Nattokinase: The Japanese Fermented Soybean Enzyme
Nattokinase is a powerful enzyme originating from a traditional Japanese food called natto, which is made by fermenting soybeans with the bacteria Bacillus subtilis. For thousands of years, natto has been a dietary staple in Japan and is revered for its health-promoting properties. The enzyme was first discovered and isolated in 1980 by Japanese researcher Hiroyuki Sumi, who found that an extract from natto could effectively dissolve artificial fibrin, a protein central to blood clot formation. This discovery paved the way for the development of nattokinase supplements, which offer the potential benefits of the enzyme without the distinctive, often polarizing, taste and texture of the fermented food itself.
The Mechanism of Action: How Nattokinase Affects Blood Clots
Nattokinase functions as a potent fibrinolytic enzyme, meaning it works to break down and dissolve fibrin. Its anti-clotting effects are thought to be more powerful than those of the body's natural clot-dissolving enzyme, plasmin.
The enzyme works through several mechanisms:
- Direct Fibrinolysis: Nattokinase directly attacks and breaks down fibrin, a key component of blood clots.
- Enhancing Natural Fibrinolysis: It stimulates the body's production of plasmin, the natural enzyme responsible for breaking down blood clots. It can also increase the levels of tissue plasminogen activator (t-PA), which activates plasmin.
- Inhibiting PAI-1: Nattokinase degrades plasminogen activator inhibitor-1 (PAI-1), a substance that can slow down the body's ability to dissolve clots. By degrading PAI-1, nattokinase supports and extends the body's natural fibrinolytic activity.
Potential Health Benefits Supported by Research
While it is not a replacement for medical treatment, preliminary studies on nattokinase have shown promising results for a range of cardiovascular conditions.
Cardiovascular Support
- Blood Pressure Regulation: Multiple studies suggest that nattokinase supplementation can help lower blood pressure in individuals with hypertension. This is partly attributed to its ability to inhibit angiotensin-converting enzyme (ACE), which plays a role in regulating blood pressure.
- Atherosclerosis Management: Research indicates that nattokinase may slow the progression of atherosclerosis, the hardening and narrowing of arteries due to plaque buildup. A study involving over 1,000 participants with hyperlipidemia and/or atherosclerosis found a significant reduction in arterial plaque size after 12 months of nattokinase supplementation.
- Healthy Cholesterol Levels: Some evidence suggests nattokinase may help manage cholesterol by reducing total and 'bad' LDL cholesterol while increasing 'good' HDL cholesterol, particularly when combined with other supplements like red yeast rice.
Other Investigated Applications
- Neuroprotection: Animal and in vitro studies propose that nattokinase may possess neuroprotective properties and could help in degrading amyloid fibrils, which are associated with conditions like Alzheimer's disease.
- Anti-inflammatory Effects: As a systemic enzyme, nattokinase may also have anti-inflammatory effects by helping to reduce oxidative stress and inflammation, which are contributing factors to cardiovascular issues.
Important Safety Considerations and Interactions
Despite being a natural enzyme, nattokinase can have powerful effects on the body's coagulation system and is not without risks. It is crucial to consult a healthcare provider before taking nattokinase, especially for individuals with pre-existing conditions or those on medication.
Key safety precautions include:
- Bleeding Risk: Nattokinase's blood-thinning effect can increase the risk of bruising and bleeding. This risk is significantly higher when combined with prescription anticoagulant or antiplatelet drugs like warfarin, heparin, or aspirin.
- Surgery: Patients scheduled for surgery, including dental procedures, should stop taking nattokinase at least two weeks beforehand to reduce the risk of excessive bleeding.
- Allergies: Individuals with a soy allergy should avoid nattokinase, as it is derived from fermented soybeans.
- Pregnancy and Breastfeeding: There is insufficient evidence to determine the safety of nattokinase for pregnant or breastfeeding individuals, and it is not recommended for use during this time.
### Nattokinase vs. Prescription Blood Thinners: A Comparison
| Feature | Nattokinase (Supplement) | Pharmaceutical Anticoagulants (e.g., Warfarin) |
|---|---|---|
| Source | Natural enzyme from fermented soybeans | Synthetic chemical compound, prescription medication |
| Mechanism | Directly degrades fibrin; supports and enhances body's natural fibrinolytic system | Interferes with vitamin K-dependent clotting factors to prevent new clots |
| Regulatory Status | Regulated as a dietary supplement; quality can vary | FDA-approved, tightly regulated prescription drug |
| Medical Supervision | Crucial to consult a doctor due to bleeding risk and interactions | Requires strict, ongoing medical monitoring (e.g., INR testing) |
| Side Effects | Generally considered mild but can increase bleeding risk | Potential for severe bleeding, drug-food interactions |
| Primary Use | Dietary supplement for promoting cardiovascular health | Medically prescribed to prevent dangerous blood clots in high-risk patients |
Conclusion
As a natural enzyme derived from fermented soybeans, the Japanese blood thinner supplement known as nattokinase offers a fascinating glimpse into the medicinal properties of traditional foods. While promising research suggests potential benefits for cardiovascular health, including blood pressure regulation, cholesterol management, and clot prevention, it is crucial to approach nattokinase with caution. As a dietary supplement, its effects are not as thoroughly understood or regulated as prescription medications. Anyone considering its use, especially those with pre-existing bleeding disorders or on existing blood-thinning medication, must seek medical advice to prevent potentially dangerous interactions and complications. For individuals seeking to support their cardiovascular health, nattokinase could be a consideration, but it should be done under a doctor's guidance as part of a broader, healthy lifestyle. For more information, the National Institutes of Health has published comprehensive reviews on nattokinase research.
