I am interested in this product. I have read that it is very good for improving blood circulation and lowering blood pressure. I need to improve blood circulation but I already have low blood pressure. Does this product have the potential to regulate blood pressure or rather will it most likely lower blood pressure?
    I am not sure how this product will influence blood pressure in those who are normal range or have low blood pressure. It does seem to be helpful in those who have hypertension.

Hello, I've been taking nattokinase for about 2 months now and it has dropped my hypertension to almost normal levels.

Dementia
I have read that nattokinase holds great promise for senile dementia. Is this true?
   I am not aware of such studies.

Blood levels
Altern Ther Health Med. 2013. A pilot study on the serum pharmacokinetics of nattokinase in humans following a single, oral, daily dose. Nattokinase is a serine protease and is derived from natto, a traditional Japanese, fermented, soybean food meal. Multiple authors have described the significant fibrinolytic, antithrombotic, and antihypertensive effects of natto. It has been growing in popularity for use as a dietary supplement for the benefit of cardiovascular health. Little is known regarding the pharmacokinetic and pharmacodynamic properties of this enzyme, and the bioavailability is currently unknown. Subjects were instructed to orally ingest a single capsule containing a known concentration of nattokinase immediately following a baseline blood draw. Subsequent blood draws occurred over a 24-h period. Administration of nattokinase occurred orally with the ingestion of a single daily dose (2000 FU) of nattokinase. Capsules, each containing approximately 100 mg of nattokinase, in softgel form (NSK-SD, Japan Bio Science Laboratory, Osaka, Japan), were used in the study. Peak serum levels of nattokinase were observed at approximately 13.3 h ± 2.5 h postdose.

Natto consumption and blood thinning
Prev Nutr Food Sci. 2012. The antithrombotic and fibrinolytic effect of natto in hypercholesterolemia rats. Antithrombotic and fibrinolytic activity of natto was evaluated on platelet aggregation in vitro and in vivo. Natto showed inhibitory effects on platelet aggregation induced by adenosine 5'diphosphate (ADP) and collagen. Orally administered natto also showed fibrinolytic activity in hypercholesterolemia rats. Normal levels of natto, when administered for four weeks, shortened euglobulin clot lysis time (ECLT) and prolonged partial thromboplastin time (PATT) significantly compared to non-treated group. In addition, the natto treatment decreased total cholesterol in serum. These results showed that intake of normal levels of natto can elicit antithrombotic and fibrinolytic effects, suggesting its consumption may improve blood circulation.

Q. I just read online that it is ok to take Natto if you are on a low dose aspirin, you say different. I just started taking a little bit less than a teaspoon of the fermented soybeans with my aspirin yesterday ( I spread it out.) How would I know if I have internal bleeding?
   A. I have not seen enough studies with natto itself to know how much of it can effect blood thinning. It does thin the blood but I am not sure the amount it takes to have a significant effect. I think small amounts would not be significant but I am not certain.

Nattokinase research studies
Dietary supplementation with fermented soybeans suppresses intimal thickening.
Nutrition. 2003.
Although soy foods have been consumed for more than 1000 years, it is only in the past 20 y that they have made inroads into Western diets. We investigated the effect of dietary supplementation with natto extracts produced from fermented soybeans on intimal thickening of arteries after vessel endothelial denudation. Natto extracts include nattokinase, a potent fibrinolytic enzyme having four times greater fibrinolytic activity than plasmin. Intimal thickening was induced in the femoral arteries by intravenous infusion of rose bengal followed by focal irradiation with a transluminal green light. Nattokinase extract supplementation was started 3 wk before endothelial injury and continued for another 3 wk after. Nattokinase supplementation suppressed intimal thickening compared with the control group. Nattokinase shortened euglobulin clot lysis time, suggesting that their thrombolytic activities were enhanced. These findings suggest that nattokinase, because of its thrombolytic activity, suppress intimal thickening after vascular injury as a result of the inhibition of mural thrombi formation.

