Nattokinase Caution, safety and side effects
Discuss with your health care professional before nattokinase use, especially if you are taking anti-coagulants, aspirin, Coumadin or other medicines or herbs that thin the blood. Those taking this blood clot dissolving enzyme should realize that it may be potent and could interact even with a baby aspirin.

buy Nattokinase NSK - SD, 100 mg

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Subscribe to a FREE Supplement Research Update newsletter. Twice a month you will receive an email with a review of several studies on various supplements and natural medicine topics and their practical interpretation by Ray Sahelian, M.D. We will discuss nattokinase enzyme research as it becomes available.

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 % Daily Value
Nattokinase providing 2,000 fibrin units ( FU ) of activity 100 mg

Q. I just purchased this nattokinase supplement, even though it was more expensive than some competitors. Being a former research biologist, I liked your approach of not extending your claims beyond what is supported by the research. My purpose in taking nattokinase is to dissolve a clot. Realistically, how much time would you suggest I give it to see if it will actually dissolve the clot? My estimate would be one month at 2 capsules a day. The studies I've seen seem to suggest it dissolves clots very quickly at least in animals. I'm also interested in it's blood pressure lowering potential. Again, the same question, how long before one would expect to see measurable results? I plan to monitor my blood pressure to see if I can see the effects over time. I should also be able to notice whether or not my clot is dissolving based on the diminution of related symptoms. I would also like to know why you feel your formulation is superior to others which use the same standardized active ingredient.
   A. It is impossible to predict in any one individual how their body will respond to a supplement or medication. All we can do is present the research with nattokinase but we can't make predictions or promises on whether clots will be dissolved or blood pressure reduced. Much depends on the where the clot is, how long it has been there, whether there is blood supply to the location, etc. We don't know the quality of the products from other companies that sell nattokinase, they may be excellent or they may not meet standards, we have no idea. We do know that our product meets high quality standards.

Nattokinase Side Effects or risk
No significant nattokinase side effects have yet been reported in the medical literature. However, this does not mean that nattokinase is side effect free, it just means that we don't have enough human trials to know all the benefits and risks with nattokinase enzyme.

How is nattokinase made?
Different labs and manufacturers have different methods, and here is one example.

Enhanced production of recombinant nattokinase in Bacillus subtilis by the elimination of limiting factors.
Biotechnol Lett. 2006 Oct;28(19):1595-600. Department of Chemical Engineering, Feng Chia University, 100 Wenhwa Road, Taichung, Taiwan, Republic of China.
By systematic investigation, glutamate and a mixture of metal ions were identified as factors limiting the production of nattokinase in Bacillus subtilis. Consequently, in medium supplemented with these materials, the recombinant strain secreted 4 times more nattokinase (260 mg l(-1)) than when grown in the unsupplemented medium.

Nattokinase absorption and gastric effects
Stabilization and target delivery of nattokinase using compression coating.
Drug Dev Ind Pharm. 2007 May;33(5):495-503. Centre for Formulation Engineering, Department of Chemical Engineering, School of Engineering, University of Birmingham. Edgbaston, Birmingham. UK.
The aim of the work is to develop a new formulation in order to stabilize a nutraceutical enzyme Nattokinase in powders and to control its release rate when it passes through the gastrointestinal tract of human. Nattokinase powders were first compacted into a tablet, which was then coated with a mixture of an enteric material Eudragit L100-55 (EL100-55) and Hydroxypropylcellulose (HPC) by direct compression. Results have shown that the activity of Nattokinase was pressure independent and the coated tablets protected Nattokinase from being denatured in the gastric juice, and realized its controlled release to the intestine based on in vitro experiments.

Deep vein thrombosis
Q. I have recently had the misfortune to develop a DVT from a minor accident and immobilization and will be on warfarin for 6 weeks and wish to find other means of treatment after that. Could you please clarify whether nattokinase is useful in the treatment of clots in veins DVT ? Mostly I see references to artery clots. Is there any research or anecdotal evidence showing it has effect on deep veins?
   A. A blood thinner that makes its way within arteries will also make its way into veins. However we cannot find any studies regarding the use of nattokinase enzyme as a treatment or prevention of deep vein thrombosis.

Risk of use with aspirin medication
Taiwanese physicians describe a patient who had a bleeding stroke after taking a nattokinase pill in addition to aspirin. Using nattokinase together with aspirin, Coumadin, Plavix, and other blood thinners should be done with caution Whether attokinase is more potent than aspirin or vice versa is not clear at this time since comparison studies are lacking as of 2009.

