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 pressure^3,4 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 benefits 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

Atherosclerosis

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.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%. 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 ability to promote healthy blood clotting, its antioxidant properties and it’s ability to support healthy lipids.^19,20

Optimal Blood Flow

By supporting healthy blood clotting, nattokinase supports optimal blood flow. 

Neuroprotection

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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