Nattokinase: Nature's Clot Fighter

Welcome to another edition of the Doctor's Note where we talk about what's on our minds when it comes to your health.

This week I dove into a topic that truly fascinates me both as a physician and a longevity enthusiast: nattokinase. Derived from fermented soybeans, nattokinase is an enzyme that’s been used for centuries in Japan, where people tend to live longer, healthier lives than in much of the world. In our clinic, interest in nattokinase has ramped up, especially since my son Andy, who is a PA and a longtime type 1 diabetic, incorporated it into his own regimen after hearing about its potential health benefits. As we see more people—especially the young—dealing with blood clots, and with the rise in clot-related health issues post-COVID era, it feels more important than ever to explore measures that can support cardiovascular health and overall longevity.

Research shows that nattokinase works by dissolving fibrin, the key protein in blood clots, and by boosting your body’s own anti-clot systems. Unlike many traditional blood thinners, nattokinase tackles clotting through multiple pathways and may also improve blood pressure, lipid status, and even reduce amyloid plaque associated with Alzheimer’s risk. That said, it’s not FDA-approved as a substitute for prescribed anticoagulants and should be used with caution—especially if you’re already on blood thinners. I also broke down the differences between nattokinase and other enzymes like lumbrokinase and serrapeptase, each with their own unique strengths and uses when it comes to cardiovascular and tissue health. Ultimately, nattokinase can be a powerful tool in supporting your longevity plan, but always do your own research, listen to your body, and consult a knowledgeable healthcare provider before incorporating it.

PODCAST NOTES 

• Nattokinase is a unique enzyme extracted from natto, a fermented soy food that’s been a staple in Japanese diets for centuries. Unlike regular soy, fermented soy offers health benefits without many of the negative effects sometimes associated with unfermented soy. Notably, the Japanese population—who consume natto regularly—tend to live longer on average than Americans, a difference that may, in part, be attributed to the protective cardiovascular properties of this enzyme.

• The supplement has been thrust into the spotlight recently, particularly for its inclusion in Dr. McCullough’s “Spike Detox Protocol,” which aims to assist those with post-COVID and potential vaccine-induced clotting risks. In this context, nattokinase is being discussed as a preventative and therapeutic option for younger and otherwise healthy individuals experiencing an uptick in blood clotting disorders in the wake of the pandemic.

• One of the standout features of nattokinase is its direct action on fibrin, the protein network that forms the structural backbone of blood clots. By actively dissolving fibrin, nattokinase contributes to keeping the blood “cleaner,” reducing the risk for the major killers: heart attacks and strokes. Additionally, it uniquely supports the body by boosting plasmin, your own natural clot-busting enzyme, which gives it wider-reaching effects than conventional pharmaceutical blood thinners that typically operate through a single pathway.

• Credible research, including a double-blind, placebo-controlled study published in Scientific Reports and referenced in Nature, indicates that intake of nattokinase can cause beneficial shifts in blood clotting markers within just hours. These studies found that a 2,000 FU capsule produced measurable changes without any reported adverse effects, supporting its safety profile for short-term use.

• Nattokinase’s benefits may go far beyond cardiovascular health. Studies are now investigating its ability to improve blood pressure control and help lower harmful cholesterol levels. There’s even growing scientific interest in its potential to reduce amyloid plaques, which are implicated in Alzheimer’s disease. As research progresses, nattokinase’s role in supporting brain as well as heart health could become even more critical.

• Despite its over-the-counter availability and reported safety, nattokinase must be used responsibly. Patients currently using prescription blood thinners (such as Eliquis, Coumadin, or Xarelto) should avoid nattokinase due to the risk of excessive bleeding or bruise formation. Watch for warning signs like frequent nosebleeds, unexplained bruising, or acute stomach pain, and always discuss potential supplement use with your healthcare provider.

• It’s important to differentiate nattokinase from lumbrokinase, a similar but much stronger enzyme derived from earthworms, typically reserved for those with serious clotting disorders. Meanwhile, serrapeptase—an enzyme from silkworm bacteria—is less potent for clot-dissolving purposes but excels at resolving chronic tissue scarring and inflammation, making each enzyme unique for different health objectives.

• The typical dosing range for nattokinase for most adults is between 2,000 and 4,000 FUs per day, with higher doses up to 10,000 FUs requiring extra caution and supervision. To maximize effectiveness, nattokinase should be taken on an empty stomach (either an hour before eating or two hours after a meal), since taking it with food means it will just digest dietary protein rather than enter the bloodstream and impart its clot-dissolving benefits.

Nattokinase is a compelling supplement to consider as part of your longevity and cardiovascular health strategy. My advice is to always be your own health advocate—research what you put in your body, pay attention to how you feel, and involve your healthcare provider in decisions about new supplements, especially if you’re already on medications. 

Remember, longevity doesn’t come from a single pill. It’s the result of a holistic approach—solid nutrition, exercise, sleep, stress management, and hormone balance. 

Stay educated. Stay healthy. 

Till next week.