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Nattokinase - current studies on an exciting enzyme


Natto is a Japanese dish made from fermented soybeans, which on the one hand is a completely normal dish in Japan and on the other hand is recommended in Japanese naturopathy as a traditional remedy for cardiovascular diseases.

In Japan, natto is also called “vegetable cheese” and is often eaten with vegetables and rice for breakfast. Natto, on the other hand, has not yet been able to establish itself in European menus, which is probably due to its taste, strong smell and unappetizing appearance.

Nattokinase is one of several enzymes in natto and is obtained from the fermentation of soybeans. To do this, the soybeans are cooked and then fermented using the bacterium “Bacillus subtilis”. The bacteria produce the enzyme nattokinase, which consists of 275 amino acids, in order to be able to metabolize the soy protein.

The name NattoKINASE resulted from the mistaken belief that nattokinase belongs to the enzyme group of kinases. But it was later discovered that it actually belongs to the group of proteases that break down proteins.



As already explained, nattokinase is an enzyme from the enzyme group of proteases - just like the body's two enzymes plasmin and thrombin, which are involved in blood clotting:

Thrombin promotes blood clotting by synthesizing the “glue” fibrin from fibrinogen, which unfortunately can not only close wounds but also form blood clots. Plasmin, in turn, dissolves fibrin again; This process is called “fibrinolysis”.Various studies suggest that nattokinase - similar to plasmin - via fibrinolytic, i.e.H may have clot-dissolving properties.



Thromboses / blood clotting

  • A 2015 randomized, double-blind, placebo-controlled trial examined the effect of nattokinase on preventing venous thrombosis in 94 patients who had undergone surgery. The study found that nattokinase significantly reduced the risk of venous thrombosis compared to the placebo group. (see. J Sato et al. "Randomized, controlled study of the postoperative preventive effect of a nattokinase-containing beverage on deep vein thrombosis."European Journal of Vascular and Endovascular Surgery, vol. 49, no. 2, 2015, pp. 230-5.)
  • A 2004 randomized, double-blind, placebo-controlled study examined the effects of nattokinase on blood clotting and endothelial function in 86 healthy volunteers. The study found that nattokinase significantly improved blood clotting and endothelial function compared to the placebo group. (see. S Fujita et al. "Increased fibrinolytic activity during exercise may be mediated by an increase in thrombin-activatable fibrinolysis inhibitor and by changes in platelet activation."Journal of Thrombosis and Haemostasis, vol. 2, no. 7, 2004, pp. 1186-92.)
  • The effect of a single dose of nattokinase was shown in a double-blind, placebo-controlled study from June 2015 (cf. Kurosawa Y et al., A single-dose of oral nattokinase potentiates thrombolysis and anti-coagulation profiles, Scientific Reports, 2015 Jun 25;5:11601). 12 healthy men were given either a dose of 2.000 FU nattokinase or a placebo preparation. In the next round the groups were swapped. Blood was then taken every two hours (after 2, 4, 6 and 8 hours) and examined for the corresponding coagulation factors. It was shown that the amount of fibrin and fibronogen degradation products increased, i.e.H Blood clots were dissolved. The amount of clotting factors decreased and the amount of clot-dissolving substances increased, so the clotting time was slowed, meaning the blood was now “thinner.”
  • A clinical study from 2002 (cf. ) supplemented 204 passengers on a flight from New York to London with a placebo or a mixture of nattokinase and pycnogenol. After the flight, the legs were examined using ultrasound: in the supplement group there were no cases of deep vein thrombosis, while in the placebo group 5 cases of deep vein thrombosis and two cases of superficial blood clot were diagnosed. In addition, leg swelling was measured before and after the flight: leg swelling increased by +12% after the flight in the placebo group, while it even decreased by 15% in the supplemented nattokinase-pycnogenol group.
  • In a human study (cf. Hsia CH et al, Nattokinase decreases plasma levels of fibrinogen, factor VII, and factor VIII in human subjects, Nutrition Research, 2009 Mar;29(3):190-6) from 2009, three groups of participants were given two capsules daily with nattokinase (2 capsules per capsule).000FU). The three groups were, on the one hand, healthy volunteers, on the other hand, patients with a certain risk of cardiovascular diseases and dialysis patients (who have a particularly high risk of thrombosis). After two months, it was found that the levels of coagulation factors had significantly reduced in all three groups. No side effects were observed.


