Nattokinase

What other names is Nattokinase known by?

BSP, Extrait de Natto, Fermented Soybeans, Haricots de Soja Fermentés, Natto de Soja, Natto Extract, Nattokinasa, NK, Soy Natto, Subtilisin NAT.

What is Nattokinase?

Nattokinase is an enzyme (a protein that speeds up biochemical reactions) that is extracted from a popular Japanese food called natto. Natto is boiled soybeans that have been fermented with a bacterium called Bacillus natto.

Natto has been used as a folk remedy for diseases of the heart and circulatory system (cardiovascular disease) for hundreds of years. Nattokinase, the chemical in natto that is probably responsible for its effects, was discovered by a University of Chicago researcher, Dr. Hiroyuki Sumi.

You won't find nattokinase in soy foods other than natto, since nattokinase is produced through the specific fermentation process used to make natto.

Nattokinase is used for cardiovascular diseases including heart disease, high blood pressure, stroke, chest pain (angina), deep vein thrombosis (DVT), “hardening of the arteries” (atherosclerosis), hemorrhoids, varicose veins, poor circulation, and peripheral artery disease (PAD).

It is also used for pain, fibromyalgia, chronic fatigue syndrome, endometriosis, uterine fibroids, muscle spasms, infertility, cancer, and a vitamin-deficiency disease called beriberi.

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Possibly Effective for...

Insufficient Evidence to Rate Effectiveness for...

More evidence is needed to rate the effectiveness of nattokinase for these uses.

How does Nattokinase work?

Nattokinase decreases the ability of blood to clot. This "thins the blood" and might protect against conditions caused by blood clots such as stroke, heart attack, and others.

Are there safety concerns?

Nattokinase is LIKELY SAFE when taken by mouth in amounts commonly found in foods. Nattokinase is a natural component of the soy food natto. It has been routinely consumed in Japanese cultures for hundreds of years.

Nattokinase is POSSIBLY SAFE when taken by mouth as medicine. Taking two doses of a specific product containing nattokinase (Flite Tabs) seems to be safe. However, it is not known if taking more than two doses is safe.

Special Precautions & Warnings:

Pregnancy and breast-feeding: There is not enough reliable information about the safety of taking nattokinase if you are pregnant or breast-feeding. Stay on the safe side and avoid use.

Bleeding disorders: Nattokinase seems to act like a “clot thinner” and might make bleeding disorders worse. Use with caution.

Surgery: Nattokinase might increase the chance of bleeding too much during or after surgery. Stop taking it at least 2 weeks before a scheduled surgery.

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Are there any interactions with medications?


Medications for high blood pressure (Antihypertensive drugs)Interaction Rating: Moderate Be cautious with this combination.Talk with your health provider.

Nattokinase might decrease blood pressure in some people. Taking nattokinase along with medications used for lowering high blood pressure might cause your blood pressure to go too low. However, it's not known if this is a big concern. Do not take too much nattokinase if you are taking medications for high blood pressure.

Some medications for high blood pressure include captopril (Capoten), enalapril (Vasotec), losartan (Cozaar), valsartan (Diovan), diltiazem (Cardizem), Amlodipine (Norvasc), hydrochlorothiazide (HydroDIURIL), furosemide (Lasix), and many others.


Medications that slow blood clotting (Anticoagulant / Antiplatelet drugs)Interaction Rating: Moderate Be cautious with this combination.Talk with your health provider.

Nattokinase can decrease blood clotting. Taking nattokinase along with medications that also slow clotting might increase the chances of bruising and bleeding.

Some medications that slow blood clotting include aspirin, clopidogrel (Plavix), diclofenac (Voltaren, Cataflam, others), ibuprofen (Advil, Motrin, others), naproxen (Anaprox, Naprosyn, others), dalteparin (Fragmin), enoxaparin (Lovenox), heparin, warfarin (Coumadin), and others.

Dosing considerations for Nattokinase.

The appropriate dose of nattokinase depends on several factors such as the user's age, health, and several other conditions. At this time there is not enough scientific information to determine an appropriate range of doses for nattokinase. Keep in mind that natural products are not always necessarily safe and dosages can be important. Be sure to follow relevant directions on product labels and consult your pharmacist or physician or other healthcare professional before using.

