Safety of Nattokinase Supplements on a Low Histamine Diet
Nattokinase supplements are generally not recommended for individuals following a low histamine diet due to its fermented origin, which typically contains high levels of histamine.
Understanding Nattokinase and Histamine Intolerance
Nattokinase is a serine protease enzyme derived from natto, a traditional Japanese fermented soybean food 1. While it has gained popularity as a dietary supplement for cardiovascular health due to its fibrinolytic and antithrombotic properties 2, its fermented nature makes it problematic for those with histamine intolerance.
Histamine Intolerance Considerations
According to histamine intolerance management guidelines, fermented foods should be strictly avoided in low histamine diets 3:
- Fermented foods, including those derived from fermentation processes like natto, contain naturally high levels of histamine
- The British Society of Gastroenterology recommends early dietitian involvement to prevent overly restrictive diets while still avoiding high-histamine foods 3
- A proper low-histamine diet should avoid all fermented foods, high-histamine foods, and foods high in putrescine 3
Why Nattokinase is Problematic for Low Histamine Diets
Fermentation source: Nattokinase is produced through fermentation of soybeans by Bacillus subtilis natto 4, and fermentation processes naturally produce histamine
Potential for histamine reactions: Individuals with histamine intolerance may experience anaphylaxis-like symptoms after consuming histamine-rich foods or supplements 3
Lack of specific safety data: While nattokinase has been studied for cardiovascular benefits 5, there is no specific research addressing its safety in histamine-intolerant individuals
Alternative Approaches
For individuals on a low histamine diet who are seeking cardiovascular benefits:
- Consider second-generation H1 antihistamines for symptom management of histamine intolerance 3
- Focus on non-fermented foods that are allowed on a low histamine diet
- Consult with a healthcare provider about alternative cardiovascular supplements that aren't derived from fermented sources
Clinical Considerations
If you're considering nattokinase despite being on a low histamine diet:
- A trial of nattokinase should only be considered after consultation with an allergist or immunologist familiar with histamine intolerance
- Start with an extremely low dose and monitor for reactions
- Be prepared to discontinue immediately if symptoms occur
- Consider that the potential cardiovascular benefits may not outweigh the risks of histamine reactions
Conclusion
While nattokinase has shown potential cardiovascular benefits in some studies 2, 5, its fermented origin makes it incompatible with a low histamine diet. Individuals with histamine intolerance should prioritize strict adherence to their low histamine diet and seek alternative, non-fermented supplements for cardiovascular support.