Nattokinase dissolves blood clots by directly hydrolyzing the fibrin and plasmin substrate. It converts endogenous prourokinase to urokinase (uPA). It also degrades the plasminogen activator inhibitor (PAI-) and increases the level of the tissue plasminogen activator (tPA). Taking nattokinase together with medications that also slow down blood clotting may increase the risk of bruising and bleeding.
Since then, the enzyme responsible for natto's health effects, nattokinase, has been extensively purified and studied. Nattokinase keeps blood flowing optimally and promotes cardiovascular health. According to research on this powerful enzyme, it can lower blood pressure3,4, help reduce the risk of atherosclerosis, 5,6, help lower lipids7, promote optimal blood flow thanks to its anticoagulant properties,8 and can even be neuroprotective.9 With a single compound, the list of benefits is impressive. Nattokinase dissolves blood clots through the process of fibrinolysis (dissolution of fibrin). Additional benefits include lowering blood pressure, reducing atherosclerosis, and inhibiting platelet aggregation.
Because of the multiple beneficial cardiovascular effects, nattokinase can be used in the prevention and treatment of cardiovascular diseases. In the present study, nattokinase extracted from fermented soybeans showed excellent antiplatelet and antithrombotic activities in vitro and in vivo. Therefore, it follows that the effects of nattokinase are similar to those of aspirin, a well-known blood flow enhancer that exerts its effect through both mechanisms. Later, plasmin dissolves fibrin, and nattokinase increases this process by increasing the conversion of prourokinase to urokinase.
However, it is not clear whether part of the nattokinase proteins are absorbed in the gastrointestinal tract undigested or if the compound contains ingredients other than the intrinsic fibrinolytic mechanisms that activate nattokinase. Nattokinase combined with red yeast rice, but not nattokinase alone, has potent effects on blood lipids in humans with hyperlipidemia. Although other exact mechanisms of action have not yet been clarified, it is suggested that nattokinase could be a functional and healthy food to improve blood flow. Animal studies have shown that nattokinase can significantly reduce the increase in fibrinogen seen after a stroke and the severity of the stroke.
The result indicates that nattokinase also attenuates inflammation-induced vascular thrombosis, in addition to the effects on thrombosis mediated by oxidative lesions in the present study. Nattokinase enhances the preventive effects of Escherichia coli Nissle 1917 on dextran-induced sodium sulfate-induced colitis in mice. Unlike other anticoagulants, such as aspirin, which only decrease the tendency to form blood clots, nattokinase acts on both sides of the coagulation cascade. It was also observed that nattokinase can limit the area of acute stroke and preserve surrounding brain tissue.
The benefits of nattokinase are likely due to the combined effect of nattokinase's ability to promote healthy blood clotting, its antioxidant properties, and its ability to maintain lipid health.