Nattokinase study
Dietary supplementation with fermented soybeans suppresses intimal thickening.
Nutrition. 2003 Mar;19(3):261-4.
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 Oct;18(10):1387-91.
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.

Nattokinase enzyme supplement emails
Q.  Nattokinase is a blood clot remover. Could nattokinase 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.

Q. I'm wondering if Nattokinase can help FV Leiden sufferers?
   A. We have not seen research regarding nattokinase and FV Leiden disease.

Q. What would be the recommendation in the use of nattokinase with fish oil. Is there a contraindication using both? Could nattokinase and fish oil be taken together at the same time, or used separately during the day? I replaced baby aspirin with nattokinase, but also want to take fish oil. And how would nattokinase effect the use of Vit. E.?
   A. Since human studies are not available, we will only be making an educated guess that reasonable amounts of fish oil and vitamin E should not interfere with nattokinase supplement use.

Q. Is there any research on the effectiveness of Nattokinase on lowering cholesterol? Mine is really high and I am trying to lower it.
   A. We are not aware of human research regarding the benefit of nattokinase for cholesterol reduction.

Q. Is nattokinase supplement beneficial in treating diabetes?
   A. We have not seen any significant human research to indicate the role of nattokinase in diabetes treatment.

Q. I take expensive Aggrenox to avoid another stroke or TIA. Would Nattokinase assist or possibly substitute for Aggrenox?
   A. Aggrenox(aspirin extended-release dipyridamole) is indicated to reduce the risk of stroke in patients who have had transient ischemia of the brain or completed ischemic stroke due to thrombosis. Since human studies with nattokinase are limited, and since nattokianase has not been tested against Aggrenox to see which is better, it is impossible for us to say.

Q. I read that Nattokinase can reverse or reduce plaque buildup and fatty deposits in the arteries. Do you know if that is 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. No research has been done comparing various brands of nattokinase in humans. There's too little human research available with nattokinase to know the ideal dosage and length of use or its overall effectiveness.

Q. I just got done reading about nattokinase on your website and you say you which more research on humans
was available. Dr. David Williams the author of Alternatives says in his product catalog (Mountain Home Nutrition) that 17 published studies have been released in the US and Japan. He also sells Nattokinase and recommends it after running his own tests on all supplements. After they pass his own tests they get put in his catalog.
   A. We would suggest you ask Dr. David Williams to give a list of the published human trials with nattokinase, and also to list any that are more than a month long. If you are able to obtain this information, then we have a basis for further discussion.

Q. If one is generally well other than a condition called polycythemia is it typically OK to take Nattokinase?
   A. We can't make the decision for you, this is something your doctor would have to read the nattokinase research and make a recommendation.

Q. I would like your opinion on the supplement Nattokinase. I have been taking a proprietary blend from Swanson once a day at 65 mg. They mention it is manufactured from Aspergillus oryzae and Aspergillus melieus (providing 1000 fibrunolytic units). I am in good health (20 lbs overweight) with no medications. I am 52 years old. I can't say I have noticed much if any effect after about a year.
   A. We have no idea what condition you are taking it for and if nattokinase works as a blood thinner we are not sure what symptoms you would experience that you would make you notice that your blood is less coagulable.

Q. If a person is taking Ginkgo, Vitamin E, and Curcumin, can they also take Nattokinase? I would like to give nattokinase to my husband to prevent blood clotting and thin his blood for better circulation.
   A. These are good questions bur we don't have good answers. We are not aware of any studies that have evaluated bleeding or clotting tendencies when nattokinase has been given in combination with other vitamins or herbs that thin the blood. The nattokinase dosage, of course, would make a significant difference, in addition to diet, and a person's inherent clotting or bleeding tendencies.

Q.  I have a patient who is on Coumadin for a DVT. He had some major problems caused by the DVT including a pulmonary embolus. He wants to stay on coumadin. He has no problems and is using 6 mg daily...he also wants to take nattokinase at the same time. I could find no info on taking the two together...he is not sure that he wants to trust the nattokinase entirely to go off of Coumadin. Are you aware of any conflict of taking the two together. Does the Coumadin dosage need to be adjusted downward? Do we still follow the INR?
   A. We have not seen studies regarding the influence of nattokinase on blood thinning when combined with Coumadin. Our guess would be that if a person is taking Coumadin, and then adds nattokinase, the dosage of the Coumadin may be reduced. However, we have no studies to back up this theory, and if nattokinase is added, and the Coumadin dose lowered, more frequent INR tests should be done to monitor the patient, at least initially. This is an area of medicine that has hardly been studied, therefore we are on uncharted grounds.

