“Nattokinase can help reverse heart disease, but only with sufficient dosing. In a significant study that included more than 1,000 participants, nattokinase was shown to reduce arterial plaque, enhance lipid profiles, and accomplish these benefits without causing side effects,” notes Sayer Ji.
Nattokinase (NK) is an enzyme known as a fibrinolytic serine protease, produced from fermented soybeans (natto). Traditionally used in Japanese medicine, NK is now receiving attention for its positive effects on cardiovascular health—especially in addressing blood clotting, reducing arterial plaque, lowering blood pressure, and minimizing associated risk factors. Related enzymes, such as serrapeptase, lumbrokinase, and bromelain, also exhibit similar benefits and are commonly analyzed or used in conjunction with nattokinase for cardiovascular support.
The Research: Real-World Results from Over 1,000 Participants
In Frontiers in Cardiovascular Medicine, a clinical trial involving 1,062 individuals assessed the impact of nattokinase on atherosclerosis progression and high cholesterol over a year. Participants received either 10,800 FU (fibrinolytic units) or 3,600 FU daily.
The study reported striking results:
- Daily intake of 10,800 FU resulted in substantial decreases in carotid artery intima-media thickness and reduced carotid plaque size.
- Plaque regression rates varied from 66.5% up to 95.4% according to individual response.
- No side effects were identified at the higher intake level.
On the other hand, people in the 3,600 FU group did not experience significant progress, suggesting the usual dose is likely insufficient for therapeutic benefit. These findings address major factors in cardiovascular mortality. Unlike statins, which focus on lowering LDL levels without resolving issues behind artery blockage or clot formation, nattokinase acts directly on the fibrin network and plaques that can cause vascular obstruction. This targets the underlying causes—an approach not commonly seen in mainstream pharmaceutical treatments.
Established Cardiovascular Advantages of Nattokinase
A 2018 review demonstrated nattokinase’s broad spectrum of cardiovascular benefits, supported by both human and animal evidence:
- Clot-Dissolving (Fibrinolytic/Antithrombotic): Breaks down fibrin, boosts tissue plasminogen activator (tPA), and mimics the body’s natural enzyme, plasmin.
- Antiatherosclerotic and Cholesterol-Lowering: Lowers LDL, reduces triglycerides and arterial plaques, and guards against oxidative stress.
- Blood Pressure Regulation: Demonstrated ability to decrease blood pressure in both clinical trials and animal studies.
- Anti-platelet/Anticoagulant: Contributes to blood thinning and enhances vascular flow.
- Neuroprotection: May mitigate stroke-related injury and support cognitive processes.
Enhancing Effects: Vitamin K2 and Aspirin Used with NK
Studies further indicated that a combination of vitamin K2 and low-dose aspirin (81 mg) with nattokinase could provide enhanced cardiovascular protection. This aligns with existing knowledge—K2 directs calcium to bones instead of arteries, and aspirin’s anti-inflammatory properties may help nattokinase’s effects. Personally, high-dose magnesium might be preferable to aspirin.
Additionally, participants who maintained regular exercise routines, avoided tobacco, and limited their alcohol consumption gained extra benefits, emphasizing that healthy lifestyle choices can boost nattokinase’s effectiveness.
Nattokinase (NK), the primary component of natto, is well documented for its cholesterol-lowering and anti-plaque actions. Consisting of an alkaline protease with 275 amino acids and weighing about 28 kDa, NK was first identified by Sumi et al. in 1987. It provides multiple cardiovascular advantages, including blood pressure reduction, antiatherosclerotic effects, improved lipid profiles, anti-platelet action, and neuroprotection. Natto’s popularity in Japan is thought to contribute to the nation’s notable longevity, with frequent consumption linked to lower cardiovascular disease mortality. NK supplements are now widely used by those aiming to reduce heart disease risk globally.
Alternative Enzymes for Heart Health
Besides nattokinase, nature offers a range of other beneficial proteolytic enzymes:
- Lumbrokinase (derived from earthworms): Often considered comparable to nattokinase, possibly offering even greater fibrinolytic capabilities.
- Serrapeptase (from silkworm-derived Serratia bacteria): Renowned for its anti-inflammatory properties and ability to facilitate the removal of damaged tissues.
- Plant-Based Proteases: Bromelain (from pineapple) and papain (from papaya) possess anti-inflammatory and mild clot-dissolving properties—though generally less potent than the above.
Summary Table
| Enzyme | Source | Key Cardiovascular Effects |
| Nattokinase | Fermented soy (natto) | Fibrinolytic, antihypertensive, cholesterol-lowering, neuroprotective |
| Lumbrokinase | Earthworm | Pronounced clot-dissolving action |
| Serrapeptase | Silkworm bacteria | Anti-inflammatory, supports tissue clearing |
| Bromelain/Papain | Pineapple/Papaya | Mild clot-dissolving and anti-inflammatory action |
Conclusion
Nattokinase emerges as a versatile, natural option for cardiovascular support—helping dissolve blood clots, enhance circulation, and decrease crucial risk indicators. Lumbrokinase and serrapeptase similarly provide valuable benefits, particularly for inflammation and blood flow. It is important to always monitor dosage for safety and efficacy.
