Querying the pharmacist.

Jun 09, 2025

I was picking up a med…. And I asked the very polite female pharmacist if I could ask a question about a supplement. She said of course, and I asked her about Nattokinase and Serrapeptase for openers. Response: What’s that?

I have Liposomal Nattokinase with Serrapeptase, Inulin and a couple other enzymes for digestion.

@the_averagechick

It dropped my platelets from 480 to 367 in a few months and so many symptoms disappeared!! Will not stop taking it!

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6043915/

Abstract

Cardiovascular disease (CVD) is the leading cause of death in the world and our approach to the control and management of CVD mortality is limited. Nattokinase (NK), the most active ingredient of natto, possesses a variety of favourable cardiovascular effects and the consumption of Natto has been linked to a reduction in CVD mortality. Recent research has demonstrated that NK has potent fibrinolytic activity, antihypertensive, anti-atherosclerotic, and lipid-lowering, antiplatelet, and neuroprotective effects. This review covers the major pharmacologic effects of NK with a focus on its clinical relevance to CVD. It outlines the advantages of NK and the outstanding issues pertaining to NK pharmacokinetics.

Available evidence suggests that NK is a unique natural compound that possesses several key cardiovascular beneficial effects for patients with CVD and is therefore an ideal drug candidate for the prevention and treatment of CVD. Nattokinase is a promising alternative in the management of compounds that possesses several key cardiovascular beneficial effects for patients with CVD and is therefore an ideal drug candidate for the prevention and treatment of CVD. Nattokinase is a promising alternative in the management of CVD.

Keywords: Nattokinase, natto, cardiovascular disease, antithrombotic agents, antihypertensive drugs, atherosclerosis

Introduction

Cardiovascular diseases (CVDs) are the most prevalent cause of deaths worldwide. In 2015, the number of CVD-related deaths represented 31% of all deaths globally (www.who.int/cardiovascular_diseases). To date, there are limited approaches available for the control and/or management of CVD-related mortality.1

Natto, a cheese-like food made of soybeans fermented with Bacillus subtilis, has been consumed as a traditional food in Asian countries for more than 2000 years. Natto consumption is believed to be a significant contributor to the longevity of the Japanese population.2 Recent studies demonstrated that a high natto intake was associated with decreased risk of total CVD mortality and, in particular, a decreased risk of mortality from ischaemic heart diseases.2

Before the 1980s, very little was known about the mechanism by which natto consumption led to overall cardiovascular health. In 1987, Sumi et al3 discovered that natto contained a potent fibrinolytic enzyme called nattokinase (NK). Since then, a considerable amount of NK research has been performed on NK in Japan, Korea, China, and the United States, and these studies confirmed that NK, an alkaline protease of 275 amino acid residues with a molecular weight of approximately 28 kDa,4 is the most active ingredient of natto and is responsible for many favourable effects on cardiovascular health.

First, NK has potent fibrinolytic/antithrombotic activity.3–6 In addition, in both animal and human studies, NK also has an antihypertensive,7,8 anti-atherosclerotic,9,10 lipid-lowering,9,11 antiplatelet/anticoagulant,12 and neuroprotective actions.13,14 All these pharmacologic actions of NK have relevance to the prevention and treatment of CVD. Indeed, NK supplementation has shown to enhance markers of fibrinolysis and anticoagulation and to decrease blood pressure (BP) and atherosclerosis in human subjects.8,9,15–17

https://pubmed.ncbi.nlm.nih.gov/21714731/

Nat Prod Res

. 2012;26(6):548-56.

doi: 10.1080/14786419.2010.528759. Epub 2011 Jun 30.

