Understanding Nattokinase's Mechanism of Action
Nattokinase (NK) is a potent enzyme derived from natto, a traditional Japanese food made from fermented soybeans. Discovered in the 1980s by Japanese researcher Dr. Hiroyuki Sumi, the enzyme was found to have a powerful ability to break down fibrin, a protein that forms the mesh-like structure of blood clots. Unlike pharmaceutical clot-busters, which are typically administered intravenously and have a very short half-life, nattokinase can be taken orally and remains active in the body for a longer period.
The enzyme works through several pathways to enhance the body's natural fibrinolytic system:
- Direct Fibrin Hydrolysis: Nattokinase directly attacks and cleaves cross-linked fibrin, the main component of blood clots, and has been shown to be more efficient at this than plasmin, the body's primary clot-dissolving enzyme.
- Indirect Activation of Plasminogen Activator: It converts endogenous prourokinase to urokinase, and also degrades plasminogen activator inhibitor-1 (PAI-1). These actions increase the level of tissue plasminogen activator (t-PA), which in turn transforms inactive plasminogen into active plasmin, amplifying the body's own clot-dissolving capabilities.
- Other Anti-coagulant Effects: Studies have observed other effects, including increased antithrombin concentrations and reduced levels of certain clotting factors like Factor VIII.
Notably, nattokinase is relatively stable in the acidic environment of the stomach and can be effectively absorbed into the bloodstream from the intestines. This bioavailability is key to its efficacy as an oral supplement.
The Timeline: How Fast Does Nattokinase Affect Clotting?
For a single oral intake of nattokinase, research provides a clearer timeline for its systemic effects on fibrinolysis, rather than the complete dissolution of an existing, established clot. These effects are often measured by changes in blood markers like D-dimer, fibrin degradation products (FDP), and clotting times.
Short-term Effects (First 8 hours)
A 2015 study demonstrated that a specific oral intake of nattokinase in healthy males significantly enhanced fibrinolysis and anticoagulation within hours.
- Onset (2-4 hours): Increased antithrombin concentration and significantly prolonged activated partial thromboplastin time (aPTT) were observed within 2 and 4 hours post-administration. Fibrin degradation products (FDP) also began to rise at the 4-hour mark.
- Peak Activity (4-6 hours): Peak fibrinolytic activity, measured by the concentration of FDP and D-dimer, was observed at 4 to 8 hours after intake. Factor VIII activity, a key clotting factor, also declined during this period.
- Duration (8+ hours): The enhanced fibrinolysis was shown to last for a relatively long period (over 8 hours) compared to pharmaceutical agents like t-PA, which have a much shorter half-life.
Long-term Effects (Weeks to Months)
For ongoing cardiovascular support, nattokinase is typically taken daily. Over several weeks or months, regular intake has been shown to reduce plasma levels of several blood clotting factors and support blood pressure, contributing to a reduced risk profile for thrombotic events. However, this is distinct from the rapid intervention required for an acute, large blood clot.
Factors Influencing How long does it take for nattokinase to affect clotting?
Several variables can affect the time and effectiveness of nattokinase in managing thrombosis:
- Potency and Formulation: Clinical studies have used varying potencies, and have found that different potencies may produce effects, such as potentially reducing arterial plaque. Enteric-coated formulations are designed to protect the enzyme from stomach acid and maximize absorption.
- Clot Size, Age, and Location: Small, newly formed clots are much more susceptible to potential effects than large, established ones. An existing, large thrombus is a medical emergency and requires immediate, aggressive medical treatment, not a supplement.
- Individual Health Status: The overall health of an individual's cardiovascular system, existing conditions (e.g., atherosclerosis), and concurrent medications will all influence the outcome.
- Consistency of Use: The consistent, long-term use of nattokinase may be necessary to maintain its effects, as it is cleared from the body relatively quickly after each intake.
Nattokinase vs. Emergency Thrombolytic Drugs
It is critical to distinguish between nattokinase as a dietary supplement for long-term cardiovascular support and powerful, fast-acting thrombolytic drugs used in medical emergencies. The following table highlights the key differences.
| Feature | Nattokinase (Supplement) | Thrombolytic Drugs (e.g., t-PA) |
|---|---|---|
| Administration | Oral capsule | Intravenous (IV) injection |
| Onset of Action | Hours for systemic effect, not immediate for dissolving established clots | Minutes to an hour for peak effect |
| Primary Use | Dietary supplement for cardiovascular health and prevention | Emergency treatment for acute thrombosis (e.g., heart attack, ischemic stroke) |
| Mechanism | Indirectly and directly supports fibrinolysis | Directly and rapidly activates plasmin to break down clots |
| Duration of Effect | Several hours after a single intake | Very short half-life (minutes), requires continuous monitoring |
| Safety Profile | Generally mild; bleeding risk if combined with blood thinners | Significant risk of major bleeding due to rapid, potent action |
| Medical Supervision | Recommended, especially with other medications | Absolutely required in a hospital setting |
Important Safety Considerations
While nattokinase is generally considered safe for healthy adults when used appropriately, it is not without risks, especially for individuals with certain health conditions or those on other medications.
- Never substitute for prescribed medication: Individuals taking prescription anticoagulants or antiplatelet drugs (e.g., warfarin, aspirin, clopidogrel) should never replace or add nattokinase without strict medical supervision. The combination can significantly increase the risk of bleeding.
- Consult a doctor before use: Anyone with a history of bleeding disorders, recent stroke, or planned surgery should avoid nattokinase unless explicitly advised by a healthcare provider.
- Monitor for bleeding: Be vigilant for signs of increased bleeding or bruising. While rare, a case report of cerebellar hemorrhage has been linked to nattokinase with aspirin, emphasizing the need for caution.
Conclusion
In conclusion, how long does it take for nattokinase to affect clotting factors? The answer is not a simple timeframe, as it depends on whether we are discussing its prompt systemic activity or the lengthy process of resolving an established thrombus. Studies show that oral nattokinase initiates its fibrinolytic and anti-coagulation effects within two to four hours, with the effects lasting several hours. However, it is a gradual and supportive process, unlike the rapid action of emergency thrombolytic drugs. While promising for promoting cardiovascular health, it should not be considered a treatment for acute blood clots. It is crucial for anyone considering this supplement to consult with a healthcare professional, especially if they are on other medications or have pre-existing health conditions.
For further reading
Kurosawa, Y. et al. (2015). A single-dose of oral nattokinase potentiates thrombolysis and anti-coagulation profiles. Scientific Reports, 5, 11601. https://www.nature.com/articles/srep11601.
