Nattokinase

Nattokinase is available in capsule or film-coated tablet form for easy oral administration. 

The gastro-resistant capsules are designed to pass through the gastric barrier and release the active substance directly into the intestine, where absorption is optimal. This formulation prevents the enzyme from being broken down in the acidic gastric environment and ensures increased bioavailability.

For example, Nattokinase 2000 FU from Zenyth, 30 gastro-resistant capsules, provides 100 mg of nattokinase per capsule, equivalent to 2000 fibrinolytic units (FU), and is intended to maintain normal blood circulation and reduce the risk of thrombosis, stroke, and other vascular complications.

Manufacturers - Nattokinase Secom, Herbagetica, Swanson, Doctor Life, etc.

Nattokinase is recommended as an adjuvant in numerous chronic and acute conditions, especially cardiovascular or inflammatory in nature:

• Deep vein thrombosis;
• Coronary artery disease, hypertension;
• Ischemic stroke (post-stroke recovery);
• Hemorrhoids, varicose veins, chronic venous disease;
• Nasal polyps, poor cerebral or ocular circulation;
• Endometriosis, fibromyalgia, chronic fatigue syndrome;
• Atherosclerosis and hyperlipidemia;
• Adjuvant in neurodegenerative diseases (Alzheimer's, dementia);
• Post-operative and post-traumatic recovery.

In general, the usual dose for adults is 1 capsule per day (2000 FU), taken between meals. 

The recommended duration of treatment varies depending on the doctor's recommendation, but can be extended to 2-3 months, with breaks between cycles. 

Nattokinase is contraindicated in the following situations:

• Allergy to soy or any of the product's excipients;
• Coagulation disorders (e.g., hemophilia, von Willebrand disease);
• Active hemorrhagic ulcers;
• History of spontaneous bleeding;
• Before or immediately after surgery (at least 3 days before/after).

The product should be administered with caution:

• in patients taking oral anticoagulants or antiplatelet agents (heparin, warfarin, aspirin);
• in the presence of advanced liver or kidney disease;
• in combination with supplements that have anticoagulant effects.

It is important to monitor for signs of bleeding (spontaneous bruising, gingival bleeding, epistaxis) and to discontinue administration if they occur.

Nattokinase is generally well tolerated, but the following may occur:

• Prolonged bruising or bleeding
• Mild gastrointestinal disorders (nausea, abdominal discomfort)
• Allergic reactions in patients with hypersensitivity 
• Dizziness or hypotension (rare, when administered concomitantly with antihypertensive drugs).

Nattokinase may influence the effect of certain drugs such as:

• Warfarin, heparin, clopidogrel, dabigatran
• Aspirin in prophylactic doses
• Other fibrinolytic enzymes 
• Antihypertensive drugs

Although there have been no documented cases of overdose with nattokinase at usual doses, excessive administration may increase the risk of bleeding. Symptoms may include:

• Extensive and painful bruising;
• Epistaxis (nosebleeds);
• Hematuria (blood in the urine);
• Melaena (dark stools due to digested blood).

If overdose is suspected, administration should be discontinued and emergency symptomatic treatment instituted.

Nattokinase should be stored in its original packaging, tightly closed, in a dry place, away from direct light and heat sources, at room temperature, below 25°C. Keep out of reach of children. Observe the expiry date printed on the packaging.

• WebMD, Nattokinase
• PubMed, Nattokinase: A promising alternative in the prevention and treatment of cardiovascular disease
• MDPI, Nattokinase: Perspectives on biological activity, therapeutic applications, and the influence of microbial fermentation
• ScienceDirect, Nattokinase as a functional food ingredient: therapeutic applications and mechanisms in age-related diseases