Optimisation of preparation conditions and properties of phytosterol liposome-encapsulating nattokinase

Xu-Yan Dong 1 , Fan-Pi Kong, Gang-You Yuan, Fang Wei, Mu-Lan Jiang, Guang-Ming Li, Zhan Wang, Yuan-Di Zhao, Hong Chen

PMID: 21714731 DOI: 10.1080/14786419.2010.528759

Abstract

Phytosterol liposomes were prepared using the thin film method and used to encapsulate nattokinase (NK). In order to obtain a high encapsulation efficiency within the liposome, an orthogonal experiment (L9 (3)(4)) was applied to optimise the preparation conditions. The molar ratio of lecithin to phytosterols, NK activity and mass ratio of mannite to lecithin were the main factors that influenced the encapsulation efficiency of the liposomes. Based on the results of a single-factor test, these three factors were chosen for this study. We determined the optimum extraction conditions to be as follows: a molar ratio of lecithin to phytosterol of 2 : 1,

NK activity of 2500 U mL⁻¹ and a mass ratio of mannite to lecithin of 3 : 1. Under these optimised conditions, an encapsulation efficiency of 65.25% was achieved, which agreed closely with the predicted result. Moreover, the zeta potential, size distribution and microstructure of the liposomes prepared were measured, and we found that the zeta potential was -51 ± 3 mV and the mean diameter was 194.1 nm. From the results of the scanning electron microscopy, we observed that the phytosterol liposomes were round and regular in shape and showed no aggregation.

I went through 3 years of vision mini strokes that just got worse to the point of full loss of vision in the right eye for several minutes. I threw my Apixaban & Ramipril away and went 1 week with no meds to clear my system. I then took Nattokinase/12,000fu/once a day and Serrapeptase/120,000/once a day.

In 1 week the mini strokes stopped and haven't returned. I have bad sciatica so I'm a couch potato and eat all the wrong foods. Its been over a month now with no relapse. I have reduced the meds to Natto/4,000 and Serra/120,000/every second day. The bonus with Serra the sciatica is reduced. So this stuff works whether you change your life style or not.

It's not about lowering lipids, it's about removing plaque. After consuming Natto for a short period, my angiogram showed my artery go from 50% to 30% occlusion. My calcium score went from 283 to 153 in a period of a year. I will scan again in February to see if it gets lower. Natto works. Add and D3 with k2.

I take 6600 FU Natokinnase from Japan Yuma brand. I am 50 and still playing competitive singles badminton vs club players half my age. I stopped taking any medications for HBP etc and I eat whatever I want. I will not stop taking it and you should too. Nattokinase + exercise 3-4x a week is a game changer.

Agreed on just about everything, however the one glaring error is regarding red meat. Any of the carnivore doctors will be more than happy to debate you on this. Red meat is good for you, it's healthy!

Biomark Insights. 2018 Jul 5;13:1177271918785130. doi: 10.1177/1177271918785130

Nattokinase: A Promising Alternative in Prevention and Treatment of Cardiovascular Diseases

Hongjie Chen 1, Eileen M McGowan 2, Nina Ren 3, Sara Lal 2, Najah Nassif 2, Fatima Shad-Kaneez 2, Xianqin Qu 2, Yiguang Lin 2,✉

Author information

Article notes

PMCID: PMC6043915 PMID: 30013308

Abstract

This review covers the major pharmacologic effects of NK with a focus on its clinical relevance to CVD. It outlines the advantages of NK and the outstanding issues pertaining to NK pharmacokinetics. Available evidence suggests that NK is a unique natural compound that possesses several key cardiovascular beneficial effects for patients with CVD and is therefore an ideal drug candidate for the prevention and treatment of CVD. Nattokinase is a promising alternative in the management of CVD.

Keywords: Nattokinase, natto, cardiovascular disease, antithrombotic agents, antihypertensive drugs, atherosclerosis

Front Cardiovasc Med. 2022 Aug 22;9:964977. doi: 10.3389/fcvm.2022.964977

Effective management of atherosclerosis progress and hyperlipidemia with nattokinase: A clinical study with 1,062 participants

Hongjie Chen 1, Jiepeng Chen 2, Fuping Zhang 3, Yuanhui Li 4, Ronghua Wang 2, Qiang Zheng 2, Xu Zhang 2, Jun Zeng 2, Feng Xu 5,*, Yiguang Lin 1,6,7,*

Author information

Article notes

PMCID: PMC9441630 PMID: 36072877

This article has been corrected. See Front Cardiovasc Med. 2022 Dec 5;9:1076420.