Q. I recently purcheased a product called Nattozimes. It dawned on me (via my reading over the Internet) that this product is not the actual soy derived Nattokinase but a non-soy alternative. In your opinion does Aspergillus oryzae and Asperigillus melleus work as well as Nattokinase? I guess overall Nattozimes are less expensive, but is one sacrificing quality for cost? Also, I have used nattokinase over the last year or two since learning of its anti-fibrolyntic properties (I have a history of pulmonary emboli and intermittent phlebitis in my legs). But I also battle nail fungus and other fungal / candida types of problems. Would using nattokinase or Nattozimes tend to make such problems worse? The Nattozimes web page says, "Nattozimes is a proprietary fungal proteolytic enzyme blend that matches the unique fibrinolytic activity of the natto fermentation processes."
   A. We have not seen any human studies with Nattozimes, so we can't say how it compares to nattokinase in terms of clinical effectiveness. Nattokinase is a blood thinner and we can't see how it would influence fungal problems in any significant way although there is still a lot to be learned about nattokinase and how it effects the body.

Q. I have had stents applied to my femoral arteries 2 years ago. Do you suggests a nattokinase supplement for maintenance?
   A. We can't make that decision for you. You could ask your doctor to read this nattokinase page and make the decision for you.

Q. My husband has developed a blood clot which is in his groin. He is being given a daily injection of Clexane of 130mls, and the physician at the hospital wants to put him on warfarin 5 mg. Why I am writing, is that our Dr in on holiday, and is an alternate practitioner who believes in nattokinase. My husband is 75, had a triple bypass 1997, lost his right eye 2 years ago ( due we think to a sinus spray called Otravine). He is on amiodarone and Plendil. Other than that all natural medicine. Why we are reluctant to go on warfarin is the fear of losing his other eye due to bleeding.
Is it safe to take 2 capsules a day of nattokinase along with his Clexane injection until his Dr returns in a week’s time?
It is so distressing dealing with the medical profession who only believe in pharmaceutical medicine, but obviously I do not want to cause my husband harm. All I want to know is if in taking both we would be doing this? And also would the daily Clexane injection hold things at bay until his Dr Gets back? His INR is 1.1 after 5 injections. He is on bromelain instead of aspirin.
   A. Clexane injection contains the active ingredient enoxaparin, a type of medicine called a low molecular weight heparin. We are not in a position to offer individual recommendations, all we can say is that nattokinase does have blood thinning activity but it is difficult to predict how it would interact with the other medicines or whether it would cause a bleeding problem if combined with the other meds.

Q. I am looking for a nattokinase formula that has not had the Vitamin K2 removed. Can you tell me if there is
Vitamin k in the nattoKinase product on this page? If so what is the amount? I have so far found only one place that has the option of nattokinase with the vitamin K left in and it means ordering from Japan.
   A. We are not aware of vitamin K being present in the nattokinase product listed on this page. Nattokinase is used for blood thinning purposes and we question the need to take vitamin K, which helps with clotting, while using a nattokinase product. If one desires to take a vitamin K supplement, it is available by itself in supplement form and this way one would know exactly the amount being taken.
      Q. One of the best natural occurring sources of Vitamin K2 is in Natto. My thought was that since I know Vitamin K naturally occurred in Natto, and that Nattokinase is most often used as an anticoagulant if there was some how a natural balance achieved. Jarrow Formulas makes a Low dose Vitamin K product (Natto Extract).

Q. Can i use nattokinase for my Deep vein thrombosis DVT. The problem is i have ITP (low platelet disorder) and i am not taking any anti coagulants like heparin or warfarin.
   A. This is a complicated question to answer. Ask your doctor to read this page on nattokinase and guide you. This is not a decision that we can make for you.

Q. I have been taken nattokinase pill for about a month and it is dissolving all kind of things in my body but the last few days I looked at my feet and a bunch of cysts have started moving up my body this is disconcerting should I stop taking nattokinase pill or will that cause more harm since the cysts are breaking loose and moving up.
   A. It is not possible for us to make any suggestions without seeing what the cysts look like and knowing your full medical history.

