Nattokinase: Benefits and Side Effects
May 10, 2025
Source: Cainiu Health
Dr. Yu Yongchao
Introduction
Nattokinase is a protease extracted from natto, a traditional Japanese fermented food, and is produced through fermentation by Bacillus subtilis. Its core function is to dissolve blood clots, effectively improving blood circulation by breaking down fibrin, and it is often referred to as a natural anticoagulant. Due to its natural food origin and high safety profile, it is commonly used as a dietary supplement for the adjunctive prevention and treatment of cardiovascular and cerebrovascular diseases.
Under normal circumstances, the effects of nattokinase include thrombolysis, assisting in blood pressure regulation, improving atherosclerosis, promoting blood circulation, protecting nerves, and anti-aging. Side effects include bleeding risk, gastrointestinal discomfort and indigestion, allergic reactions, drug interactions, and risks for specific populations. Details are as follows:
I. Effects
1. Thrombolysis: Nattokinase directly degrades fibrin and activates plasminogen conversion to plasmin, enhancing the body's natural thrombolytic capacity. It also inhibits platelet aggregation factors, reducing the risk of thrombosis.
2. Assisting in blood pressure regulation: Nattokinase inhibits angiotensin-converting enzyme (ACE), reducing the production of vasoconstrictive substances, similar to the mechanism of certain antihypertensive medications. It improves vascular endothelial function, promotes nitric oxide release, and dilates blood vessels.
3. Improving atherosclerosis: Nattokinase reduces the deposition of oxidized low-density lipoprotein (ox-LDL) in vascular walls and inhibits foam cell formation. It lowers inflammatory factors and alleviates vascular inflammatory responses.
4. Promoting blood circulation: Nattokinase alleviates microcirculatory disorders, improves cerebral hypoperfusion-induced dizziness and memory decline, and relieves peripheral circulatory disorders in diabetic patients, such as hand numbness.
5. Nerve protection and anti-aging: Nattokinase degrades β-amyloid protein, a pathological marker of Alzheimer's disease, reduces oxidative stress, and minimizes neuronal damage, thereby exerting anti-aging and neuroprotective effects.
II. Side effects
1. Bleeding risk: Nattokinase directly degrades fibrin and activates plasminogen conversion to plasmin, which degrades fibrin and fibrinogen, weakening coagulation system function.
2. Gastrointestinal discomfort and indigestion: As a potent protease, nattokinase may degrade protective mucus proteins on the gastric mucosal surface, allowing gastric acid to directly irritate the stomach lining, causing bloating or pain.
3. Allergic reactions: Incomplete soybean fermentation may leave soybean antigens, triggering IgE-mediated type I hypersensitivity reactions. As a foreign protein, it may be recognized by the immune system as a foreign substance, activating mast cells to release histamine.
4. Drug interactions: Nattokinase inhibits angiotensin-converting enzyme, reducing angiotensin II production. When used in combination with ACE inhibitors such as enalapril, it may cause a sudden drop in blood pressure.
5. Risks for specific populations: Since nattokinase may cross the placental barrier and interfere with fetal coagulation factor synthesis, it affects the infant's coagulation system; therefore, it is contraindicated in pregnant women. Due to its fibrinolytic activity interfering with hemostasis at surgical wound sites, preventing stable clot formation and increasing postoperative bleeding risk, it is contraindicated in surgical patients.
As a natural thrombolytic agent, nattokinase shows potential in cardiovascular health. While it offers multiple health benefits, it also has several side effects closely related to its anticoagulant activity. It is recommended for use under medical supervision and should not replace standard antithrombotic therapy.
