There are no official guidelines to assist in answering this question. I will search for relevant research papers instead.
From the Research
Role of Nattokinase in Managing Hypercholesterolemia
- Nattokinase, a fibrinolytic enzyme from fermented soybean, has been studied for its potential benefits in cardiovascular health, including its effects on hypercholesterolemia 1, 2, 3, 4, 5.
- A systematic review and meta-analysis of randomized controlled trials found that nattokinase supplementation had a negative effect on blood total cholesterol, high-density lipoprotein cholesterol, and low-density lipoprotein cholesterol, but the effect was dependent on the dosage of nattokinase 1.
- A study on the serum pharmacokinetics of nattokinase in humans found that peak serum levels of nattokinase were observed at approximately 13.3 hours post-dose, and statistically significant increases in binding were detectable from baseline 3.
- Another study found that nattokinase decreased plasma levels of fibrinogen, factor VII, and factor VIII in human subjects, suggesting its potential as a cardiovascular disease nutraceutical 4.
- A randomized, double-blind, placebo-controlled study found that combined nattokinase with red yeast rice, but not nattokinase alone, had potent effects on blood lipids in human subjects with hyperlipidemia, including significant decreases in triglycerides, total cholesterol, and low-density lipoprotein cholesterol 5.
Key Findings
- Nattokinase may have a negative effect on blood lipids, but the effect is dependent on the dosage 1.
- Nattokinase can decrease plasma levels of fibrinogen, factor VII, and factor VIII, which are associated with an increased risk of cardiovascular disease 4.
- Combined nattokinase with red yeast rice may be a more effective neutraceutical for patients with hyperlipidemia than nattokinase alone 5.
Mechanisms of Action
- Nattokinase has fibrinolytic, antithrombotic, and antihypertensive effects, which may contribute to its potential benefits in managing hypercholesterolemia 1, 2, 4.
- The exact mechanisms of action of nattokinase on blood lipids are not fully understood, but may involve the inhibition of enzymes involved in lipid metabolism or the enhancement of lipid clearance 5.