  • In summary, the data from a large clinical trial from 2022 with 1.062 participants (see ) suggests that nattokinase in a daily dose of 10.800 FU, which is higher than the recommended dose of 2.000 FU, is significantly effective in treating the progression of atherosclerosis and hyperlipidemia. No side effects associated with the use of nattokinase have been observed. These results demonstrate that using nattokinase at a dose of 10.800 FU per day can achieve promising and positive clinical results in the treatment of atherosclerosis progression and hyperlipidemia.

High blood pressure

  • A 2008 study examined the effects of nattokinase on blood pressure in 86 patients with uncontrolled hypertension. The study found that nattokinase significantly reduced systolic blood pressure compared to the placebo group (cf. K Kim et al. "Effects of Nattokinase on Blood Pressure: A Randomized, Controlled Trial." Hypertension Research, vol. 31, no. 8, 2008, pp. 1583-1588.)

Stroke/ischemic heart disease

  • In 2017 there was a study (cf. with almost 30,000 test subjects over the age of 35. This documented natto eating habits and came to the conclusion that the group with the highest natto consumption was the one with the lowest number of strokes and ischemic heart disease, i.e. the mortality risk was the lowest. There were no significant associations between cardiovascular disease mortality risk and intake of total soy protein, total soy isoflavone, and soy protein or soy isoflavone from soy foods other than natto. The highest quartiles of total soy protein and natto intake were significantly associated with reduced risk of mortality from total stroke. The highest quartile of natto intake was also significantly associated with a reduced risk of mortality from ischemic stroke. Conclusion: Data suggest that natto intake may help reduce cardiovascular mortality.

Long-Cov / Post-Vac

  • This study has recently become a real political issue - we would still like to mention it for the sake of completeness: An in-vitro study from 2022 (cf. suggest that nattokinase could play a positive role in the degradation of spike proteins in connection with SARS-CoV-2 disease or mRNA vaccination. Specifically, the effect of nattokinase on the S protein of SARS-CoV-2 was examined. When cell lysates transfected with S protein were incubated with nattokinase, the S protein was degraded in a dose- and time-dependent manner. Immunofluorescence analysis showed that the S protein on the cell surface was degraded when nattokinase was added to the culture medium. The authors of the study note that the results suggest that nattokinase has the potential to inhibit SARS-CoV-2 infection via S protein degradation. However, it should be critically noted that this is only an in vitro study - i.e.H in the test tube. Clinical studies on humans are pending.

Cancer diseases

  • There are still no conclusive results on the effect of nattokinase on cancer cells. Initial studies with mice suffering from liver cancer show that nattokinase could have a protective effect. Compared to the placebo group, there were more survivors in the nattokinase group. Ascites (water in the abdominal cavity) also occurred less frequently. The ultrasound even showed that tumor growth had decreased in the nattokinase group. A certain protein (FOXM1), which can promote tumor growth, was less pronounced in the nattokinase group and could therefore apparently be inhibited by the enzyme. The levels of other tumor markers (CD31, CD44 and vimentin) were also lower in the nattokinase group than in the placebo group (cf. Yan Y, Wang Y, Qian J, Wu S, Ji Y, Liu Y, Zeng J, Gong A. Nattokinase Crude Extract Inhibits Hepatocellular Carcinoma Growth in Mice. J Microbiol Biotechnol. 2019 Aug 28;29(8):1281-1287).


  • Since nattokinase can dissolve blood clots, it is conceivable that it could also dissolve the deposits in the brain that are typical of Alzheimer's. In vitro, i.e.H This was actually shown in laboratory tests (not on humans) by a study from 2009 (cf. Hsu RL et al., Amyloid-degrading ability of nattokinase from Bacillus subtilis natto, Journal of Agricultural and Food Chemistry, 2009 Jan 28;57(2):503-8). Clinical studies on humans are pending.

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