Nattokinase Dosage: Blood Clots, Hypertension and Arteriosclerosis

What is Nattokinase?

Nattokinase (NK) is an enzyme derived from a traditional Japanese food called natto, and it is thought to help lower cholesterol, reduce inflammation, and improve circulation. The enzyme is produced during natto’s fermentation process by a specific bacterium called Bacillus subtilis.

In 1980, Hiroyuki Sumi, a Japanese researcher at the Chicago University Medical School, discovered that natto can dissolve artificial fibrin [Source]. Sumi and his team extracted an enzyme from natto that not only degraded fibrin but also a plasmin substrate. He named this novel, fibrinolytic enzyme “nattokinase”  [Source].

Nattokinase Dosage for Blood Clots

Nattokinase dissolves blood clots by directly hydrolyzing fibrin and plasmin substrate. It converts endogenous prourokinase to urokinase (uPA). It also degrades plasminogen activator inhibitor (PAI-1) and increases the level of tissue plasminogen activator (t-PA). (Source)

Human trials have demonstrated that NattoKinase (NK) provides support to the circulatory system by thinning the blood and dissolving blood clots. (Source, Source)

In a randomized controlled trial (2015), a single-dose of 2,000 FU NK (NSK-SD, Japan Bio Science Laboratory Co., Ltd) appears to potentiate thrombolysis and anti-coagulation profiles.

In another 8-week randomized controlled trial (2016), subjects were given 8 weeks supply of either a placebo or a nattokinase. Nattokinase NSK-SD® (subtilisin NAT) was encapsulated in veggie caps with 100 mg/capsule and standardized to at least 2,000 fibrinolytic units (FU) per each 100 mg daily oral dose.  Subjects were instructed to take one capsule daily in the morning and to return the bottles with any remaining capsules at the 8-week visit.

The average level of vWF (Von Willebrand Factor) was reduced by 15% in the nattokinase group, whereas no consistent change was seen for the subjects consuming placebo for 8 weeks. The difference in vWF levels at 8 weeks between the two groups showed a statistical trend (P<0.09). This decrease in vWF levels was sex specific, as it was seen for the group of females consuming nattokinase (26% reduction, P<0.09) but not in the male group consuming nattokinase.

Note: There is no set recommendation for nattokinase, but studies suggest its health benefits come with an oral dose of 100 milligrams a day. Nattokinase 100 mg/day is equivalent to 2,000 fibrinolytic units [FU]).

Clinical studies to guide safe and effective nattokinase dosing are lacking. Nattokinase 100 mg/day (equivalent to 2,000 fibrinolytic units [FU]), typically for a duration of 8 weeks, has been used in some studies evaluating thrombolytic/fibrinolytic and blood pressure effects.

Nattokinase Dosage for Hypertension

In a randomized controlled trial (2008), 86 participants ranging from 20 to 80 years of age with an initial untreated systolic blood pressure (SBP) of 130 to 159 mmHg received nattokinase (2,000 FU/capsule) or a placebo capsule for 8 weeks.

The study concluded that nattokinase supplementation resulted in a reduction in blood pressure. These findings suggest that increased intake of nattokinase may play an important role in preventing and treating hypertension.

Nattokinase Dosage for Atherosclerosis

A study has also suggests that daily NK supplementation is an effective way to manage the progression of atherosclerosis and potentially may be a better alternative to statins which are commonly used to reduce atherosclerosis and further to prevent cardiovascular attack and stroke in patients.

In this clinical study (Chen 2022) involving 1,062 participants, the objective was to examine the efficacy of NK (nattokinase) in atherosclerosis and hyperlipidemia and safety at the dose of 10,800 FU/day (500 mg/day) after 12 months of oral administration. 

Authors found that NK at a dose of 10,800 FU/day effectively managed the progression of atherosclerosis and hyperlipidemia with a significant improvement in the lipid profile. The lipid-lowering effect of NK was more prominent in subjects who smoked, drank alcohol, and subjects with higher BMI. Regular exercise further improved the effects of NK. 

Co-administration of vitamin K2 and aspirin with NK produced a synergetic effect. In conclusion, the data demonstrate that atherosclerosis progression and hyperlipidemia can be effectively managed with NK at a dose of 10,800 FU/day. The lower dose of 3,600 FU per day might be ineffective. Some lifestyle factors and the co-administration of vitamin K2 and aspirin lead to improved outcomes in the use of NK. The findings provide clinical evidence on the effective dose of NK in the management of cardiovascular disease and challenge the recommended dose of 2,000 FU per day.

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