Can Nattokinase Reverse Atherosclerosis?
In a Nutshell
Nattokinase, an enzyme from traditional Japanese fermented soybeans (natto), is linked to 25% lower cardiovascular mortality in observational studies and showed promising reversal of atherosclerosis in a 1-year study of 1,062 people taking 10,800 FU daily: carotid intima-media thickness dropped 21.7%, plaque area 36%, with improved lipids (triglycerides -15.7%, LDL -18.1%, HDL +15.8%). It works via anti-thrombotic (fibrin breakdown), anti-hypertensive (ACE inhibition, e.g., 5.6/2.8 mmHg BP drop in RCT), and antioxidant effects. Therapeutic dosing starts at 6,000 FU/day, well-tolerated up to 14,000 FU, making it a biologically plausible, accessible option for heart health.
These notes were generated by AI and may contain inaccuracies.
Summary of research on nattokinase, one of the most misunderstood and talked about supplements in heart health. Questions: What is it? Where does it come from? Can it reverse atherosclerosis? This enzyme from fermented Japanese soybeans has bold claims rooted in over a thousand years of tradition. Some studies link nattokinase to lower cardiovascular mortality, improved lipid markers, or reversal of arterial plaque. Data have limits and nuances. Video breaks down: what it is, how it works, research, dosing protocols. Check Stay Curious Metabolism newsletter for references, details, and five-ingredient heart health stack.
Four chapters:
- What natto is, origins, lore, link to decreased cardiovascular disease death.
- Human study suggesting nattokinase improves or reverses atherosclerosis.
- Mechanisms of nattokinase for cardiovascular health (anti-thrombotic, anti-hypertensive, antioxidant).
- Dosing protocols.
Natto is traditional Japanese fermented soybean made by fermenting soybeans with Bacillus subtilis bacteria. Consumption dates back about 1,000 years. Legend: 11th-century samurai Minamoto no Yoshi's troops boiled soybeans for horses, were attacked, packed beans in straw bags, fled; beans fermented naturally. They tried them, natto was born.
Natto intake associated with longer life, lower rates of cardiovascular disease and related death. Study: 29,000 participants followed 16 years tracking cardiovascular mortality. Highest quartile of natto consumption vs. lowest: 25% lower risk of dying from cardiovascular disease. Observational study, possible healthy user bias, but no significant associations with total soy protein or other soy foods. Signal specific for natto.
Nattokinase: enzyme produced during fermentation by Bacillus bacteria, thought to have cardioprotective properties.
Study: 1,062 participants, 10,800 units nattokinase per day for 1 year. Measured carotid intima-media thickness (IMT) and carotid plaque surface area via ultrasound. After 12 months: carotid IMT decreased 21.7%, plaque surface area decreased 36%.
Lipid changes: triglycerides down 15.7%, LDL down 18.1%, HDL up 15.8%.
Not a randomized controlled trial (RCT); no control group, compared to baseline. Confounding variables possible, but promising, especially as widely available supplement.
Authors noted inconsistent prior studies (including RCTs) used lower doses, e.g., 2,000 units vs. 10,800 units here.
Focus on three: anti-thrombotic, anti-hypertensive, antioxidant.
Anti-Thrombotic Effects
Thrombus: blood clot blocking nutrient/oxygen delivery, causing infarction (e.g., heart attack, stroke). Driven by coagulation cascade: chain reaction activating factors leading to fibrin activation. Fibrin forms mesh trapping platelets into stable clot.
Nattokinase has natural fibrinolytic activity: directly breaks down fibrin, dissolves clots. Also alters tissue plasminogen activator (tPA) activity and plasminogen activator inhibitor-1 (PAI-1) levels; reduces platelet aggregation.
Summary: degrades fibrin mesh, modulates regulatory enzymes, lowers clot risk.
Renin-angiotensin system: Kidneys release renin, acts on liver angiotensinogen to form angiotensin I. Angiotensin-converting enzyme (ACE, mainly lungs) converts to angiotensin II, which constricts vessels, promotes kidney sodium/water retention, raising blood pressure.
ACE inhibitors (e.g., lisinopril, enalapril) target ACE.
Nattokinase inhibits ACE, reducing vascular resistance, blood pressure, arterial stress.
RCT: 2,000 units nattokinase daily vs. placebo. Reductions: systolic BP 5.6 mmHg, diastolic 2.8 mmHg. Comparable to DASH diet.
Reduces oxidative stress: reactive oxygen species overwhelm antioxidants, damaging lipids/proteins/carbs, causing inflammation, vessel dysfunction.
Nattokinase upregulates key antioxidants, prevents LDL oxidation, protects vascular endothelium.
Studies use wide dose range. Recommend at least 6,000 fibrinolytic units (FU) per day for therapeutic effect. Lower doses (e.g., 2,000 FU RCT) show some benefits, but inconsistent; higher doses may add benefits. Limited by cost, not toxicity.
Well-tolerated up to 14,000 FU/day in humans; no toxicity. Rat studies toxic at human equivalent ~13.4 million units.
For brands and five-ingredient heart health stack, check Stay Curious Metabolism newsletter.
Nattokinase: real biological plausibility, encouraging data from observational studies to RCTs, mechanisms including clot breakdown, blood pressure regulation, oxidative stress reduction. Not a miracle or definitive proof it reverses heart disease, but surprisingly promising for widely available enzyme from ancient fermented bean.
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