Thrombolytic effect of nattokinase on a chemically induced thrombosis model in rat.
Biol Pharm Bull. 1995.
Nattokinase is a new fibrinolytic enzyme which cleaves directly cross-linked fibrin in vitro. In this study, we investigated the thrombolytic effect of nattokinase on a thrombus in the common carotid artery of rat in which the endothelial cells of the vessel wall were injured by acetic acid. When a section of occluded vessel was stained for CD61 antigen by immunofluorescence utilizing a monoclonal antibody, the antigen was localized around the surface of the occluded blood vessels. This result suggests that the occlusive thrombosis was caused by platelet aggregation. In addition, thrombolysis with urokinase (UK; 50000 IU/kg, i.v.) or tissue plasminogen activator (tPA; 13300 IU/kg, i.v.) in our model was observed to restore the blood flow over a 60 min monitoring period. The results indicate that our chemically induced model is useful for screening and evaluating a thrombolytic agent. We evaluated the thrombolytic activity of nattokinase using this model and compared it with fibrino(geno)lytic enzyme, plasmin or elastase. On a molar basis, the recovery of the arterial blood flow with nattokinase, plasmin and elastase were 62%, 15% and 0%, respectively. The results indicate that the thrombolytic activity of nattokinase is stronger than that of plasmin or elastase in vivo.

Transport of nattokinase across the rat intestinal tract.
Biol Pharm Bull. 1995.
Intraduodenal administration of nattokinase at a dose of 80 mg/kg, resulted in the degradation of fibrinogen in plasma suggesting transport of nattokinase across the intestinal tract in normal rats. The action of nattokinase on the cleavage of fibrinogen in the plasma from blood samples drawn at intervals after intraduodenal administration of the enzyme was investigated by sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE) and Western blotting analysis with an anti-fibrinogen gamma chain antibody. The 270 kDa fragment carrying antigenic sites for the binding of the anti-fibrinogen gamma chain antibody appeared within 0.5 h and was then degraded gradually to a 105 kDa fragment via a 200 kDa fragment. This suggests that fibrinogen was degraded to a 105 kDa fragment via several intermediates (270 and 200 kDa). In parallel with the degradation process, plasma recalcification times were remarkably prolonged NK was also detected in the plasma from blood samples drawn 3 and 5 h after administration of the enzyme by SDS-PAGE and Western blotting analysis with an anti-nattokinase antibody. The results indicate that nattokinase is absorbed from the rat intestinal tract and that nattokinase cleaves fibrinogen in plasma after intraduodenal administration of the enzyme.

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.
A strong fibrinolytic enzyme nattokinase was purified from the vegetable cheese natto. Nattokinase was extracted from natto with saline and isolated by sequential use of hydrophobic chromatography. The isolated protein gave a single sharp band on SDS-PAGE either before or after reduction. The sequence consisted of a total 275 amino acid residues (M.W = 27,728) and exhibited a high homology with the subtilisins. The purified nattokinase digested not only fibrin but also several synthetic substrates. The results indicate that nattokinase is a subtilisin-like serine protease.

Enhancement of the fibrinolytic activity in plasma by oral administration of nattokinase.
Acta Haematol. 1990.
It was confirmed that oral administration of nattokinase (or natto) produced a mild and frequent enhancement of the fibrinolytic activity in the plasma, as indicated by the fibrinolytic parameters, and the production of tissue plasminogen activator. Nattokinase capsules were also administered orally to dogs with experimentally induced thrombosis, and lysis of the thrombi was observed by angiography. The results obtained suggest that nattokinase represents a possible substance for use not only in the treatment of embolism but also in the prevention of the disease, since nattokinase has a proven safety and can be mass produced.

Secretory expression of a heterologous nattokinase in Lactococcus lactis.
Appl Microbiol Biotechnol. 2007. Center for Metabolic Engineering of Microorganisms, Institute of Microbiology, Chinese Academy of Sciences, Beijing, People’s Republic of China.
Nattokinase has been reported as an oral health product for the prevention of atherosclerosis. We developed a novel strategy to express a nattokinase from Bacillus subtilis in a live delivery vehicle, Lactococcus lactis. Promoter P( nisZ) and signal peptide SP(Usp) were used for inducible and secretory expression of nattokinase in L. lactis. Western blotting analysis demonstrated that nattokinase was successfully expressed, and about 94% of the enzyme was secreted to the culture. The recombinant nattokinase showed potent fibrinolytic activity, equivalent to 41.7 urokinase units per milliliter culture. Expression and delivery of such a fibrinolytic enzyme in the food-grade vehicle L. lactis would facilitate the widespread application of nattokinase in the control and prevention of thrombosis diseases.