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Natural Medicines Comprehensive Database rates effectiveness based on scientific evidence according to the following scale: Effective, Likely Effective, Possibly Effective, Possibly Ineffective, Likely Ineffective, and Insufficient Evidence to Rate (detailed description of each of the ratings).

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Reviewed on 9/17/2019
References

Chang, Y. Y., Liu, J. S., Lai, S. L., Wu, H. S., and Lan, M. Y. Cerebellar hemorrhage provoked by combined use of nattokinase and aspirin in a patient with cerebral microbleeds. Intern Med 2008;47(5):467-469. View abstract.

Kazuya, O., Shigeo, I., and KenichimS. Report of research: an oral safety study of nattokinase containing food, Natural Super Kinase II: a randomized placebo controlled double-blind study. Progress in Medicine 2006;26(5):5.

Kim, J. Y., Gum, S. N., Paik, J. K., Lim, H. H., Kim, K. C., Ogasawara, K., Inoue, K., Park, S., Jang, Y., and Lee, J. H. Effects of nattokinase on blood pressure: a randomized, controlled trial. Hypertens.Res 2008;31(8):1583-1588. View abstract.

Krishnan Medical Association SC. Effect of NSK-SD on Blood Pressure by Oral Administration. 7-12-2003;

Law, D. and Zhang, Z. Stabilization and target delivery of Nattokinase using compression coating. Drug Dev.Ind.Pharm 2007;33(5):495-503. View abstract.

Pais, E., Alexy, T., Holsworth, R. E., Jr., and Meiselman, H. J. Effects of nattokinase, a pro-fibrinolytic enzyme, on red blood cell aggregation and whole blood viscosity. Clin Hemorheol.Microcirc. 2006;35(1-2):139-142. View abstract.

Tai, M. W. and Sweet, B. V. Nattokinase for prevention of thrombosis. Am J Health Syst.Pharm 6-15-2006;63(12):1121-1123. View abstract.

Takano, A., Hirata, A., Ogasawara, K., Sagara, N., Inomata, Y., Kawaji, T., and Tanihara, H. Posterior vitreous detachment induced by nattokinase (subtilisin NAT): a novel enzyme for pharmacologic vitreolysis. Invest Ophthalmol.Vis.Sci 2006;47(5):2075-2079. View abstract.

Maruyama M, Sumi H (eds): Effect of natto diet on blood pressure, in Basic and Clinical Aspects of Japanese Traditional Food Natto II. Japan Technology Transfer Association (JTTAS), 1998, pp 1–3.

Cesarone MR, Belcaro G, Nicolaides AN, et al. Prevention of venous thrombosis in long-haul flights with Flite Tabs: The LONFLIT-FLITE randomized, controlled trial. Angiology 2003;54:531-9. View abstract.

Fujita M, Hong K, Ito Y, et al. Thrombolytic effect of nattokinase on a chemically induced thrombosis model in a rat. Biol Pharm Bull 1995;18:1387-91. View abstract.

Fujita M, Nomura K, Hong K, et al. Purification and characterization of a strong fibrinolytic enzyme (nattokinase) in the vegetable cheese natto, a popular soybean fermented food in Japan. Biochem Biophys Res Commun 1993;197:1340-7. View abstract.

Sumi H, Hamada H, Nakanishi K, Hiratani H. Enchancement of fibrinolytic activity in plasma by oral administration of nattokinase. Acta Haematol 1990;84:139-43. View abstract.

Sumi H, Hamada H, Tsushima H, et al. A novel fibrinolytic enzyme (nattokinase) in the vegetable cheese Natto; a typical and popular soybean food in the Japanese diet. Experientia 1987;43:1110-1. View abstract.

Suzuki Y, Kondo K, Ichise, H, et al. Dietary supplementation with fermented soybeans suppresses intimal thickening. Nutrition 2003;19:261–4. View abstract.

Suzuki Y, Kondo K, Matsumoto Y, et al. Dietary supplementation of fermented soybean, natto, suppresses intimal thickening and modulates the lysis of mural thrombi after endothelial injury in rat femoral artery. Life Sci 2003;73:1289-98.. View abstract.

Urano T, Ihara H, Umemura K, et al. The Profibrinolytic Enzyme Subtilisin NAT Purified from Bacillus subtilis Cleaves and Inactivates Plasminogen Activator InhibitorType 1. J Biol Chem 2001;276:24690-6. View abstract.