Abstract

Nattokinase (NK), known as a potent fibrinolytic and antithrombotic agent, has been shown to have antiatherosclerotic and lipid-lowering effects. However, data on human clinical studies are limited. In this clinical study involving 1,062 participants, our objective was to examine the efficacy of NK in atherosclerosis and hyperlipidemia and safety at the dose of 10,800 FU/day after 12 months of oral administration. Various factors, including lower doses that influence NK pharmacological actions, were also investigated. We found that NK at a dose of 10,800 FU/day effectively managed the progression of atherosclerosis and hyperlipidemia with a significant improvement in the lipid profile. A significant reduction in the thickness of the carotid artery intima-media and the size of the carotid plaque was observed.

The improvement rates ranged from 66.5 to 95.4%. NK was found to be ineffective in lowering lipids and suppressing atherosclerosis progression at a dose of 3,600 FU/day. The lipid-lowering effect of NK was more prominent in subjects who smoked, drank alcohol, and subjects with higher BMI. Regular exercise further improved the effects of NK. Co-administration of vitamin K2 and aspirin with NK produced a synergetic effect. No noticeable adverse effects associated with the use of NK were recorded. In conclusion, our data demonstrate that atherosclerosis progression and hyperlipidemia can be effectively managed with NK at a dose of 10,800 FU/day. The lower dose of 3,600 FU per day is ineffective.

The dose of 10,800 FU/day is safe and well tolerated. Some lifestyle factors and the coadministration of vitamin K2 and aspirin lead to improved outcomes in the use of NK. Our findings provide clinical evidence on the effective dose of NK in the management of cardiovascular disease and challenge the recommended dose of 2,000 FU per day.

Keywords: nattokinase, atherosclerosis, hyperlipidaemia, anti-atherogenic drug, lipid lowering effect, retrospective study, lipid lowering agent, Nattokinase (NK)

Nutrients. 2021 Jun 13;13(6):2031. doi: 10.3390/nu13062031

Data Recorded in Real Life Support the Safety of Nattokinase in Patients with Vascular Diseases

Giuseppe Gallelli 1,†, Giulio Di Mizio 2,*,†, Caterina Palleria 3, Antonio Siniscalchi 4, Paolo Rubino 1, Lucia Muraca 5, Erika Cione 6, Monica Salerno 7, Giovambattista De Sarro 3,8, Luca Gallelli 3,8

Editor: Herminia González Navarro

Author information

Article notes

PMCID: PMC8231931 PMID: 34199189

Abstract

Nattokinase (NK) is a serine protease enzyme with fibrinolytic activity. Even if it could be used for the treatment of several diseases, no data have been published supporting its use patients who underwent vascular surgery. In this study, we evaluated both the efficacy and the safety of nattokinase (100 mg/day per os) in patients admitted to vascular surgery. Patients were of both sexes, >18 years of age, with vascular diseases (i.e., deep vein thrombosis, superficial vein thrombosis, venous insufficiency), and naïve to specific pharmacological treatments (anticoagulants or anti-platelets).

Patients were divided into three groups. Group 1: patients with deep vein thrombosis, treated with fondaparinux plus nattokinase. Group 2: patients with phlebitis, treated with enoxaparin plus nattokinase. Group 3: patients with venous insufficiency after classical surgery, treated with nattokinase one day later. During the study, we enrolled 153 patients (age 22–92 years), 92 females (60.1%) and 61 males (39.9%;), and documented that nattokinase was able to improve the clinical symptoms (p < 0.01) without the development of adverse drug reactions or drug interactions. Among the enrolled patients, during follow-up, we did not record new cases of vascular diseases.

Attention to patients’ clinical evolution, monitoring of the INR, and timely and frequent adjustment of dosages represent the cornerstones of the safety of care for patients administered fibrinolytic drugs as a single treatment or in pharmacological combination. Therefore, we can conclude that the use of nattokinase represents an efficient and safe treatment able to both prevent and treat patients with vascular diseases.

