What if I told you that the number one killer in the world might have a surprising opponent, not from a high-tech lab, but from a traditional Japanese breakfast food? It sounds almost too good to be true, but a growing body of research is pointing toward an enzyme called nattokinase as a powerful agent in the fight against cardiovascular disease. For decades, we’ve been told that clogged arteries are a one-way street; you can slow the process, but you can’t really go back. But some compelling studies are challenging that long-held belief.
Atherosclerosis, the hardening and narrowing of your arteries, is a silent and relentless process. It’s like rust slowly building up inside the pipes of your house, until one day, the pressure builds, and something bursts. In your body, that burst is a heart attack or a stroke. While modern medicine, particularly statin drugs, has been invaluable in slowing this process down, it has never offered a true reversal. But today, we’re going to talk about something that might. We’ll explore the science behind nattokinase, look at the studies that have researchers buzzing, and discuss what it could mean for your heart health.
Key Takeaways
- Atherosclerosis is the dangerous buildup of fatty deposits, or plaque, in your arteries, which can lead to heart attacks and strokes.
- Standard treatments like statins are effective at slowing down plaque growth by lowering cholesterol but are not designed to significantly reverse existing plaque.
- Nattokinase is a natural enzyme derived from natto, a traditional Japanese food made from fermented soybeans. It is known for its powerful ability to break down blood clots.
- Remarkable human studies have shown that nattokinase may significantly reduce the size of arterial plaque. One study found it reduced plaque by over 36% in just six months.
- The dosage of nattokinase appears to be critical. Studies using higher doses (6,000 FU or more) have shown significant benefits, while studies with lower doses have not.
- While promising, nattokinase has blood-thinning effects and should only be considered after a thorough discussion with your healthcare provider, especially if you are on other medications.
1. What Exactly Is Atherosclerosis (And Why Is It So Dangerous)?
Before we can understand the solution, we need to get a clear picture of the problem. Think of your arteries as busy highways that transport oxygen-rich blood from your heart to every part of your body. In a healthy person, these highways are wide open and smooth. Atherosclerosis is what happens when roadblocks, called plaques, start to form along the walls of these highways.
This plaque isn’t just one substance; it’s a messy combination of cholesterol (specifically LDL or “bad” cholesterol), fats, cellular waste, calcium, and a clotting material called fibrin. The process often starts when the inner lining of an artery, the endothelium, gets damaged—perhaps by high blood pressure, smoking, or high blood sugar. Your body sends in immune cells called macrophages to clean up the cholesterol that gets stuck at the damage site. But sometimes, the macrophages get overwhelmed, eat too much cholesterol, and become what are known as “foam cells.” These foam cells get trapped in the artery wall, die, and spill their contents, creating more inflammation and attracting even more immune cells. This vicious cycle is what builds the plaque, which grows larger and harder over years, narrowing the highway for blood flow.
The real danger comes when one of these plaques becomes unstable and ruptures. Your body sees the rupture as an injury and rushes to form a blood clot to patch it up. But this clot can completely block the already narrowed artery, cutting off blood flow. If this happens in an artery supplying the heart, it causes a heart attack. If it happens in an artery leading to the brain, it causes a stroke.
2. The Limits of Conventional Treatments
For the last few decades, the primary strategy for fighting atherosclerosis has been to lower LDL cholesterol. The main tool for this has been a class of drugs called statins. And to be clear, statins have saved countless lives. By reducing the amount of cholesterol your liver produces, they lower the amount of LDL cholesterol circulating in your blood. This effectively reduces the amount of material available to build new plaque and can slow down the growth of existing plaque.
However, statins are a strategy of containment, not reversal. While they are excellent at slowing the progression of the disease, they don’t do much to remove the plaque that’s already there. The best-case scenarios in major clinical trials show that intensive cholesterol-lowering therapy might, in some patients, achieve a plaque regression of around 10-15%. That’s certainly better than nothing, but it’s far from a cure. The disease still progresses, albeit more slowly, and people are still at risk. This has left researchers searching for something that can actively break down and remove the existing, dangerous plaque.
3. Enter Nattokinase: The Enzyme from Fermented Soybeans
This brings us to natto, a food that has been a staple in Japan for centuries. Natto is made by fermenting soybeans with a specific bacterium, Bacillus subtilis natto. It has a very strong smell and a sticky, stringy texture that many people outside of Japan find to be an acquired taste. But hidden within this unique food is a powerful enzyme called nattokinase.
Nattokinase was discovered in the 1980s by Dr. Hiroyuki Sumi, who was looking for a natural agent that could dissolve blood clots. He found that when he dropped a small amount of natto onto an artificial blood clot in a petri dish, the clot completely dissolved in a matter of hours. The enzyme responsible, which he named nattokinase, has potent “fibrinolytic” properties. This means it is exceptionally good at breaking down fibrin, the fibrous mesh that forms the backbone of a blood clot. Because of this, it has been studied for its potential to support circulation and prevent dangerous clots.
4. The Shocking Study: Nattokinase vs. Statins
While its clot-busting ability was well-known, a 2017 study published in the Chinese Journal of Medicine put nattokinase on the map for a different reason: plaque reversal. Researchers conducted a 26-week clinical trial with 76 patients who had atherosclerotic plaque in their carotid arteries (the main arteries in your neck that supply blood to the brain).
