From the Guidelines
Nattokinase has not been proven to reverse atherosclerosis. The most recent and highest quality evidence suggests that aggressive LDL cholesterol lowering, potentially using combinations of maximally tolerated statins, ezetimibe, and new drugs such as PCSK9 or CETP inhibitors, may have profound effects on atherosclerosis stabilization and regression 1. While nattokinase, an enzyme derived from fermented soybeans (natto), has shown some promising effects in laboratory and small clinical studies for breaking down blood clots and potentially improving blood flow, there is insufficient scientific evidence to support claims that it can reverse established atherosclerotic plaque in human arteries. Some key points to consider:
- Aggressive LDL cholesterol lowering can reset the vascular aging clock, and intermittent retreatment every decade or so might, in essence, “cure” atherosclerosis 1
- Clinically proven approaches for managing or preventing atherosclerosis include statins, antiplatelet medications, lifestyle modifications (regular exercise, heart-healthy diet, smoking cessation), and controlling conditions like hypertension and diabetes
- Nattokinase does have fibrinolytic (clot-dissolving) properties and may help reduce blood pressure and improve circulation in some individuals, but these effects are different from actually reversing the complex process of atherosclerosis If you're considering nattokinase supplements, typical doses range from 1000-2000 FU (fibrinolytic units) daily, but you should consult with a healthcare provider before starting any supplement, especially if you take blood thinners or have bleeding disorders, as nattokinase may increase bleeding risk.
From the Research
Nattokinase and Atherosclerosis Reversal
- The effect of nattokinase on atherosclerosis reversal is a topic of ongoing research, with some studies suggesting potential benefits 2, 3, 4.
- A 2021 study published in Clinical Hemorheology and Microcirculation found that nattokinase supplementation had a null effect on subclinical atherosclerosis progression in healthy individuals at low risk for cardiovascular disease 2.
- In contrast, a 2022 study published in Frontiers in Cardiovascular Medicine found that nattokinase effectively managed the progression of atherosclerosis and hyperlipidemia at a dose of 10,800 FU/day, with significant improvements in lipid profile and carotid artery intima-media thickness 3.
- Another study published in 2017 in Zhonghua Yi Xue Za Zhi found that daily nattokinase supplementation reduced carotid artery intima-media thickness and carotid plaque size, and improved lipid profiles, suggesting that nattokinase may be an effective alternative to statins in managing atherosclerosis 4.
Key Findings
- Nattokinase has been shown to have antithrombotic, antihypertensive, and anti-atherosclerotic effects, making it a potential therapeutic agent for cardiovascular disease prevention and treatment 5.
- The optimal dose of nattokinase for atherosclerosis reversal is unclear, with studies suggesting that higher doses (10,800 FU/day) may be more effective than lower doses (2,000 FU/day) 3.
- Lifestyle factors, such as regular exercise and co-administration of vitamin K2 and aspirin, may enhance the effects of nattokinase on atherosclerosis reversal 3.
Pharmacokinetics and Bioavailability
- The pharmacokinetics and bioavailability of nattokinase are not well understood, with limited studies available on its absorption, distribution, metabolism, and excretion in humans 6.
- A pilot study published in 2013 found that nattokinase was detectable in human blood following oral ingestion, with peak serum levels observed at approximately 13.3 hours post-dose 6.