Emails
If a person is allergic to soy, would nattokinase pose a problem? Some say that it is only proteins that cause allergies and since the natural blood thinner is an enzyme, it would not. Yet, many of the nattokinase preparations marketed are in a base of soy oil and soy lecithin…. which would be a whole other issue besides the nattokinase enzyme, itself.
   It's a good question, I really don't know the answer but I would think that nattokinase itself would not cause an allergy, but perhaps if it is in soy base, the product could.

Q.  Is it safe to use nattokinase while breastfeeding? The dose of nattokinase that I have on hand is 100mg per capsule.
   A. There's very little human research on this topic and we don't really know how well it goes through breast milk. To be on the safe side, it would be best not to use it during pregnancy.

Q. Is nattokinase enzyme helpful in fibroids?
   A. I don't know, I have not seen any studies relating its use in those with fibroids.

Q.  I know you stated that nattokinase is a blood clot remover. Could it break up or remove blocked arteries and veins?
   A. There is not enough human research on nattokinase and blood clots or blocked arteries for us to know this answer at this time, but the initial nattokinase research regarding blood clot dissolving potential looks promising.

Q.  I am a health food store owner, ordered mattokinase for a gentleman that was supposed to have by bypass surgery, He is also on a vegan diet, He has been taking the nattokinase medicine for a few months and when he went to the doctor last week, they told him he did not have to have bypass surgery. He is still on the plan but he wants to know how long does he have to take the nattokinase medicine.
   A. This is interesting. We really are not in a position to say how long a person should or should not take a nattokinase supplement. That is the decision of their doctor.

Q. Why is nattokinase enzyme sold separately from fermented soy? If I consume fermented soy supplements ( natto ), wouldn't I also be consuming the nattokinase enzyme found in it?
   A. Hi, sure you could get nattokinase from fermented soy, but it may not be found nearly enough. This is the same as vitamin C. Let's say you wish to have 1000 mg of vitamin C, that means you would have to ingest a dozen or more oranges. We are not sure how much nattokinase is in an ounce of fermented soy, a lot depends on how it is prepared.

Q. 2 years ago I had a central retinal vein occlusion, thank God my vision has been restored almost completely, except for a tiny area in my right eye. Would it be advisable to take nattokinase enzyme to dissolve the clot?
   A. We have not seen any studies regarding nattokinase enzyme use and central retinal vein occlusion, hence we can't advise.

I read a comment on your nattokinase page that someone had a central retinal artery occlusion and had regained their sight. Could you put me in touch with that person or send them my email address so that they may contact me? I have had the same problem (CRAO) and would appreciate any information regarding how my sight may be regained if at all possible.
   Sorry but we do not keep email addresses, we get dozens of emails a day and once read they are deleted.

Q. is it true that nattokinase is not safe for people with high blood pressure and/or who are taking medication for it? if so, why?
   A. We have not seen any research that indicate nattokinase should or should not be used by those on blood pressure medication or those who have hypertension.

Q. My mom had a recent TIA as a result of her pulmonary valve stenosis. She was released from the hospital yesterday. I would like to have my Mom use nattokinase instead of Coumadin for obvious reasons. However I am concerned about your warnings and my doctor says nattokinase research is inconclusive, so he can’t advise. Mom has atrial fibrillation due to a mitral valve stenosis (one doctor calls it atrial valve stenosis). The result is that blood pools in the lung and there is danger of throwing clots from the pooled blood. Of course, the other problem with the pooled blood is that it goes out into the lung cavity in the form of fluid, which must be drawn off using a diuretic, Lasix. Mom is also on Lopressor to control the heart rate, and in the process it lowers blood pressure. Ma was on a drug similar to Coumadin while in the hospital, but when she was discharged, the doctor put her on aspirin, while waiting for a decision from the family as to whether to switch to Coumadin or nattokinaise. Obviously, it would be one or the other, NOT both! The doctor warns that on aspirin alone, the danger of having another stroke is 80% over the next 2 months, so we need to find a suitable substitute. The reason that aspirin is ineffective is that it is a blood thinner, in the sense that it prevents platelets from sticking together. However, the source of her clots is not sticky platelets, but because the blood is pooling in the lungs, forming clots. She requires a substance that will prevent such clots from forming and will dissolve clots already formed. Please provide whatever information you can on nattokinaise and its viability in this sort of case.
   A. There has not been enough human research with nattokinase and heart valve stenosis and subsequent clot formation to determine whether nattokinase is effective in these conditions or whether it is a substitute for Coumadin or other drugs. This is a complicated situation and we cannot get involved in diagnosis or treatment suggestions. Her doctor may wish to read this nattokinase page and make a decision.