Q. When blood clots are present in a man's leg, what is the probability of the nattokinaise taken orally of dissolving the clots causing some of the clot to dislodge to pass up stream resulting in an embolism or heart attack?.
   A. We are not aware of human studies evaluating this particular situation to determine what role nattokinase supplements would play in leg clots and their potential embolism.

Q. My son is 14 years old and has an inherited protein c deficiency. In myself, and all the other males in the family who have this, it has first manifested itself sometime in the early 20s with a blood clot in the leg and/or lung. No physician we have talked to advises starting him on Coumadin until he has a clot. I agree. On the other hand it is hard to sit and wait for a clot. Thrombosis is 100% in the other males in our family who are protein c deficient. I feel nattokinase may be something he could start now, since there are no reported side effects when used without other anticoagulants. My son wrestles and plays football. So, here is my question: Would tests suggest that use of nattokinase by itself may help prevent clots in an asymptomatic protein c deficient adolescent? Would use of nattokinase by itself increase the risk of bleeding in such a kid? Would anyone be interested in following his progress for test purposes? If nattokinase safely prevented or delayed the onset of clotting, it would be huge!
   A. These are good questions but we are not aware of any clinical studies that have looked into this matter. If nattokinase did work, what is the appropriate dosage in a teenager for long term use? What would the risks be of a teenager taking nattokinase and engaging in sports where he could be injured and bruised? Unfortunately such answers are not available.

Q. What is the difference between Nattokinase and Nattokinase SKD-SD? Is one of them better? Briefly...I have a little bump about the size of a BB-gun pellet on the outer rim of my anus. It's been like that for about 4 years, and it was bigger when it first appeared. It shrunk but never completely went away. It's normal color (not red or purple) and there's no discomfort. It may be an old, tiny hemorrhoid that is congested or a clot that never totally dissolve, therefore it won't go away. I read that Nattokinase can be effective for hemorrhoids and clots. Can you tell me how much fibrinolytic units (FU) per day to get rid of it and how long does it normally take for Nattokinase to make something like that disappear?
   A. We have not seen any studies with the use of a nattokinase supplement for the treatment of hemorrhoids. Nattokinase SKD-SD is a brand name for nattokinase made by Pure Prescriptions company. We have no way of knowing the quality of this product since we have not seen any independent analysis of this Pure Prescriptions nattokinase supplement.

Q.  I recently read some information on nattokinase. Is nattokinase okay to use for someone with a low red blood cell count?
   A. There are many medical conditions that can cause a low red blood cell count. Some of these conditions also include a low platelet count or abnormalities in clotting. It is not possible to give a simple answer. Your doctor would know best regarding your particular condition and whether a blood thinner is safe for you to use. Nattokinase would not be safe in someone who already has a clotting problem.

Q. I am aware of the effects of proteolytic enzymes such as nattokinase on fibrin. Do you think that these enzymes could have a positive effect on fibrotic tissue buildup in chronically tight and irritated muscles i.e. trigger points? Do you have any other supplement suggestions for these types of problems?
   A. We have not seen studies regarding the role of nattokinase as a treatment for fibrotic tissue.

If I'm reading the information right , it says that vitamin K is extracted out. Does that mean you should not take vitamin K with nattokinase? Please let me know, I'm trying to figure out if nattokinase would benefit me more than anything else.
    People take this enzyme to thin the blood while vitamin K helps with clotting, so one has to decide whether they want their blood to not clot well or to clot easier in order to know which supplement they would benefit from.

Do you know that why some people after taking nattokinase supplement, they will experience headache and dizziness at the beginning? why is it so? some may say is due to the improving reaction, how to explain these symptom is actually the improving reaction or not?
    We are not sure why, of if, this occurs, perhaps you can try another nattokinase product from another company to see if the same reaction occurs. We have not had such feedback before.

I have been taking nattokinase capsules for nine years and last week was diagnosed with a pulmonary embolism and then they found two clots in my left arm and leg. How can this be? Originally I began taking this product after feeling as though the old discomforts and shortness of breath were returning two years after having stents in my coronary arteries. Within a week those symptoms vanished and I became an enthusiastic supporter of the nattokinase regime, telling friends how wonderful it was. Now my beliefs are all shattered and I don't know why. Have you ever heard of anything like this before? I really would like to know.
    There are too many unknown factors to make a good guess. The product itself may not have been of good quality, your need for anti-coagulation may have increased, or there may be other factors that are difficult to know without a full exam and blood tests.




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