From the Guidelines
Natokinase, bromelain, and curcumin are dietary supplements with potential health benefits.
Key Characteristics of Each Supplement
- Curcumin: a naturally occurring phenol with anti-inflammatory, anti-oxidant, antibacterial, antiviral, antifungal, anti-tumour, antispasmodic, hepato-protective, and wound healing properties 1
- Natokinase: an enzyme extracted from natto, a Japanese food made from fermented soybeans, with fibrinolytic activity (not mentioned in the provided evidence)
- Bromelain: a mixture of enzymes found in pineapple, with anti-inflammatory and anti-edematous properties (not mentioned in the provided evidence)
Evidence for Curcumin
Curcumin has been studied for its potential benefits in ulcerative colitis 1 and periodontal diseases 1, with some evidence suggesting it may be effective in reducing plaque and gingivitis levels 1. However, more research is needed to fully understand its effects and optimal dosage.
Limitations of the Evidence
While curcumin has shown promise, the evidence is limited by small study sizes and lack of dose-finding efficacy studies 1. Additionally, the use of curcumin as a dietary supplement is not regulated, and its long-term safety and efficacy are not well established 1.
Clinical Implications
In clinical practice, curcumin may be considered as a complementary therapy for patients with mild-to-moderate ulcerative colitis or periodontal diseases, but its use should be weighed against the potential risks and benefits 1. However, due to the lack of strong evidence for natokinase and bromelain, their use as dietary supplements cannot be recommended at this time.
The FDA Drug Labels for natokinase (PO), bromelain (PO), curcumin (PO) do not address this question.
From the Research
Overview of Natokinase, Bromelain, and Curcumin
- Natokinase is a serine protease derived from natto, a traditional Japanese fermented soybean food meal, with significant fibrinolytic, antithrombotic, and antihypertensive effects 2, 3.
- Bromelain is a cysteine protease isolated from the pineapple stem, exerting immunomodulatory actions and interfering with the inflammatory, coagulation, and bradykinin cascades 4.
- Curcumin is a natural phenol found in turmeric, with anti-inflammatory, antioxidant, and anticancer effects, and has been shown to prevent entry of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) into cells and viral replication 4, 5, 6.
Properties and Effects
- Natokinase has been shown to have a pharmacokinetic pattern in humans, with peak serum levels observed at approximately 13.3 hours post-dose 2.
- Bromelain and curcumin have been proposed as a potential therapeutic combination for the prevention of severe COVID-19, due to their immunomodulatory and anti-inflammatory effects 4.
- Curcumin has been found to have low stability and bioavailability, but its analogs and combinations with other bioactive compounds have shown synergistic effects and potential health benefits 5, 6.
Potential Health Benefits
- Natokinase may be beneficial for cardiovascular health due to its fibrinolytic and antithrombotic effects 2, 3.
- Bromelain and curcumin may have potential in preventing severe COVID-19 and other inflammatory and infectious diseases 4.
- Curcumin and its analogs may have anti-cancer, anti-malarial, and anti-inflammatory activities, and may be useful in the prevention and treatment of various illnesses 5, 6.