Nattokinase: benefits, side effects and medications


Nattokinase is an enzyme extracted from natto, a popular Japanese breakfast dish made from fermented soybeans. Natto has long been used in folk medicine to treat cardiovascular disease; Nattokinase is believed to have the same properties.

Known for its strong cheesy smell and sticky texture, natto is made by adding Bacillus subtilis natto bacteria to boiled soybeans and allowing them to ferment. The only source of nattokinase is natto and it can only be obtained through this specific fermentation process.

The extracted enzyme is used to make capsules and tablets, although it can also be found in powder form in Japan. Although nattokinase is generally considered safe and tolerable, it can cause side effects and interact with some medications.

What is nattokinase used for?

In alternative medicine, nattokinase is believed to benefit people with heart and vascular disease by partially destroying blood clots that can obstruct blood circulation. Nattokinase is believed to prevent or treat the following conditions:

To date, there are several studies that strongly support these claims. This does not mean that there are no promising studies; it's just that most studies are small and often poorly designed. Here are some of them to keep in mind.

deep vein thrombosis

Deep vein thrombosis is the medical term used to describe a blood clot in a deep vein, usually in the leg. It generally affects older people who are obese and have circulatory problems.

A 2015 study published in Scientific Reports notes that a single 100-milligram (mg) oral dose of nattokinase is capable of breaking down fibrin, a protein involved in blood clotting, more efficiently than placebo . It also acted as a powerful anticoagulant (blood thinner) by reducing the concentration of a blood clotting protein known as factor VIII .

Research shows that nattokinase supplements can provide protection against DVT by preventing blood clots.

While the results are encouraging, the findings are limited by the small size of the study. Furthermore, the participants recruited for the study (12 healthy young adults) belong to the demographic group with the lowest probability of developing DVT. More research will be needed to see if the same results can be replicated in high-risk groups.


Atherosclerosis, also called hardening of the arteries, is caused by the accumulation of fatty plaques on the walls of the arteries.

A 2018 study in China involving 76 adults with atherosclerosis found that participants who received 150 mg of nattokinase per day for 26 weeks experienced a 36.6% reduction in arterial plaque, compared to just 11.5% in those who received a 20 mg dose of simvastatin . Furthermore, nattokinase increased the level of "good" HDL cholesterol , whereas simvastatin did not .

However, simvastatin was much more effective in reducing total cholesterol, triglycerides , and "bad" LDL cholesterol , which are vital for preventing cardiovascular disease.

Controversial as these results may seem, they highlight how little scientists understand how nattokinase works. More research is needed to determine how nattokinase works and its importance in preventing heart attacks, strokes, and other conditions associated with atherosclerosis.


Heart disease and brain health are closely related. In recent years, it has been suggested that nattokinase may have neuroprotective properties that stop disease progression in people with ischemic stroke .

A 2015 study published in the journal Stroke reports that injected nattokinase can improve blood flow to the brain after a stroke. By injecting laboratory mice with three doses of nattokinase before the induced stroke, the researchers found that the smallest vessels in the brain remained unblocked, limiting the spread of tissue damage. Confirmation of this effect in humans requires further investigation .

The ability to break down fibrin (called fibrinolysis) makes nattokinase an ideal candidate for research, not only for stroke, but also for other conditions affected by fibrinolysis disorders, including Alzheimer's disease .

Possible side effects.

Nattokinase, a derivative of natto, is believed to be safe. But this does not mean that it is not a cause for concern.

Since nattokinase can affect circulation and chemistry, it should be used with caution in certain groups, namely:

  • People with bleeding disorders, such as hemophilia , in whom nattokinase can make symptoms worse.
  • People taking blood thinners , including warfarin , for whom nattokinase can cause bleeding and bruising.
  • People with low blood pressure , also known as hypotension , in whom nattokinase can cause dizziness, headaches, dizziness, and fainting.
  • People taking antihypertensive drugs , such as ACE inhibitors and calcium channel blockers , in whom nattokinase can increase the effect of the drug, causing hypotension.

You should also stop taking nattokinase at least two weeks before elective surgery to reduce the risk of excessive bleeding.

Due to lack of research, nattokinase should not be used in children or during pregnancy or breastfeeding.

There is little data on the long-term effects of nattokinase.

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Dosage and preparation

In the United States, nattokinase is found almost exclusively in capsule or tablet form. Doses are often expressed in fibrin units (FU), where 2000 FU translates to approximately 100 milligrams (mg) and 3000 FU translates to 150 mg.

There are no universal guidelines for the correct use of nattokinase. Doses of up to 3000 FU have been used safely for 26 weeks, although most manufacturers recommend no more than 2000 FU per day.

Besides dietary supplements, you can also get nattokinase by adding natto to your diet. There are small producers in the United States that supply fresh natto directly to consumers and health food stores. You can also make your own by buying Bacillus subtilis natto spores online.

Natto has some advantage over nattokinase supplements because it is rich in probiotic bacteria that are beneficial for gut health .

Natto is also rich in fiber and provides more than 20% of the RDA for iron, magnesium, calcium, vitamin C, and potassium.

On the other hand, a cup of natto contains approximately 371 calories. It's not too much, but it makes up about a fifth of the 2,000 calorie diet. If you decide to consume natto, its calories should be factored into your daily intake.

What to look for

Since nutritional supplements are not strictly regulated in the United States, the quality can vary from brand to brand.

To ensure quality and safety, select brands that have been tested by an independent certification body, such as the United States Pharmacopeia (USP), ConsumerLab, or NSF International. Certification does not mean that a product is effective, it simply contains the ingredients indicated on the product label in the amount indicated.

If you buy Bacillus subtilis natto spores, choose those that are 100% organic and obtained from a reputable seller. You should also ensure that Bacillus subtilis or Bacillus subtilis natto is printed on the product label to ensure that you are receiving the correct product.

Other questions

How can I make natto?
The process for making fresh natto includes the following 10 steps. Before you begin, be sure to sterilize any equipment you intend to use by submerging it in a pot of boiling water.

  1. Wash and soak 1 pound of dried soybeans for 24 hours.
  2. Boil or simmer beans for three to six hours, until tender.
  3. Drain and transfer the soybeans to a bowl.
  4. Mix one teaspoon of Bacillus subtilis powder with two tablespoons of sterile water.
  5. Pour the spore mixture over the beans and stir.
  6. Transfer the beans to a sterilized container so that they are no more than 1 inch deep.
  7. Place a piece of cheesecloth on a plate and secure with a rubber band.
  8. Place the dish in the oven with the oven light on but the temperature off. For most ovens, this provides an internal temperature of 74 and 79 degrees Fahrenheit. Some recipes call for an oven temperature of 100 to 115 degrees Fahrenheit, but this can create a fire hazard if there is a gas warning light.
  9. Leave the soybeans in the oven for 22-24 hours, checking the temperature from time to time.
  10. Remove the dish from the oven and place it in the refrigerator overnight with the cheesecloth on. Stir before eating.

When does natto expire?
Natto can be stored for up to a week in the refrigerator and up to two months in the freezer.

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