© by Elizabeth Lee Vliet MD and Kathy Kresnik
Nattokinase, the Japanese secret weapon against heart disease, has become truly a life-saving, clot-dissolving natural enzyme Big Pharma does not want you to know. Nattokinase may be the game-changer for heart patients you have been looking for if you are concerned about blood clots and plaque but bothered by statin risks and side effects.
Nattokinase is an enzyme derived naturally from the fermentation of soybeans that is far less expensive than statin medications, has markedly less risk than statins and none of the major adverse side effects characteristic of statins, which we will be discussing in depth on our upcoming Faith Over Fear seminar February 24 8 PM ET (link above). Some nattokinase products are synthetically created in the laboratory, but I am focused in today’s health tip on the many advantages and remarkable powers of Nattokinase derived naturally from the fermentation of soybeans.
For years we have known that high natto consumption has been linked to the Japanese population’s longer average lifespans and lower chronic disease rates. In particular, studies show that people with diets rich in this traditional Japanese food made by fermenting soybeans with friendly bacterium called Bacillus subtilis natto, have lower rates of death from heart diseases. Unfortunately, natto is not commonly consumed in the American diet In fact, natto can be hard to find in the US as a food source. Fortunately, the health benefits in natto come from the potent enzyme, nattokinase, that is extracted from natto and can purchased in a supplement –but you do need to check for a reliable source to improve safety.
Nattokinase has really taken off in the US with practitioners promoting natural, safer treatments for COVID illness, and the even greater problem of widespread and long lasting micro blood clots triggered by the mRNA COVID shots. Researchers are gradually uncovering its mechanisms of action in the body and additional health benefits, even though large scale clinical trials have been slow in coming.
Today’s health tip for our Heart Month series is just focused on nattokinase in heart disease (dissolving blood clots, maintaining healthy blood vessel structure), but I wanted to first list some of its many other remarkable benefits:
- anti-cancer properties
- reducing amyloid plaques in the brain (linked to dementia)
- improved health of mucosal lining of the sinuses
- shrinking nasal polyps and thinning sticky mucus
- promoting improved balance of gut bacteria
- strengthening immune system
- boosting metabolism
Nattokinase is best known for its ability to break down fibrin, the main structural protein in blood clots. Fibrin is a whitish, filamentous protein that is formed in blood after a trauma or injury. Fibrin’s function is to protect the body from excessive blood loss. Strands of fibrin can accumulate along the walls of blood vessels and affect blood flow. In 1980, during a series of in vitro experiments at the University of Chicago Medical School, Dr. Hiroyuki Sumi discovered that natto affected fibrin levels.
Nattokinase primarily supports your body’s own “clot‑cleanup crew” and does so by several actions:
- Directly dissolves fibrin in clots
- Activates plasmin, the body’s main clot‑dissolving enzyme
- Reduces PAI‑1, a protein that normally puts the brakes on clot breakdown.
Abnormal clotting, sluggish blood flow, and high blood pressure all contribute to heart attacks and strokes, which explains the reason nattokinase has been used as supplement for cardiovascular conditions in Japan for many years. Nattokinase role in heart disease reduction is mainly due to its abilities to help break down atherosclerotic plaques and break down blood clots (antithrombotic properties).
REVIEW OF KEY EVIDENCE FOR SPECIFIC HEART BENEFITS:
Taken together, all of the research findings below show that nattokinase as a supportive cardiovascular health strategy—especially for blood pressure, clot reduction, plaque clearance, and anti-inflammatory actions. For more serious heart disease patients, nattokinase may not be a replacement for established treatments, but certainly can be a beneficial complementary strategy to be considered, and may help to reduce the doses (and side effects) of other medicines.
1. Blood pressure and blood flow
A 2023 meta‑analysis pooling randomized controlled trials (607 participants) found that nattokinase supplementation modestly lowered both systolic and diastolic blood pressure compared with placebo. In individual trials using 2,000 FU (fibrinolytic units) per day for about 8 weeks, average blood pressure dropped by roughly 3–6 mmHg—similar to what you might see with some lifestyle interventions.
Mechanisms include:
- Blocking angiotensin‑converting enzyme (ACE) and lowering angiotensin II, which relaxes blood vessels and reduces pressure.
- Breaking down fibrinogen in the blood, which helps your blood flow more smoothly and makes blood less sticky.
For someone with borderline or mild hypertension, this reduction is small but meaningful, especially when combined with diet, exercise, and standard medications.
2. Clotting and thrombosis risk
Human and laboratory data show that nattokinase:
- Increases fibrin/fibrinogen breakdown products after a single 2,000 FU oral dose, indicating enhanced blood clot dissolution.
