Saturday, May 15, 2010

Nattokinase Revisited

I had one of my regular meetings with Doc Davis of Track Your Plaque book and website fame today where he remarked about a patient he encountered that nearly died of a pulmonary embolism after going off prescription anti-thrombotic medicine in favor of nattokinase.

Doc Davis has been a critic of nattokinase and endured the slings and arrows of its promoters and those statistical "n of one" users who swear by it. (Interesting to note that Doc Davis is part Japanese and is not without experience with natto as a food his mother made him eat - childhood trauma perhaps? LOL!).

I was curious enough to take a look at the debate on his blog and do a little of my own research. As most readers of my blog know I am a "numbers" guy. Normally, the ridiculous bloviating and hyperbole I found on some sites pushing nattokinase would be enough to turn me off but just because "bad" people say "good" things about a product does not preclude it from actually being good! On the other hand, there is some pretty damning science against the concept that nattokinase works (the small problem of any protein surviving the gut) as well as common sense that suggests if it did work it may be a dangereous way to self-medicate (at least with a prescription drug like Coumadin you are under supervision by a doctor).

For better or worse I decided to go to my trusted sources at PubMed and look at some of the more recent studies to see if there is anything new that supported casual and chronic oral adminstration of nattokinase to prevent heart disease. Here is what I found in a highly summarized (and editorialized) form so as not to induce boredom (use the links for more info).

Bioproperties of potent nattokinase from Bacillus subtilis YJ1.
Yup, nattokinase is still fibrinolytic - if it gets into the blood stream.

Purification and Characterization of Nattokinase from Bacillus subtilis Natto B-12
Now if we could only get this stuff to work orally as a functional food!

Combined nattokinase with red yeast rice but not nattokinase alone has potent effects on blood lipids in human subjects with hyperlipidemia
Nattokinase does not appear to exert its effects (if any) via lipids.

Enhancement of oxidative stability of the subtilisin nattokinase by site-directed mutagenesis expressed in Escherichia coli
Hey, we are getting closer to at least limiting oxidative degradation - still no panacea.

Purification, immobilization, and characterization of nattokinase on PHB nanoparticles
Nanoparticles are all the rage these days and may have some utility with stabilizing nattokinase but still no oral in vivo data.

Nattokinase decreases plasma levels of fibrinogen, factor VII, and factor VIII in human subjects
Now we're talking - hard data with oral nattokinase in humans! Unfortunately, this was an open-label, self-controlled sudy with 45 people (15 in each arm). Can you imagine trying to get a prescription drug past the FDA with a study like this? Still, at least SOMETHING for proponents to hang their hats on.

Effects of nattokinase on blood pressure: a randomized, controlled trial
Hey, hey! More human data and this time randomized, controlled, and with almost twice as many participants as the previous study. Too bad the end point was blood pressure data - but it did show improvement.

Effect of nattokinase on restenosis after percutaneous transluminal angioplasty of the abdominal artery in rabbits
Reminds me of Judah Folkman's comment when the media overhyped his results and declared he had cured cancer, "If you are a mouse and you have cancer we can take good care of you!" Lucky rabbits!

Cerebellar hemorrhage provoked by combined use of nattokinase and aspirin in a patient with cerebral microbleeds
Oh yeah, just when you thought everything was rosy this booger shows up. Just because something is not classified as a drug by the FDA does not mean it is safe for general use. First Doc Davis relates a story about nattokinase putting a patient at risk because id did not bust a clot and now here is someone who "over-busted!"

Nattokinase-promoted tissue plasminogen activator release from human cells
More geek science. Yeah, if you get it in the blood nattokinase has numerous effects. So do a lot of chemicals!

The fibrinolytic activity of a novel protease derived from a tempeh producing fungus, Fusarium sp. BLB
Here is an even more powerful natural product. Should everyone abandon nattokinase and rush out to buy tempeh - the next wonder supplement?

Here is what (I think) we know.

1. Nattokinase exhibits lytic effects in vitro.
2. It MAY have some effect taken orally in vivo.
3. If it does work no one knows the mechanism of action for certain. Consider this, maybe it is some component or action OTHER than the lytic effect seen in vitro. Why take the risky components to enjoy the effective components?
4. There is a tiny amount of evidence for nattokinase taken orally but certainly nothing conclusive.
5. There is absolutely NO safety data on it other than small study and anecdotal experience. Remember torcetrapib the wonder HDL drug? I couldn't wait for it to hit the market so I could take it! It did everything Pfizer said it would - then downstream the data showed it killed more people than it saved. No way would nattokinase be FDA approved based on existing HARD data.

It seems what we have in nattokinase is an interesting agent - but nothing more. Since it is unregulated we are all free to experiment (and I experiment plenty). But don't kid yourself - it is nothing more than an experiment with an unknown outcome! "Natural supplement" does not equal "safe" any more than "drug" equals "effective!"

As always, I remain a fan of Informed, Self-directed, Healthcare (ISH). But, stay informed, remain a skeptic, and play safe!

Looking out for your heart health,



Chuck said...

The thing about Dr Davis' post was he never said the patient "went off" his prescription in favor of Nattokinase. The doctor's blog commenters are all confused by his post.

Harry said...