Q. I read that nattokinase can reverse or reduce plaque buildup and fatty deposits in the arteries. Do you know if that is that true? If so, can you tell me now much nattokinase needs to be taken daily for this to be effective? Is nattokinase NSK-SD better? And how long does it normally take before there is significant reduction of plaque buildup and fatty deposits?
   A. These are good questions but we still have not seen enough human studies with nattokinase to have a clear idea of the effectiveness of this enzyme in terms of atherosclerosis or blood thinning. There is no research comparing different brands, hence we can't say Nattokinase NSH-SD is better or worse than other brands. There's too little human research available with nattokinase to know the ideal dosage and length of use or its overall effectiveness.

Q. I have been taking nattokinase for years to lower fibrinogen, and I think it works. Today I had my blood drawn for a fibrinogen test, and the technician asked me if I was taking a blood thinner and mentioned two drugs. I said no, but asked why she was asking. She said be cause if I was she would have to prepare the sample differently for sending to the lab. I asked her if nattokinase would make a difference. She had never heard of it. I asked her to call the lab the check it out. She did and was told that they never heard of it. Later, I was picking up a prescription and asked the pharmacist, and she had never heard of it and had nothing in her database about it either. Seems to me that if you are not supposed to take blood thinners with it, and it must have blood thinning properties and might need to be handled at the lab the same as a blood thinner. What do you think? Could my results be off because it was not handled a certain way? Would it be higher or lower?
   A. There's a lot we still need to learn about nattokinase and how it influences various blood coagulation proteins and factors when taken as a supplement. But research is being done and within a few years we should have a more complete understanding. In the meantime, it does appear that nattokinase breaks down firbrinogen and prevent red blood cells from aggregating, and it does have blood thinning properties. How potent nattokinase is when compared to Coumadin? I don't know.

Q. What do you think of taking a nattokinase supplement before a long flight to prevent blood clotting?
   A. This is an interesting idea. However, whether it offers any advantages over aspirin is not clear to me.

Q. Could you please tell me if this product has been found to be safe for pregnant women and their developing baby?
   A. We are not aware of any research with nattokinase in women who are pregnant. It is preferable to be on the safe side and not take nattokinase during pregnancy. 

Q. Could you tell me if there has been any new research or studies on nattokinase? It seems that all your posted questions are pretty much answered with the same answer; There’s not enough nattokinase research. I’m very interested in this product but am not convinced there is enough evidence that would sway my decision to use it. I have had 2 stents put in and have factor 5 liden blood protein abnormality. I would like to find a proven product that would prevent clots.
   A. We will update our site as more nattokinase studies are published. Until then we can't say too much. Sorry. We don't want to make false promises if studies do not support them.

Q. Are there any reliable studies regarding any possible adverse reaction when taking nattokinase in a person with a known or possible penicillin allergy.
   A. We have not seen such studies. A search on Medline with the keywords nattokinase and penicillin reveals no articles published on this topic.

Q. Must products with nattokinase be enteric-coated capsules?
   A. We have not seen any studies comparing nattokinase supplement that are enteric coated to those that are not.

Q. Since there are people taking nattokinase in an effort to reduce blood clotting, why isn't the standard prothrombin time test used to measure it's affect? This would seem to resolve any doubts, at no risk to the patients, and little expense. It works, or it doesn't, and with what variables.
   A. Sure, prothrombin time would be a good way to measure one's clotting status before use and during treatment.

