Top Reasons to Take Nattokinase

Article at-a-glance:

  • Nattokinase, an enzyme derived from the Japanese food natto, is a powerful support for optimal blood flow
  • Nattokinase has been shown to mimic and enhance the activity of our own natural clot-dissolving enzyme, plasmin
  • Optimal, healthy blood pressure can be supported by nattokinase
  • Nattokinase is both cardioprotective and neuroprotective

by Dr. John Neustadt

According to a Japanese legend, about a thousand years ago a man put warm, cooked soybeans in a rice-straw sack on the back of his horse and rode off. He didn’t realize that as the sun beat down the soybeans would ferment into a pungent, gooey paste that tasted great with white rice. And thus, natto was born, a staple of the Japanese diet reputed to contribute to longevity and health.1,2

The enzyme responsible for natto’s health effects, nattokinase, has since been purified and widely studied. Nattokinase keeps blood optimally flowing and promotes cardiovascular health. According to the research on this powerful enzyme, it can lower blood pressure3,4 help reduce the risk of atherosclerosis,5,6 help lower lipids7, support optimal blood flow with its anticoagulant properties,8 and may even be neuroprotective.9 For one single compound, that’s an impressive list of benefits. 

Nattokinase works its cardioprotective magic by its unique ability to dissolve fibrin, a protein that helps our body form clots. As we age, we can experience an increase in blood viscosity or thickness. Our own natural clot-dissolving enzymes, which are generated by the cells lining our blood vessels, begin to decline. Blood that is too ‘thick’ is more prone to clotting and doesn’t flow as easily through the blood vessels. This can increase blood pressure as the heart has to pump harder to circulate the same amount of blood and reduce the amount of oxygen and nutrients that reach your organs and tissues. Elevated blood viscosity contributes to cardiovascular disease, stroke, and dementia.10 

There are two sides to the blood clotting cascade. There’s the formation of blood clots on one side. And on the other is how our body breaks down blood clots one they’re created. Unlike other blood thinners like aspirin that only decrease the tendency to form blood clots, nattokinase effects both sides of the clotting cascade. 

Fibrinogen is a blood protein that increases the risk of forming blood clots. Nattokinase decreases levels of fibrinogen in our blood.11 Nattokinase also supports healthy blood clotting by activating our body’s own natural enzymes that break apart blood clots after they’re already formed. Nattokinase has been compared to our clot-dissolving enzyme, called plasmin. Nattokinase enhances our body’s production of plasmin and another clot-dissolving enzyme, urokinase.  Nattokinase has been shown to increase tissue plasminogen activator (tPA), a protein that activates plasmin so it can do its job of breaking down blood clots.12 As tPA goes up, so does plasmin, and so does the ability to dissolve blood clots.13 

By all these means, nattokinase helps decrease blood viscosity, or thick, sludgy blood and supports healthy blood flow.14 And nattokinase activity has been demonstrated to last as long as eight hours, providing more lasting protection than many other naturally based molecules.15

Blood Pressure

Nearly half the adults in the U.S. suffer from high blood pressure, defined as a systolic blood pressure ≥ 130 mm Hg or a diastolic blood pressure ≥ 80 mm Hg.16 Nattokinase has been associated with a decrease in both systolic and diastolic blood pressure. When 79 individuals from North America, all with hypertension, took nattokinase for eight weeks both their diastolic and systolic blood pressure decreased.17 An earlier, 2008 randomized, double-blind, placebo-controlled trial on nattokinase looked at 86 individuals from 20 to 80 years of age with high blood pressure. They received nattokinase or a placebo for eight weeks. Seventy-three subjects completed the study, and those taking nattokinase had a significant reduction in blood pressure.18


Clot formation is part of the process of atherosclerosis, where narrowing and hardening of the arteries occur along with plaque buildup. Atherosclerosis can occur in arteries anywhere in the body and decrease blood flow to the legs and feet, kidneys, heart, and brain. Daily supplementation with nattokinase can suppress the progression of atherosclerosis in individuals with atherosclerotic plaques. 

A 26-week study randomized 82 volunteers to take either 6,000 fibrinolytic units (300 mg) of nattokinase daily or 20 mg daily of the anti-cholesterol medication simvastatin.5 In people taking nattokinase, both the arterial wall thickness, and the size of arterial plaques significantly decreased. In the nattokinase group, plaque size decreased by 36.6% compared with only an 11.5% reduction in the simvastatin group. Not only that, volunteers taking nattokinase showed significant reductions in total cholesterol, low-density lipoprotein cholesterol (LDL-C or “bad cholesterol”) and triglyceride (TG) while at the same time their of high-density lipoprotein cholesterol (HDL-C, or “good cholesterol”) increased. 

It’s likely that the benefits of nattokinase are due to the combined effect of nattokinase’s antithrombotic, anticoagulant, antioxidant, and lipid-lowering activities.19,20

Optimal Blood Flow

By reducing excessive clot formation, nattokinase supports optimal blood flow. 


