The Discovery and Source of Nattokinase
Nattokinase (NK) is an enzyme derived from natto, a traditional Japanese food made from fermented soybeans. The fermentation process involves boiling soybeans and fermenting them with the bacterium Bacillus subtilis. In 1980, Dr. Hiroyuki Sumi, a researcher at the University of Chicago, discovered that natto contained a powerful fibrinolytic enzyme, which he named nattokinase. Natto has a strong, pungent odor and a sticky texture, which can be unappealing to some, leading to the development of nattokinase supplements as a popular alternative. It is important to note that nattokinase is distinct from vitamin K2, which is also present in natto but can interfere with certain medications like warfarin. Nattokinase supplements are often manufactured with the vitamin K2 removed to prevent this interaction.
How Does Nattokinase Work? The Mechanisms of Action
The pharmacological activity of nattokinase is multifaceted, primarily focusing on its ability to enhance fibrinolysis, the process of breaking down blood clots. Its mechanisms include:
- Directly hydrolyzing fibrin: Nattokinase acts as a potent protease, directly cleaving cross-linked fibrin—the protein that forms the mesh of a blood clot. This direct action is a key component of its thrombolytic effect and is considered to be more powerful than the body's natural plasmin.
- Increasing endogenous plasminogen activation: Nattokinase boosts the body's own fibrinolytic system. It does this by increasing the levels of tissue plasminogen activator (t-PA) and converting prourokinase to urokinase, both of which activate plasminogen to produce plasmin, another clot-dissolving enzyme.
- Degrading plasminogen activator inhibitor-1 (PAI-1): Nattokinase also breaks down PAI-1, which is the main inhibitor of t-PA. By reducing the activity of PAI-1, nattokinase further amplifies the body's ability to dissolve clots.
- Antiplatelet effects: The enzyme has been shown to inhibit platelet aggregation, which is the clumping of platelets that initiates blood clot formation. It can block the formation of thromboxane, a substance involved in this process.
- Antihypertensive effects: Nattokinase can also act as an angiotensin-converting enzyme (ACE) inhibitor, reducing the production of angiotensin II, a potent vasoconstrictor. This leads to a relaxation of blood vessels and a reduction in blood pressure.
Cardiovascular Health Benefits
Research on nattokinase has highlighted several potential cardiovascular benefits, many stemming from its powerful fibrinolytic properties. These benefits include:
- Reduced Blood Clot Risk: Through its direct and indirect fibrinolytic actions, nattokinase helps prevent and dissolve blood clots, which is a key factor in conditions like deep vein thrombosis (DVT).
- Lowered Blood Pressure: Clinical trials have shown that daily supplementation with nattokinase can lead to significant reductions in both systolic and diastolic blood pressure in individuals with prehypertension and stage 1 hypertension.
- Anti-atherosclerotic Effects: Studies have indicated that nattokinase can help suppress the progression of atherosclerosis, the hardening and narrowing of arteries due to plaque buildup. It may help reduce common carotid artery intima-media thickness (CCA-IMT) and plaque size, potentially offering a better alternative to some conventional therapies.
- Lipid-Lowering Effects: Some research suggests nattokinase can favorably impact lipid profiles by reducing total cholesterol, LDL-cholesterol, and triglycerides while increasing HDL-cholesterol.
- Neuroprotective Properties: Given the link between cardiovascular and brain health, nattokinase's ability to improve blood flow may offer neuroprotective benefits, particularly in recovery from ischemic stroke and potentially in treating amyloid-related diseases like Alzheimer's.
Nattokinase Compared to Conventional Anticoagulants
| Feature | Nattokinase | Conventional Anticoagulants (e.g., Warfarin) |
|---|---|---|
| Origin | Natural enzyme derived from fermented soybeans | Synthetic drug |
| Mechanism | Directly hydrolyzes fibrin, increases t-PA, and degrades PAI-1 | Interferes with vitamin K-dependent clotting factors |
| Route of Administration | Oral capsule/supplement | Oral tablet/other forms |
| Monitoring | Minimal, if any, laboratory monitoring needed | Frequent laboratory monitoring (INR) required |
| Safety Profile | Generally considered safe, but risk of bleeding with other thinners | Well-established efficacy but higher risk of bleeding complications |
| Drug Interactions | May interact with blood thinners, aspirin, and blood pressure medications | Numerous food and drug interactions, particularly with vitamin K |
| Use Case | Dietary supplement for health promotion, not a treatment substitute | Prescribed medication for specific medical conditions |
Safety, Precautions, and Consultations
While generally considered safe for most people, nattokinase should be used with caution, and always under the guidance of a healthcare provider. Key safety considerations include:
- Increased Bleeding Risk: Nattokinase's blood-thinning properties can increase the risk of bleeding, especially for those taking anticoagulant or antiplatelet medications such as warfarin, heparin, and aspirin. Combining these can lead to excessive bruising or serious bleeding events.
- Surgery: Patients should stop taking nattokinase at least two weeks before any scheduled surgery, including dental procedures, to minimize the risk of excessive bleeding.
- Pre-existing Conditions: Individuals with bleeding disorders, a history of deep vein thrombosis, or who have had a stroke should exercise extreme caution or avoid nattokinase entirely, as theoretically, it could dislodge a clot.
- Pregnancy and Breastfeeding: There is insufficient evidence to confirm the safety of nattokinase during pregnancy or lactation, so it should be avoided.
- Consultation with a Healthcare Provider: It is crucial to consult a doctor to determine if nattokinase is appropriate for individual needs and to discuss any potential interactions or risks. Following the guidance of a healthcare professional is paramount when considering any supplement.
Conclusion
Nattokinase, a natural enzyme derived from fermented soybeans, is a promising supplement with multiple potential cardiovascular benefits, including its potent ability to dissolve blood clots, lower blood pressure, and reduce atherosclerotic plaque. Its multifaceted mechanism of action, which includes direct fibrinolysis and enhancement of the body's natural clot-dissolving pathways, distinguishes it from many conventional medications. However, it is not a substitute for prescribed medication and comes with significant safety precautions, particularly regarding bleeding risk and interactions with other drugs. For anyone considering nattokinase supplementation, a thorough consultation with a healthcare provider is essential to weigh the potential benefits against the risks and determine appropriate use.
For more in-depth scientific literature on nattokinase and cardiovascular health, see this National Institutes of Health (NIH) Study.
