Nattokinase
Nattokinase (from Natto)
Enzyme from Japanese fermented soybeans that supports healthy blood flow and may help break down fibrin.
Nattokinase is a fibrinolytic enzyme extracted from natto, a traditional Japanese fermented soybean food. It has potent effects on blood clot breakdown and may support cardiovascular health by improving blood flow. Popular in longevity circles for its blood-thinning properties without the side effects of pharmaceutical anticoagulants.
Mechanisms of Action
Fibrin Breakdown
Directly breaks down fibrin in blood clots
Blood Pressure Support
May modestly reduce blood pressure
Recommended Dose
2000-4000 FU (fibrinolytic units)
Optimal Timing
- On empty stomach or between meals
Can be taken without food
Best Form
Capsules standardized to FU
Alternatives: Natto food
Look for products standardized to fibrinolytic units (FU) rather than just mg.
Duration
Minimum: 4 weeks
Optimal: 8 weeks
Cycling: Not required
Note: Taking on empty stomach may improve absorption. Avoid taking with blood thinners.
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Improved Blood Flow
Better circulation throughout body
Blood Pressure Support
Modest BP reduction in some
Avoid — may increase bleeding risk
Stop at least 2 weeks before any surgery
Who Should NOT Take This
- Bleeding disorders
- Before surgery (stop 2 weeks prior)
- Those on anticoagulants
Drug Interactions
Significantly increases bleeding risk
May have additive effects
Possible Side Effects
Tip: Reduce dose; stop if concerning
Tip: Take with small amount of food
Warnings
- Potent blood-thinning effects — do NOT combine with anticoagulants
- Stop before any surgery or dental procedures
- Seek medical attention if unusual bleeding occurs
Top studies from 31+ peer-reviewed papers
Wei C et al. • Nutrients (2025)
“There are various types of nattokinase preparations on the market, and consumers should choose regular products with high activity and purity, and pay attention to their safety and applicable population.”
Key Findings:
- Large-scale clinical trials have confirmed that nattokinase significantly improves the lipid profile and reduces the atherosclerotic plaque area and intima-media thickness with a favorable safety profile.
- There are various types of nattokinase preparations on the market, and consumers should choose regular products with high activity and purity, and pay attention to their safety and applicable population.
- Further research warranted to confirm findings
Dobre MZ et al. • International journal of molecular sciences (2025)
“Given the variability in evidence and product quality, their use should be individualized, with further large-scale clinical trials needed to establish safety and efficacy.”
Key Findings:
- Omega-3 fatty acids, berberine, garlic, and nattokinase exert favorable metabolic and vascular effects, yet their clinical efficacy depends on formulation, dosage, and patient characteristics and may be limited by bleeding risk or drug interactions.
- Antioxidant agents such as vitamin C, vitamin E, resveratrol, astaxanthin, and coenzyme Q provide additional vascular protection but can interfere with hemostasis, metabolism, or redox-sensitive pathways.
- Similarly, ginkgo biloba, ginger, ginseng, and curcumin exhibit anti-inflammatory vascular activity but also increase the risk of bleeding when combined with antithrombotic therapy.
- Given the variability in evidence and product quality, their use should be individualized, with further large-scale clinical trials needed to establish safety and efficacy.
Bernacka K et al. • Nutrients (2025)
“Potential future studies focused on developing functional fermented foods and easy-to-use supplements based on fermented plant products are suggested.”
Key Findings:
- Fermented fruits and vegetables, including table olives, caper fruits, and kimchi, contain polyphenols and probiotic bacteria, which are beneficial in terms of obesity and impaired glucose and lipid metabolism.
- Fermented legumes are a valuable source of bioactive peptides and isoflavone aglycones.
- Among fermented soybean products, natto stands out due to the presence of γ-polyglutamic acid, which improves glucose tolerance and the lipid profile, and nattokinase, an enzyme that acts as an angiotensin-converting enzyme inhibitor.
- Potential future studies focused on developing functional fermented foods and easy-to-use supplements based on fermented plant products are suggested.
Liu X et al. • Nutrients (2023)
“However, it did not significantly affect serum TG, HDL-C, and CIMT.”
Key Findings:
- There were no significant differences in coagulation, liver function, renal function, or other indicators.
- No intervention-related adverse events, such as mouth ulcers, drooling, and stomach pain, were reported.
- The study results demonstrate that NMSs can ameliorate lipid levels (TC, LDL-C, non-HDL-C, and the LDL-C to HDL-C ratio) without the occurrence of adverse events.
- However, it did not significantly affect serum TG, HDL-C, and CIMT.
Gasmi A et al. • Critical reviews in food science and nutrition (2022)
“Moreover, the paper reviews the enzyme nattokinase's role in thrombotic prevention due to its fibrinolytic activity.”
Key Findings:
- Research has linked vitamin D deficiency to the development of diabetes mellitus, hypertension, cancer, and osteoporosis.
- Vitamin K has been associated with a reduced risk of osteoporosis, cancer, and cardiovascular diseases (due to improved vascular elasticity).
- This review highlights the importance of vitamins D and K in the metabolism of calcium and phosphorus and explores various molecular mechanisms that help maintain the system's mineral homeostasis.
- Moreover, the paper reviews the enzyme nattokinase's role in thrombotic prevention due to its fibrinolytic activity.
Study Type Distribution
Goals This Supplement Supports
This information is for educational purposes only and is not intended as medical advice. Always consult a qualified healthcare provider before starting any supplement.