- Lowers fibrinogen, factor VII, and factor VIII after 1–2 months of use, shifting the blood toward a less clot‑prone state.
- Reduces platelet aggregation and thromboxane formation in experimental models, adding a mild antiplatelet effect.
These changes help lower risk of deep vein thrombosis, certain strokes, and other clot‑related events.
3. Atherosclerosis and cholesterol
Several longer‑term studies suggest nattokinase benefits the health of arteries throughout the body:
- A large year‑long study of 1,062 adults taking 10,800 FU/day reported significant reductions in carotid artery plaque area and improvements in total cholesterol, LDL‑C, triglycerides, and HDL‑C.
- Other trials and reviews show that nattokinase modestly improves lipid profiles and helps slow atherosclerotic progression.
Mechanisms include, but may not be limited to, nattokinase’s weak “statin‑like” actions, with improved clearance of triglycerides (another blood fat), anti‑inflammatory and antioxidant effects on the arterial wall. Further research may show additional mechanisms for nattokinase beneficial actions.
Is Nattokinase Helpful in Cardiac Amyloid Disease?
Cardiac amyloid disease (cardiac amyloidosis) is an inflammatory, infiltrative cardiomyopathy in which misfolded proteins (amyloid fibrils) are deposited in the myocardium. This causes a stiff, thick-walled ventricle that impairs the pumping ability of the heart and can lead to diastolic heart failure and arrhythmias. I have seen a rise in cardiac amyloid disease, both transthyretin (ATTR) or light‑chain (AL) cardiac amyloidosis, since 2021 and roll-out of the COVID shots. This parallels the findings on increased amyloid deposits in the brain (confirmed on imaging studies) in those who got the COVID shots.
We do not yet have clinical trials to show that nattokinase improves cardiac amyloid disease in humans, there is existing data for its beneficial effects on amyloid in brain disorders such as Alzheimer‑type dementia. Here is a brief overview of what we do know based on current research.
- In vitro studies demonstrate that nattokinase can degrade several types of amyloid fibrils (e.g., Aβ and other model amyloids) at neutral pH and body temperature, suggesting broad amyloid‑degrading potential.
- Animal and mechanistic work in neurodegeneration shows nattokinase can break down amyloid‑β aggregates and may improve cognitive and behavioral endpoints in Alzheimer‑type models, but these are brain‑focused studies. We need studies that use similar approaches to study cardiac amyloid deposits.
- A patent and reviews speculate that nattokinase might be useful in systemic amyloidoses (including cardiac), based on this generic amyloid‑degrading ability, but this remains a theoretical application rather than a therapy confirmed in clinical trials in humans.
My take: I think taken together, the data we have indicates that nattokinase shows potential for reducing amyloid burden in cardiac amyloid but not as a replacement for more established therapies. We simply do not have enough clinical evidence from studies I humans to use nattokinase as a primary strategy with something as potentially serious and life-threatening as cardiac amyloidosis.
How Much Nattokinase for Heart Support?
Dosing will differ for each individual based on other medicines, risk factors, and other variables, but these are some general guidelines to help you start a conversation with your own physician. CAUTION: DO NOT START TAKING NATTOKINASE ON YOUR OWN WITHOUT CHECKING WITH YOUR PHYSICIAN. Just as with all therapies that reduce blood clots, excessive bleeding can be a risk. I also do blood tests for D-Dimer and Fibrinogen levels in all my patients prior to starting any therapy aimed at reducing blood clots.
The doses listed are expressed in fibrinolytic units (FU), not milligrams, and you will find this on the back of the label. Most 100 mg capsules contain about 2,000 FU, but products can vary, so you need to check doses carefully.
- General cardiovascular support / mild hypertension
- 2,000 FU once daily (≈100 mg) on an empty stomach.
- Increasing to 2,000 FU twice daily (4,000 FU/day) has been shown to have stronger fibrinolytic and better BP lowering effects in clinical research, but also can increase the risk of excessive bleeding. Higher doses should be monitored by a medical professional.
- In experiments for aggressive plaque and lipid targets
- 6,000 FU/day for 26 weeks matched simvastatin 20 mg/day for carotid plaque regression in one trial
- 10,800 FU/day for 12 months produced clear improvements in lipids and carotid plaque, while 3,600 FU/day did not, suggesting a threshold effect. Again, due to the risk of excessive bleeding. Higher doses should be monitored by a medical professional.
Bleeding risks and long‑term safety at very high doses have not been fully defined by clinical trials, so most clinicians treating nattokinase as an adjunct for heart health stay within the 2,000–4,000 FU/day range in routine practice, reserving ≥6,000 FU/day for carefully selected and closely monitored patients, or in research protocols where individuals are closely monitored with objective measures.
How to Evaluate Products and Take Nattokinase
|
|
|
|
