Nattokinase

Overview

Nattokinase is a serine protease enzyme extracted from natto, a Japanese fermented soybean product. It exerts fibrinolytic and anticoagulant activity by directly degrading fibrin and activating endogenous plasminogen. A 2024 meta-analysis of 6 RCTs (n=546) found significant reductions in systolic blood pressure (MD -3.45 mmHg) and diastolic blood pressure (MD -2.32 mmHg) vs placebo. Individual RCTs confirm effects on blood pressure and reduced von Willebrand factor. Standard dose is 100 mg (2,000 FU) per day, which the European Food Safety Authority considers safe. Critical safety note: nattokinase must not be used as a substitute for prescribed anticoagulants (warfarin, direct oral anticoagulants). A documented case report describes valve thrombosis in a patient who replaced warfarin with nattokinase after mechanical heart valve replacement. Combination with anticoagulants, antiplatelets (including aspirin), or other fibrinolytic supplements increases bleeding risk. Not recommended without medical supervision in patients on blood-thinning medication.

Dosage

100 mg · With meal · Take with food

Scientific Sources

• Meta-analysis 6 RCTs n=546: SBP -3.45 mmHg, DBP -2.32 mmHg vs placebo
• RCT n=86, 8 weeks, 2000 FU/day: SBP -5.55 mmHg, DBP -2.84 mmHg
• RCT n=79, 8 weeks: reduced blood pressure and von Willebrand factor
• Case report: valve thrombosis after warfarin substitution with nattokinase — do not substitute anticoagulants
• Single-dose: potentiates thrombolysis and anticoagulation profiles
• PubChem Compound 16133850

Frequently Asked Questions