Keywords: nattokinase, vascular diseases, clinical trial, low-molecular-weight heparin, Clinical Risk Management, safety of care in pharmacological treatments

I'm a stroke survivor. I've been using this for 3 years. Doppler tests prove my carotid arteries are clearing. Let's get excited here!! 😊 Also, using the ketogenic lifestyle has made a wonderful difference. I'm 68 and doing great!

l took nattokinase x serrapeptanase together after having long covid for 6 months ( i also suffer from dvt which i had too ..) well what amazing stuff this is I've been on 2000 iu for 6 months now and feel 5 years younger .......still working outside doing lots of physical jobs ...clots all gone and my bp now 121/64 amazing never been that low ever in the last 50 years ,just had my 83 birthday in Dec and went onto keto six months ago too and lost 2 stone now 70 k feel much better ......yes i think its a life saver ....im not on any medication from my Doctor ,they tried giving me bp tabs and statins but i refused i know my own body better than these Drs do ....i only take a few vitamins ….

I was surprised that you didn't mention the study that utilized 10.800 FUs of nattokinase daily and what a great reduction was shown in atherosclerosis.

Here's a ChatGPT summary:

- Nattokinase can degrade or break down fibrin clots, which can be problematic in some people.

- 2,000 units per day of Nattokinase significantly decreases both systolic and diastolic blood pressure.

- Daily intake of 6,000 units of Nattokinase may manage the progression of atherosclerosis better than statins and improve lipid profiles.

- In animal studies, Nattokinase improved blood flow to the brain after induced ischemic brain damage by blocking platelet and thrombus formation.

- Post-surgery, Nattokinase improved venous insufficiency without significant side effects.

- Nattokinase showed potential benefits for deep vein thrombosis (DVT) when added to the medication Erixtra, though the exact contribution of Nattokinase is unclear.

- Main message: Nattokinase shows promising benefits for blood pressure, atherosclerosis, stroke, venous insufficiency, and potentially DVT, but further research is needed, especially in humans.

The concert that showed reduction in AS as measured by cimt had quite diseased carotids as compared to the normal 65yo carotids 1.33 vs .0.77. I doubt 19% reduction in ldlc and assuming same reduction of. 18% apoB was responsible. (120mg/dl to 105mg/dl) foamcell delipidation (reversal of cimt measured soft plaque) os generally considered to iccur with apob(ldlc) < 40mg/dl, mu money os on the hydrolyzation of fibrin binding the soft plaque areas a together.

From personal experience (3 yrs at apoB < 40mg/dl and 21% reduction in cimt measured soft,plaque) 30% reduction is HUGE .. but starting with a cohort of 1.33 is really choosing the very worst case. I’ve added 12KFU for 5 months and am excited to see if my soft plaque regression has accelerated [my soft plaque went from 770 (62yo) to 600(65yo plant based (apoB:70, then added + 10mg resu + 10mg eze, apoB:37/ldlc:30). I’m excited to get next cimt scan (I get them every 6mo). I do agree that as a mild anti coagulant NK may well, be worth taking daily at around 6KFU. (Chinese study was at 10400FU)

I take Serrapeptase for spike protein removal. I experienced better breathing.

I could have sworn the studies on clot breaking was in humans and already confirmed benefit

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9441630/

Front Cardiovasc Med. 2022; 9: 964977.

Published online 2022 Aug 22. doi: 10.3389/fcvm.2022.964977

PMCID: PMC9441630

PMID: 36072877

Effective management of atherosclerosis progress and hyperlipidemia with nattokinase: A clinical study with 1,062 participants

Hongjie Chen, 1 Jiepeng Chen, 2 Fuping Zhang, 3 Yuanhui Li, 4 Ronghua Wang, 2 Qiang Zheng, 2 Xu Zhang, 2 Jun Zeng, 2 Feng Xu,corresponding author 5 , * and Yiguang Lincorresponding author 1 , 6 , 7 , *

Author information Article notes Copyright and License information PMC Disclaimer

This article has been corrected. See Front Cardiovasc Med. 2022 December 05; 9: 1076420.

Associated Data

Data Availability Statement

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Abstract

Nattokinase (NK), known as a potent fibrinolytic and antithrombotic agent, has been shown to have antiatherosclerotic and lipid-lowering effects. However, data on human clinical studies are limited.