Q. How is natto made?
   A. Natto is made by steaming or boiling soybeans and then fermenting this with a bacterium called Bacillus subtilis natto. Natto contains a high amount of vitamin K2.

Q. Does the use of nattokinase supplement lower blood pressure?
   A. I have not seen studies focusing on the use of nattokinase as a treatment for hypertension, but I have read articles by a few doctors who claim that the use of nattokinase had a mild effect in lowering blood pressure. However, caution is advised since nattokinase is also a blood thinner and problems may arise when used in combination with aspirin or other blood thinners.

I am a practicing chiropractor and mother of several boys. A family history of Factor V Leiden deficiency with a positive MTHFR and Factor II variance. My oldest does heparin injections and middle son is on Coumadin. My 8 year old has yet to be tested however the pediatric hematologist is certain he has at least one genetic variance. So our dilemma is the starting of full contact football and not proactively putting him on a thinner. So a pharmacist recommended nattokinase. Can children use this product?
    I have not seen studies with nattokinase in children so I don't know what kind of benefits or side effects would occur, what the appropriate nattokinase dose would be and what kind of bleeding problems may occur if engaging in contact sports while on nattokinase blood thinner. There are many unknowns so it is difficult to predict the outcome.

Do you think I could take nattokinase one dose per day with serrapeptase one dose per day? I have been diagnosed with blocked carotid arteries 50% on the left side 20% on the right. I discontinued using serrapeptase when I began the nattokinase. I was using the serrapeptase for my lower back pain and it was helping tremendously along with myofascial release. I think my back pain has gotten worse since I quit the serrapeptase. What is your opinion?
    Nattokinase enzyme and serrapeptase enzyme are potent supplements that should be used carefully with the knowledge or supervision of a health care provider. I am not aware of studies that have looked into using both supplements together, so I don't know what kind of potential benefits or side effects would occur. Each person is different in how they respond to these enzyme supplements, therefore it is not possible to predict your response to nattokinase or serrapeptase in combination.

I know that nattokinase is considered a substitute for baby aspirin taken to prevent heart attacks, but I was wondering if there is any interaction between the two. Would taking both “thin” the blood too much? I ask because I take Bufferin for back pain (it works best for me of all the non-narcotic pain relievers) and wondered if I can also start taking nattokinase.
    There is not enough research to know whether nattokinase works as well as a baby aspirin to prevent heart attacks. Even in the case of aspirin, which has been studies a great deal, there is no consensus on the ideal dosage for heart attack prevention. There is a possibility that the combination of nattokinase and aspirin could thin the blood too much but this has to be evaluated on a case by case basis.

I have just read your question and answer section concerning nattokinase pills, and from a personal standpoint here is what I have done that is working for me for almost 3 years. I was on Plavix, 80mg of Lipitor, and Lisinopril, so dizzy 90% of the time that I would have to lie down on the ground, putting my feet up against something to hold them to where I would get adequate blood flow, so I closed my business thinking that my cardiologist, being a highly trained individual should know what she was doing. Big Mistake, I finally told my RN wife, I had had enough, so I dropped the cardiologist, and all medications, I had a roto rooter job in 1994, and if I died that was fine with me, as I had throat cancer in 2000, been clear since, so death was not a threat to me, anyway I started taking 2000iu or what ever the deal is on Nattokinase, have not been dizzy, feel better that I have felt in 20 years, I take herbs, lots of vitamins, this is now going on 3 years, I had Hypertension in the range of 210/100 even on all the meds, then it may run early of a morning to 80/52 just constantly unable to regulate my BP, for the last 3 years the only time it is irregular is when I get excited by thinking about how much money I paid that lady to screw me over at one of the major heart hospitals in Dallas Tx, I do still take my metoprolol and have since 1994, but you now have my take on nattokinase and what it has done to make my life, a 1000% better than it was prior to starting it.

Do you know that if taking natto supplement taking 2 capsule daily will cause any hiccup and bloating. i'm asking on behalf of my friend 60 yrs old and all the while don't have hiccup but since taking nattokinase supplement she used to have hiccup day and night. could you explain to me why is it so?
    I have not had reports of anyone else with these symptoms, so I don't know.

