinase Dissolves Blood Clots Directly by Lysing and Hydrolyzing Fibrin
Blood clots form when a protein known as Fibrin creates a net and traps blood platelets and red blood cells. Fibrinolytic enzymes such as Nattokinase act by degrading fibrin. Certain forms of Nattokinase, such as NSK-SD act to both degrade fibrin, as well as increase the production of enzymes in the body known as urokinase and plasmin, which degrade clots. While blood clotting is a critical component of tissue healing, there are 2 components of the blood clotting cascade: intrinsic (inside blood vessels), and extrinsic (tissues). The following effects are known to be induced by nattokinase:
Nattokinase Increases aPTT (activated partial thromboplastin time), increases PT (prothrombin time) – An elevation of aPTT indicates an increased time to form an intrinsic blood clot (in vessels), whereas an elevation in PT indicates an increased time to form an extrinsic clot (in tissues) A randomized controlled trial involving 50 non-diabetic subjects with high cholesterol found that after 8 weeks and 100mg daily (2,000 F.U. of nattokinase) nattokinase significantly increased aPTT, and PT (4). The magnitude of effect for increasing aPTT went from approximately 27.3 seconds to nearly 28 seconds. PT increased from approximately 10.8 seconds to 11 seconds.
Nattokinase Decreases Fibrinogen, Factors VII & VIII – Factor 8 increases thrombin. An elevation of Factor 8 is a significant cardiovascular disease risk factor. Thrombin, which is a serine protease acts by converting fibrinogen into fibrin, which leads to clots. Nattokinase disrupts this process, and reduces Factor VIII (2). A study involving 45 subjects were divided into 3 groups: normal subjects, cardiovascular disease risk and kidney dialysis. All subjects were given 4,000 F.U’s of Nattokinase daily for 8 weeks. Fibrinogen, Factor VII and Factor VIII were measured in all 3 groups before and after the trial. The healthy subject group experienced: a 9% decrease in Fibrinogen, 14% reduction in Factor VII and 17% reduction in Factor VIII. The cardiovascular risk group experienced: a 7% decrease in Fibrinogen, 13% reduction in Factor VII, and a 19% reduction in Factor VIII. The dialysis group experienced: a 10% decrease in Fibrinogen, a 7% reduction in Factor VII, a 19% reduction in Factor VIII (5).
Nattokinase increases Antithrombin (2). Antithrombin inhibits thrombin. In the referenced study, 12 healthy males were given a single 2,000 F.U. dose of nattokinase, while their coagulation blood markers were monitored over 8 hours. The magnitude of the effect of increasing antithrombin levels went from baseline levels of 27 to about 28.5 mg/dl. The duration of elevation was maintained for 6 hours, and began tapering off after 8 hours. The referenced study used a low dose of nattokinase, containing only 2,000 F.U., which is the equivalent to a single 100mg capsule of nattokinase. To date, this is the only human study that has measured nattokinase on antithrombin levels.
Nattokinase increases D-Dimer (2). When D-dimer levels elevate, it’s an indication of recent intrinsic fibrin degradation.
Other Scientific Studies on Nattokinase
Nattokinase has been shown in vivo to increase platelet lysis (degradation) by way of increasing cAMP (cyclic AMP). Nattokinase increases nitric oxide signaling, relaxes vascular smooth muscle endothelial cell function, and inhibits calcium influx (which tends to increase contraction of smooth muscle) (3).
A single 2,000 F.U. dosage of nattokinase daily for 8 weeks reduced blood pressure in hypertensive subjects by -5.55 Hg (systolic) and 2.84 Hg (diastolic) (6). Higher, therapeutic dosages have not been trialed to date for hypertension.
Nattokinase is a candidate for nasal polyps and has been studied as efficacious in vitro (7). This is based on preliminary research that fibrin is integral in the formation of nasal polyps.(7).
Commercially available nattokinase products typically feature 2,000 F.U. per capsule.
Nattokinase NSK-SD is non-GMO and non-irradiated.
Nattokinase NSK-SD is the most reputable form of nattokinase produced.
Nattokinase NSK-SD has Vitamin K2 activity removed. Therefore, it is less likely to adversely affect patients taking other blood thinning drugs.
Nattokinase NSK-SD is fermented using a strain of bacillus subtillus.
Nattokinase NSK-SD increases Tissue Plasminogen Activator (t-PA)
Nattokinase NSK-SD decreases Plasminogen Activator Inhibitor Type 1 (PAI-1)
Questions About Nattokinase and Warfarin
Question: Can nattokinase be taken with Warfarin?
Answer: A double-blind placebo-controlled study from 2008 (Ninomiya, 2008) used a highly potent form of nattokinase, known as NSK-SD. The study involved 60 subjects who were all taking Warfarin, and were given either nattokinase NSK-SD (1,700-3,400 F.U./daily) or a placebo, for 26 weeks. No adverse effects occurred when taking NSK-SD nattokinase. In fact, the rate of change that had occurred for APTT and PT blood measures on Warfarin + Nattokinase subjects achieved target values closer towards ideal, compared to those taking Warfarin + placebo. In other words, nattokinase NSK-SD works synergistically with Warfarin. NSK-SD nattokinase has Vitamin K2 removed.
Where Can I Get NSK-SD:
Klaire Labs Nattokinase NSK-SD, 100mg/2,000 F.U. per capsule
Question: Where can I learn more about my genetic and blood chemistry?