In this clinical study involving 1,062 participants, our objective was to examine the efficacy of NK in atherosclerosis and hyperlipidemia and safety at the dose of 10,800 FU/day after 12 months of oral administration.

Various factors, including lower doses that influence NK pharmacological actions, were also investigated. We found that NK at a dose of 10,800 FU/day effectively managed the progression of atherosclerosis and hyperlipidemia with a significant improvement in the lipid profile.

A significant reduction in the thickness of the carotid artery intima-media and the size of the carotid plaque was observed. The improvement rates ranged from 66.5 to 95.4%. NK was found to be ineffective in lowering lipids and suppressing atherosclerosis progression at a dose of 3,600 FU/day. The lipid-lowering effect of NK was more prominent in subjects who smoked, drank alcohol, and subjects with higher BMI.

Regular exercise further improved the effects of NK. Co-administration of vitamin K2 and aspirin with NK produced a synergetic effect. No noticeable adverse effects associated with the use of NK were recorded. In conclusion, our data demonstrate that atherosclerosis progression and hyperlipidemia can be effectively managed with NK at a dose of 10,800 FU/day. The lower dose of 3,600 FU per day is ineffective.

Keywords: nattokinase, atherosclerosis, hyperlipidaemia, anti-atherogenic drug, lipid lowering effect, retrospective study, lipid lowering agent, Nattokinase (NK)

https://pmc.ncbi.nlm.nih.gov/articles/PMC9441630/
Front Cardiovasc Med. 2022 Aug 22;9:964977. doi: 10.3389/fcvm.2022.964977
Effective management of atherosclerosis progress and hyperlipidemia with nattokinase: A clinical study with 1,062 participants
Hongjie Chen 1, Jiepeng Chen 2, Fuping Zhang 3, Yuanhui Li 4, Ronghua Wang 2, Qiang Zheng 2, Xu Zhang 2, Jun Zeng 2, Feng Xu 5,*, Yiguang Lin 1,6,7,*
Author information
Article notes
Copyright and License information
PMCID: PMC9441630 PMID: 36072877
This article has been corrected. See Front Cardiovasc Med. 2022 Dec 5;9:1076420.
Abstract

Nattokinase (NK), known as a potent fibrinolytic and antithrombotic agent, has been shown to have antiatherosclerotic and lipid-lowering effects. However, data on human clinical studies are limited. In this clinical study involving 1,062 participants, our objective was to examine the efficacy of NK in atherosclerosis and hyperlipidemia and safety at the dose of 10,800 FU/day after 12 months of oral administration. Various factors, including lower doses that influence NK pharmacological actions, were also investigated. We found that NK at a dose of 10,800 FU/day effectively managed the progression of atherosclerosis and hyperlipidemia with a significant improvement in the lipid profile.

A significant reduction in the thickness of the carotid artery intima-media and the size of the carotid plaque was observed. The improvement rates ranged from 66.5 to 95.4%. NK was found to be ineffective in lowering lipids and suppressing atherosclerosis progression at a dose of 3,600 FU/day. The lipid-lowering effect of NK was more prominent in subjects who smoked, drank alcohol, and subjects with higher BMI. Regular exercise further improved the effects of NK. Co-administration of vitamin K2 and aspirin with NK produced a synergetic effect.

No noticeable adverse effects associated with the use of NK were recorded. In conclusion, our data demonstrate that atherosclerosis progression and hyperlipidemia can be effectively managed with NK at a dose of 10,800 FU/day. The lower dose of 3,600 FU per day is ineffective. The dose of 10,800 FU/day is safe and well tolerated. Some lifestyle factors and the coadministration of vitamin K2 and aspirin lead to improved outcomes in the use of NK. Our findings provide clinical evidence on the effective dose of NK in the management of cardiovascular disease and challenge the recommended dose of 2,000 FU per day.

Keywords: nattokinase, atherosclerosis, hyperlipidaemia, anti-atherogenic drug, lipid lowering effect, retrospective study, lipid lowering agent, Nattokinase (NK

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