I take Nattokinase natural blood thinner. Have used it for two years. I require a pulse (pacemaker) shortly. Of course the medics want me to take Coumadin (warfarin) which I do not wish to take. My Cardio Doc. is "OK" with Nattokinase, except he says: The only thing he has against it is that it "may not be manufactured in the US" and therefore could possibly have things in it that wouldn't be in it if made say in China (He is Chinese! ! ) and says many "imports" have chemicals that aren't
allowed in US - that are not shown on the bottle - Do you know if the natural blood thinner you provide is made in the USA; or is it made in a foreign company. I buy mine from a mail order distributor (after studying about it for some time on the internet) but my distributor say's she doesn't know exactly where it is manufactured.
    We don't know where other products are made from other companies, but the one we provide is made in Japan.

Since nattokinse is made from soy, will taking it interfere with thyroid function if you have Hashimoto's thyroiditis? I've heard that people with this condition should avoid most forms of soy except for small (2 - 4 tsp.) amounts of fermented soy. Also, is a combination of natto and amla a good substitute for fish oil, co-q-10 products for cardio & vascular health? Any real studies done on these issues?
    One has to consume a great deal of soy for it to have any effect on thyroid function. There are many supplements that could be helpful for heart and vascular health and it is not easy to predict in any one individual which ones would be most helpful without knowing the full medical history, physical exam, and blood tests.

My 17 yr old son has inherited protein C deficiency, but has never had any clots or other symptoms. He plays football and wrestles. Of the men in our family with the disorder, symptoms usually start with a clotting event around age 20, followed by commencement of lifelong Coumadin therapy. Obviously our doctor does not want to start Coumadin until there is a clot because of the side effects. I have asked about using nattokinase as a prophylactic that may help avoid that 1st clot. Our Doctor says he would not be opposed. I am prepared that nattokinase may not be work, as long as it is not likely to cause harm. My question is whether if used alone it will increase his risk of bleeding, especially during contact sports? Doesn’t natto work in a way that on its own does not increase bleeding risk? What would be the lowest/ best effective dose?
   There are not enough long term studies with this substance to know for sure how well it would work in this condition and what the side effects would be in teenagers would are involved in contact sports. There just isn't enough good information on this enzyme to provide confident answers.

Q. I notice reading through the references that nattokinase has been measured in FU - fibrinolytic units and CU which I am not familiar with. Is there any conversion scale?
   A. According to one study, "A strong fibrinolytic activity was demonstrated in the vegetable cheese Natto, which is a typical soybean food eaten in Japan. The average activity was calculated at about 40 CU (plasma units)/g wet weight." I have come across one source that claims fibrinolytic activity of 40 CU is equal to 30 FU: fibrin degradation units but I can't yet be sure how reliable this is.

Q. I take nattokinase 3 x 100 mg per day due to atherosclerosis and one implanted stent...it has worked wonders for three years now... I take no pharmaceutical prescription medications.

I am a 57 year old male with Factor V and mthfr clotting disorders. I have had two DVTs and two superficial clots within the last four years. Otherwise, I am in good health and exercise regularly. My doctor put me on Coumadin after my 2nd DVT for the rest of my life and I am looking for an alternative. Do you have any experience using nattokinase with clotting disorders?
   At this time I do not.

Q. I am a cardiac surgeon. Nattokinase is a week PA-1 inhibitor, but a more potent form cultured in a low salinity medium (halotolerant B. Peptidase f) produces NKCP a secret patented form made in Northern Japan. We use it in a product called Vasculex. Warfarin (an aflatoxin) reduces the activity of prothrombin but can also promote vascular wall (arterial & venous) sclerosis, through vascular wall protein crosstalk disruption.

buy Nattokinase 2000 units fibrinolytic activity per pill
Nattokinase is a systemic enzyme isolated from the traditional Japanese soy food, natto. It has been shown to support healthy blood flow by assisting the circulatory clearing system of the body.

Amount per serving
Nattokinase, providing 2,000 fibrin degradation units ( FU ) of activity per pill.

Q. Your site shows nattokinase 1 capsule per day. The directions on back of bottle of Drs Best says twice daily. Which is best one or two capsules for blood thinner.
   A. I prefer using low dosages but each person and each case is different, every person has different needs depending on diet, other medications, supplements and herbs used, and medical condition.