It’s often said that what’s good for the heart is good for the brain. Healthy circulation and improved blood flow can protect the brain from being starved of oxygen when dangerous blood clots form. A 2004 study of nattokinase in stroke patients found that showed a clear protective effect.21 It’s also thought that nattokinase, with its ability to dissolve fibrin, may also help dissolve amyloid fibrils implicated in Alzheimer’s disease.22  

Animal studies have shown that nattokinase can significantly reduce the increase in fibrinogen seen after a stroke and the severity of a stroke.23 Nattokinase is thought to be neuroprotective because of its ability to reduce the clumping together of cells called platelets that help your body form clots, as well as by preventing injured cells from dying.9

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1 Nagata C, Wada K, Tamura T, et al. Dietary soy and natto intake and cardiovascular disease mortality in Japanese adults: the Takayama study. Am J Clin Nutr. 2017;105:426–431 [Article]

2 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;43:1110–1111. doi: 10.1007/BF01956052. [Article]

3 Fujita M, Ohnishi K, Takaoka S et al. Antihypertensive effects of continuous oral administration of nattokinase and its fragments in spontaneously hypertensive rats. Biol Pharm Bull. 2011;34:1696–1701 [Article]

4 Kim JY, Gum SN, Paik JK, et al. Effects of nattokinase on blood pressure: a randomized, controlled trial. Hypertens Res. 2008;31:1583–158 [Article]

5 Ren N, Chen H, Li Y et al. A clinical study on the effect of nattokinase on carotid artery atherosclerosis and hyperlipidaemia. Nat Med J China. 2017;97:2038–2042. [Article]

6 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: 1289–1298 [Article]

7 Lee MY, Lin CS, Wu DJ. Lipid-Lowering effect of nattokinase in patients with primary hypercholesterolemia. Acta Cardiologica Sinica 2009;25(1) [Article]

8 Jang JY, Kim TS, Cai J, et al. Nattokinase improves blood flow by inhibiting platelet aggregation and thrombus formation. Lab Anim Res. 2013;29:221–225. [Article]

9 Ji H, Yu L, Liu K, et al. Mechanisms of nattokinase in protection of cerebral ischemia. Eur J Pharmacol. 2014;745:144–151. [Article]

10 Simmonds MJ, Meiselman HJ, Baskurt OK. Blood rheology and aging. J Geriatr Cardiol. 2013;10(3):291–301. [Article]

11 Hsia CH, Hsia CH, Shen MC et al. Nattokinase decreases plasma levels of fibrinogen, factor VII, and factor VIII in human subjects. Nutr Res. 2009;29(3):190‐196 [Article]

12 Sumi H, Yanagisawa Y, Yatagai C et al. Natto Bacillus as an oral fibrinolytic agent: nattokinase activity and the ingestion effect of Bacillus subtilis natto. Food Sci Technol Res. 2004;10:17–20. [Article]

13 Yatagai C, Maruyama M, Kawahara T et al. Nattokinase-promoted tissue plasminogen activator release from human cells. Pathophysiol Haemost Thromb. 2008;36(5):227‐232. [Article]

14 Pais E, Alexy T. Holsworth RE Jr. Effects of nattokinase, a pro-fibrinolytic enzyme, on red blood cell aggregation and whole blood viscosity Clin Hemorheol Microcirc. 2006;35(1-2):139-42. [Article]

15 Kurosawa Y, Nirengi S, Homma T, et al. A single-dose of oral nattokinase potentiates thrombolysis and anti-coagulation profiles. Sci Rep. 2015;5:11601. [Article]

16 Facts About Hypertension, The Centers for Disease Control. National Center for Chronic Disease Prevention and Health Promotion , Division for Heart Disease and Stroke Prevention. February 2020. [Report]

17 Jensen GS, Lenninger M, Ero MP et al. Consumption of nattokinase is associated with reduced blood pressure and von Willebrand factor, a cardiovascular risk marker: results from a randomized, double-blind, placebo-controlled, multicenter North American clinical trial. Integr Blood Press Control. 2016;9:95–104. [Article]

18 Kim JY, Gum SN, Paik JK, et al. Effects of nattokinase on blood pressure: a randomized, controlled trial. Hypertens Res. 2008;31(8):1583‐1588. [Article]

19 Chen H, McGowan EM, Ren N, et al. Nattokinase: a promising alternative in prevention and treatment of cardiovascular diseases. Biomark Insights. 2018;13:1177271918785130  [Article]

20 Iwai K, Nakaya N, Kawasaki Y et al. Antioxidative functions of natto, a kind of fermented soybeans: effect on LDL oxidation and lipid metabolism in cholesterol-fed rats. J Agric Food Chem. 2002;50:3597–3601. [Article]

21 Shah AB, Rawat S, Mehta S. An open clinical pilot study to evaluate the safety and efficacy of natto kinaseas an add-on oral fibrinolytic agent tolow molecular weight heparin & anti-platelets in acute ischaemic stroke. Japan Pharmacol Therap. 2004;32:437–451. [Article]

22 Hsu R-L, Lee K-T, Wang J-H et al. Amyloid-degrading ability of nattokinase from Bacillus subtilis natto. J Agric Food Chem. 2008;57:503–508. [Article]

23 Wang JM, Chen HY, Cheng SM et al. Nattokinase reduces brain infarction, fibrinogen and activated partial thromboplastin time against cerebral ischemia-reperfusion injury. J Food Drug Anal. 2012;3: 686–691. [Article]

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