HH, I use MK-7 from nattokinase to balance the warfarin I take for DVT. Because MK-7 is a form of vitamin K2, it tends to reduce the effects of warfarin, which is a vitamin K antagonist. I find that I can fine-tune my INR by varying the amount of MK-7 that I'm taking, and INR seems to be more stable when doing that than trying to fine-tune INR by varying the warfarin dose. My Doctor says that my INR is more stable than any of his other patients, and I attribute that to taking both warfarin and MK-7, and avoiding all other sources of vitamin K. The typical problem with keeping a constant INR while on warfarin is the varying dietary vitamin K intake that most people experience when they don't monitor their diet closely.

Maybe nattokinase has other effects on coagulation proteins besides the vitamin K it contains, but MK-7 from natto is a warfarin antagonist that promotes coagulation in a patient on warfarin and thus can't be a substitute for warfarin.

PS - glad to see you are doing more blogging these days.


HeartHawk said...


Good to hear from you. Yeah, it all works together - but differently for each of us! I think you will find me blogging much more regularly again!


Dr. William Davis said...

Great summary, Heart Hawk.

My beef with nattokinase is not about small effects, it is the notion that people can treat their life-threatening deep vein thromboses or pulmonary emboli with it.

I've had people ask: Should I stop my warfarin and take natural nattokinase instead? That is the situation that the sellers of nattokinase have created, one that has potential for real harm, including death.

Chuck--The patient was not taking warfarin, only nattokinase, when his pulmonary embolus developed.

Association Management said...

Well I think that Nattokinase should not be used by people who suffer from bleeding disorders, or by people who are taking Coumadin.

Anonymous said...

I have been told to take Neprinol a magnesium & nattokinase based naturopathic supplement. The preescriber suggested it has had terific effects in ridding plaque from patients. I am trying this to see what it will do for my recently elevated scan score. Also checking thryroid and more...

wholesaleherbs said...

Nattokinase - Nattokinase Products are good source of protein and vitamin B2, which keeps your skin young.

Daniel Taylor said...

Thanks for sharing this blog..but i think one professional doctor can give more details regarding

viagra online said...

what? you had a meeting with Doc Davis of Track Your Plaque book?? wow you are so lucky, it must have been such an amazing experience!!!

term papers sale said...

Still not clear, what is the right dosage to take? I'm reading it's 100 mg a day. Can more be taken?

nanduut said...

We have Nattokinase. This Products are essential and good source of protein and vitamin B2.It keeps your skin young.

Learn about Nattokinase said...

Through our program, we are offering bike racks, complete with installation, for $75. For public spaces and qualifying nonprofit organizations, this fee will be waived.


What difference does it make whether you take a pharmaceutical drug or a possible safer alternative? Just because pharmaceuticals are "FDA APPROVED" does not make them a safe choice, and when you weight some of the side effects compared to alternatives it makes you think. People should be giving a choice as to how they want to treat their health without being judged by narrow minded doctors. They give you one drug which creates a side effect so they prescribe another drug and another and another, it's a vicious cycle especially for the elderly who may not have an advocate to monitor their consumption of drugs. If doctors offered patients more safer alternatives and educated themselves to treat the patient as a whole and not a symptom then patients would have more trust in their doctors. There is no such thing as a pharmaceutical deficiency yet there are plenty of nutritional deficiencies that can cause major illness, so let's find out what the deficiency is before we apply a pharmaceutical band aid to it. My husband was on Plavix before having an allergic reaction, was then put on Effient, both have the potential to cause a major bleed which can lead to death, oh how comforting is that? My husband is an auto mechanic who has gotten his share of injuries over the years, the most recent one was quite scary where a car lift fell on his hand crushing it, causing broken fingers, wrist, and multiple stitches, ER doctor had to drill holes in 3 of his finger nails to relieve the pressure from the blood that was building up. My husband bled for hours....... the cardiologist on duty that night when I called for some kind of reassurance basically told me, "well, no one ever bled to death from a cut hand", gee thanks. So after this incident don't you think
we would want to find a safer alternative?

Anonymous said...

And just how the hell do you think "bike racks" and "public spaces" relates to B12, nattokinase, and artery health!? Man, youre STUPID! Why not talk about discount "bathing suits" while you're at it!? STUPID!

Anonymous said...

Yeah, theres always some stupid "nimby-wad" out there advertising weird stuff like "used car batteries" on health topic blog sites. Stupid!

Dr. Mark Debrille said...

When Dr. Davis first started trying to debunk nattokinase, he said it couldn't possibly work -- it was "nonsense", because...

"Any oral fibrinolytic agent is promptly degraded in the highly acid environment of the stomach. That's why all medically used fibrinolytics are given intravenously. Drug companies have struggled for years to encapsulate, modify, or somehow protect protein (or polypeptide) products taken orally from degrading this way. They've never succeeded."

Then three years later, he posts the story of his patient who experienced a potentially life-threatening blood clot, he says because he was taking nattokinase.

But how could that be, if nattokinase is destroyed by stomach acid?

Sorry Dr. Davis, it doesn't wash.

Paul Smith said...

This article is useful, thank for sharing! Your title is appealing and attracts many visitors to post comments. I'm not sure why are you talking about saying that the nattokinase is destroyed by stomach acid... Regards, the high school and university writing scholarships

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