Does 4000 units of nattokinase have any anticoagulant (blood thinning) effects?

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Last updated: April 30, 2025View editorial policy

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From the Research

Yes, 4000 units of nattokinase does have blood-thinning effects, which can increase the risk of bleeding when combined with other anticoagulants or antiplatelet agents, such as warfarin, apixaban, or aspirin. Nattokinase is an enzyme derived from natto (fermented soybeans) that can affect blood clotting by dissolving fibrin, a protein involved in blood clot formation. At a dose of 4000 units, which is considered a moderate to high dose, nattokinase may significantly inhibit blood coagulation and promote fibrinolysis (the breakdown of blood clots) 1. This blood-thinning effect is why nattokinase is sometimes used as a natural alternative to conventional anticoagulants. However, the combination of nattokinase with other anticoagulants or antiplatelet agents can increase the risk of bleeding, as seen in studies that evaluated the safety and efficacy of combining warfarin with dual antiplatelet therapy (ie, triple antithrombotic therapy) 2, 3, 4.

Some key points to consider when taking nattokinase include:

  • Discontinue nattokinase at least two weeks before any surgical procedure to reduce bleeding complications
  • Consult with your healthcare provider before taking nattokinase supplements, especially if you have any bleeding disorders or are planning to undergo surgery
  • Monitor your bleeding risk and adjust your treatment plan accordingly, as the combination of nattokinase with other anticoagulants or antiplatelet agents can increase the risk of bleeding
  • Be aware of the potential interactions between nattokinase and other medications, such as warfarin, apixaban, or aspirin, and adjust your treatment plan accordingly 1.

It's also important to note that the evidence on the safety and efficacy of nattokinase is limited, and more research is needed to fully understand its effects on blood clotting and bleeding risk. However, based on the available evidence, it's clear that nattokinase can have blood-thinning effects and should be used with caution, especially when combined with other anticoagulants or antiplatelet agents.

Professional Medical Disclaimer

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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