The patients were randomly divided into two groups. One group took a daily statin (20 mg of simvastatin), the standard of care. The other group took a daily dose of nattokinase (6,000 FU, or fibrinolytic units, which is a measure of its enzyme activity). The results were stunning. Both groups saw a reduction in plaque size, but the difference was dramatic. The statin group experienced an 11.5% reduction in plaque size. The nattokinase group, however, saw an average plaque reduction of 36.6%.
That’s more than triple the effect of the statin. The nattokinase group also saw improvements in their blood lipid profiles, including a drop in triglycerides and LDL cholesterol and a rise in HDL (“good”) cholesterol. A result this profound from a simple, natural supplement was almost unheard of and certainly warranted a closer look.
5. Does Dosage Matter? A Tale of Two Studies
As with many supplements, the amount you take can make all the difference. The promising results of the 2017 study used a relatively high dose of 6,000 FU per day. This is important because other studies using lower doses have not found the same benefits. For example, a 2023 trial led by Dr. Howard Hodis studied the effect of 2,000 FU of nattokinase per day and concluded that it had a “null effect” on the progression of atherosclerosis.
However, a more recent and larger study from 2022 by Chen et al., published in Frontiers in Cardiovascular Medicine, seems to confirm the dose-dependent effect. This year-long study involved over 1,000 patients and used an even higher dose of 10,800 FU per day. The results were once again remarkable. Participants saw their total plaque area decrease by an average of 36.9%, mirroring the results of the earlier high-dose study. They also experienced significant improvements in their cholesterol profiles, with LDL cholesterol dropping by over 18% and HDL cholesterol increasing by nearly 15%. The takeaway here is clear: when it comes to nattokinase and plaque, dosage matters. The lower doses that might be found in some supplements may not be sufficient to produce these therapeutic effects.
6. How Might Nattokinase Work to Reduce Plaque?
The exact mechanism by which nattokinase reduces plaque is still being investigated, but there are several leading theories. Its primary fibrinolytic action is likely a key factor. Atherosclerotic plaques are stabilized by a fibrous cap that contains a lot of fibrin. By directly breaking down this fibrin, nattokinase may help to dissolve the structural framework of the plaque, allowing the body’s own repair systems to clear away the debris.
Furthermore, the studies show that nattokinase does more than just work on the plaque itself. It also improves blood lipid profiles by lowering LDL and triglycerides while raising HDL. This reduces the raw materials available for plaque formation. It also has known anti-inflammatory and antihypertensive effects, addressing other key factors that contribute to the development of atherosclerosis. It appears to work on multiple fronts, creating an overall environment that is less conducive to plaque and more conducive to healing.
7. Important Considerations and Cautions
After hearing these results, you might be tempted to rush out and start taking nattokinase. However, it’s crucial to approach this with caution and knowledge. First and foremost, nattokinase has significant blood-thinning effects. This is part of how it works. Because of this, you should never take it alongside prescription blood thinners like warfarin, Eliquis, Xarelto, or even daily aspirin without the explicit guidance and supervision of your doctor. Combining them could increase the risk of serious bleeding.
Second, remember that these are still relatively new findings, and more research is needed to confirm the results and understand the long-term effects. The quality of supplements can also vary widely, so ensuring you are getting a reputable product with a clearly stated FU activity is essential. As with any change to your health regimen, the most important step is to have a conversation with a trusted healthcare professional who understands your personal health history. They can help you determine if nattokinase is a safe and appropriate option for you to consider.
Conclusion
The evidence surrounding nattokinase and its ability to reverse atherosclerotic plaque is one of the more exciting developments in cardiovascular health in recent years. It challenges the old paradigm that clogged arteries are a permanent condition. While conventional treatments like statins remain a critical part of managing heart disease risk, nattokinase presents a potential complementary approach that may actually help to clean out existing plaque, not just slow its growth.
This is not a magic bullet, and it’s not a replacement for a healthy lifestyle of good diet and regular exercise. But it is a powerful example of how compounds found in nature can sometimes offer profound health benefits that rival or even exceed those of pharmaceuticals. As research continues, we will learn more, but for now, nattokinase stands as a beacon of hope in the fight against our most persistent killer.
Sources
- Chen, H., Chen, J., Zhang, F., Li, Y., Wang, R., Zheng, Q., Zhang, X., Zeng, J., Xu, F., & Lin, Y. (2022). Nattokinase improves blood lipids and atherosclerotic plaque in patients with hyperlipidemia. Frontiers in Cardiovascular Medicine, 9, 964977. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9441630/
- Ren, Y., Zuo, H., Ma, F., Li, S., & Liu, J. (2017). [A clinical study on the effect of nattokinase on carotid artery atherosclerosis and hyperlipidaemia]. Zhonghua yi xue za zhi, 97(26), 2038–2042. (Abstract in English)
- Weng, Y., Yao, J., Wang, S., & Zhang, Y. (2017). Nattokinase: A Promising Alternative in Prevention and Treatment of Cardiovascular Diseases. Biomarker Insights, 12, 1177271917725024. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5569271/
- Hodis, H. N., Mack, W. J., & Kono, N. (2023). Nattokinase for prevention of subclinical atherosclerosis and cognitive decline: a randomized controlled trial. Scientific Reports, 13(1), 19089. https://www.nature.com/articles/s41598-023-46286-5