What is the evidence for Nattokinase (subtilisin NAT), a serine protease?

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Last updated: April 30, 2025View editorial policy

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From the Research

Nattokinase can be considered a safe and efficient treatment for patients with vascular diseases, as evidenced by a 2021 study published in Nutrients, which found that nattokinase improved clinical symptoms without adverse drug reactions or interactions 1. The evidence on nattokinase suggests it may have potential cardiovascular benefits, primarily through its fibrinolytic (clot-dissolving) and anti-inflammatory properties. Some key points to consider when using nattokinase include:

  • Typical dosages used in research range from 2,000 to 4,000 FU (fibrinolytic units) daily, usually taken in divided doses.
  • Nattokinase should be used with caution if you're taking blood thinners like warfarin, aspirin, or other anticoagulants, as it may increase bleeding risk, as noted in various studies 2, 3.
  • Those with bleeding disorders, upcoming surgery, or pregnancy should avoid nattokinase.
  • The mechanism behind nattokinase's effects involves its ability to activate pro-urokinase, which converts plasminogen to plasmin, the enzyme that degrades fibrin and dissolves clots. However, it's essential to note that the overall evidence is still limited compared to conventional medications, with most studies being small-scale and short-term, as seen in a 2021 randomized controlled trial published in Clinical hemorheology and microcirculation, which found no significant effect of nattokinase supplementation on subclinical atherosclerosis progression in healthy individuals at low risk for CVD 4. Recent studies have also explored the potential of nattokinase in preventing blood-brain barrier dysfunction in neurodegenerative disorders, with promising results in preclinical studies using experimental animals, as discussed in a 2025 review published in Brain research 5.

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This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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