Natto extract

Related Terms

Fermented soybeans, Flite Tabs, natto, natto extract, nattokinase, NK, NSK II, NSK-SD, subtilisin NAT.

Background

Natto is a traditional Japanese food, prepared by fermenting boiled soybeans with the bacterium Bacillus subtilis. Nattokinase is an enzyme, which breaks down protein, and is purified from the cheese-like natto. Nattokinase was discovered in 1980 by a researcher who was trying to identify a natural agent that could successfully dissolve clots.
People throughout Asia have consumed soybeans in a variety of traditional foods (including natto) for over 1,000 years. Due to their possible contribution to the observed low rates of heart disease in Asian countries, soy products such as natto have recently attracted attention in the West. As a result, nattokinase is a popular health food supplement.
Nattokinase has been reported to have blood-thinning effects. Recently, research has indicated that nattokinase may have potential in the treatment of vein clots, or deep venous thrombosis (DVT), and high blood pressure, when used in combination with the standard therapies for these conditions.

Evidence Table

These uses have been tested in humans or animals. Safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider. GRADE *
These uses have been tested in humans or animals. Safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider. GRADE *


Nattokinase has traditionally been used as a blood pressure-lowering agent in Asia. Results of clinical studies support this use. Future studies will provide additional valuable information on the use of nattokinase to treat high blood pressure.

 B


Nattokinase has traditionally been used as a blood pressure-lowering agent in Asia. Results of clinical studies support this use. Future studies will provide additional valuable information on the use of nattokinase to treat high blood pressure.

 B


Evidence suggests that the combination product Flite Tabs, containing nattokinase and Pycnogenol?, may reduce the frequency of clotting effects and swelling in high-risk individuals on long air flights. Further research on the effect of nattokinase alone is needed before a conclusion can be made.

 C


Evidence suggests that the combination product Flite Tabs, containing nattokinase and Pycnogenol?, may reduce the frequency of clotting effects and swelling in high-risk individuals on long air flights. Further research on the effect of nattokinase alone is needed before a conclusion can be made.

 C
* Key to grades

A: Strong scientific evidence for this use
B: Good scientific evidence for this use
C: Unclear scientific evidence for this use
D: Fair scientific evidence for this use (it may not work)
F: Strong scientific evidence against this use (it likley does not work)
* Key to grades

A: Strong scientific evidence for this use
B: Good scientific evidence for this use
C: Unclear scientific evidence for this use
D: Fair scientific evidence for this use (it may not work)
F: Strong scientific evidence against this use (it likley does not work)

Tradition / Theory

The below uses are based on tradition, scientific theories, or limited research. They often have not been thoroughly tested in humans, and safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider. There may be other proposed uses that are not listed below.

Dosing

Adults (18 years and older)
Manufacturers recommend that nattokinase be given by mouth at a dose of 100 milligrams three times daily. Other recommended doses range from 2,000 to 6,000 fibrinolytic units (FU). A fibrinolytic unit is a measure of the ability to break down the protein fibrin, a component of blood clots.
For high blood pressure, the following has been taken: one capsule of NSK-II (Japan Bio Sciences Laboratories Company Ltd., Japan; containing 2,000 FU/capsule) by mouth daily for eight weeks; two capsules of NSK-II by mouth daily for four weeks; a freeze-dried extract (80% ethanol; equivalent to 200 grams of natto and 6,400 FU) by mouth daily for four consecutive days.
For vein clots (deep venous thrombosis (DVT)), two capsules of Flite Tabs (Aidan, Tempe, AZ; containing 150 milligrams of pinokinase (Pycnogenol? and nattokinase)) has been taken by mouth with 250 milliliters of water, two hours before a flight and six hours later.

Safety

The U.S. Food and Drug Administration does not strictly regulate herbs and supplements. There is no guarantee of strength, purity or safety of products, and effects may vary. You should always read product labels. If you have a medical condition, or are taking other drugs, herbs, or supplements, you should speak with a qualified healthcare provider before starting a new therapy. Consult a healthcare provider immediately if you experience side effects.

Interactions

Interactions with Drugs
Nattokinase may increase the risk of bleeding when taken with drugs that increase the risk of bleeding. Some examples include aspirin, anticoagulants ("blood thinners") such as warfarin (Coumadin?) or heparin, antiplatelet drugs such as clopidogrel (Plavix?), and nonsteroidal anti-inflammatory drugs such as ibuprofen (Motrin?, Advil?) or naproxen (Naprosyn?, Aleve?). Some natto and nattokinase supplements contain vitamin K, which may work against the effects of anticoagulants ("blood thinners") such as warfarin (Coumadin?) or heparin.
Nattokinase may cause low blood pressure. Caution is advised in patients taking drugs that lower blood pressure.

Attribution

This information is based on a systematic review of scientific literature edited and peer-reviewed by contributors to the Natural Standard Research Collaboration (www.naturalstandard.com).

Bibliography

Cesarone MR, Belcaro G, Nicolaides AN, et al. Prevention of venous thrombosis in long-haul flights with Flite Tabs: the LONFLIT-FLITE randomized, controlled trial. Angiology 2003;54(5):531-539.
Chang YY, Liu JS, Lai SL, et al. Cerebellar hemorrhage provoked by combined use of nattokinase and aspirin in a patient with cerebral microbleeds. Intern Med 2008;47(5):467-469.
Fujita M, Hong K, Ito Y, et al. Thrombolytic effect of nattokinase on a chemically induced thrombosis model in rat. Biol Pharm Bull 1995;18(10):1387-1391.
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Maruyama and Sumi. Effect of Natto Diet on Blood Pressure. 1998.
Pais E, Alexy T, Holsworth RE Jr., et al. Effects of nattokinase, a pro-fibrinolytic enzyme, on red blood cell aggregation and whole blood viscosity. Clin Hemorheol Microcirc 2006;35(1-2):139-142.
Sumi H, Hamada H, Nakanishi K, et al. Enhancement of the fibrinolytic activity in plasma by oral administration of nattokinase. Acta Haematol. 1990;84(3):139-143.
Sumi H, Hamada H, Tsushima H, et al. A novel fibrinolytic enzyme (nattokinase) in the vegetable cheese Natto; a typical and popular soybean food in the Japanese diet. Experientia 1987;43(10):1110-1111.
Suzuki Y, Kondo K, Ichise H, et al. Dietary supplementation with fermented soybeans suppresses intimal thickening. Nutrition 2003;19(3):261-264.
Suzuki Y, Kondo K, Matsumoto Y, et al. Dietary supplementation of fermented soybean, natto, suppresses intimal thickening and modulates the lysis of mural thrombi after endothelial injury in rat femoral artery. Life Sci 2003;73(10):1289-1298.
Tai MW, Sweet BV. Nattokinase for prevention of thrombosis. Am J Health Syst Pharm 6-15-2006;63(12):1121-1123.
Takano A, Hirata A, Ogasawara K, et al. Posterior vitreous detachment induced by nattokinase (subtilisin NAT): a novel enzyme for pharmacologic vitreolysis. Invest Ophthalmol Vis Sci 2006;47(5):2075-2079.
Urano T, Ihara H, Umemura K, et al. The profibrinolytic enzyme subtilisin NAT purified from Cleaves and inactivates plasminogen activator inhibitor type 1. J Biol Chem 2001;276(27):24690-24696.