Supplement
Nattokinase
Real blood pressure effects in meta-analysis; a big null trial keeps it honest.
Nattokinase is a serine protease enzyme produced during the fermentation of soybeans into natto, a traditional Japanese food. We grade Nattokinase B- on evidence and B- for worth-it at about $10-20 per month.
Evidence
Worth it
Typical cost: $10-20/month
What it does
Nattokinase is a serine protease enzyme produced during the fermentation of soybeans into natto, a traditional Japanese food. It has fibrinolytic activity, meaning it helps break down fibrin, a protein involved in blood clotting. It is marketed for circulation and cardiovascular support.
What the research says
Lowers blood pressure
Evidence: moderate. A 2023 meta-analysis of 6 RCTs (546 participants) found nattokinase significantly reduced systolic BP by 3.45 mmHg and diastolic by 2.32 mmHg versus placebo. However, a larger 265-person, 3-year double-blind trial (Hodis et al.) found no significant effect on blood pressure or atherosclerosis progression in healthy low-risk individuals.
Reduces atherosclerosis progression
Evidence: weak. One 1,062-person study reported a 21.7 percent reduction in carotid intima-media thickness after 12 months, but the rigorous 3-year Hodis trial found null effects on CIMT and carotid stiffness. The two studies conflict directly.
Improves lipid profiles
Evidence: weak. The 2023 meta-analysis actually found nattokinase raised total cholesterol and LDL versus placebo at lower total doses, the opposite of what marketing claims. No triglyceride effect was found.
The blood pressure meta-analysis is real and methodologically decent, which earns the B-. But the null result from the largest, longest trial is a serious counterweight, and the cholesterol finding goes the wrong way. B- reflects genuinely mixed evidence, not a clear win.
What the experts say
Every position links to its source. We include skeptics alongside supporters.
Peter Attia
Specific position on nattokinase not verified.
Is it worth it?
Derived from the October 2026 worth-it model: B- evidence at about $15 a month, targeted applicability, scored as evidence squared over the square root of cost.
Typical cost
$10-20/month
Common form, not a brand recommendation
Dosage contextemerging
Standard clinical dose is 100 mg (2,000 FU) per day. The European Food Safety Authority has reported no adverse effects at this dose in short-term studies.
Safety notes
Has fibrinolytic activity and can interact with warfarin, aspirin, and other anticoagulants or antiplatelets. Stop before surgery. Avoid with bleeding disorders, and during pregnancy or breastfeeding. No notable adverse events in trials, but the interaction profile demands clinician involvement.
Longevity Lab Report
Nattokinase news, graded when it happens.
The grade on this page stays free. The reporting goes further in the email: new studies, dose debates, and expert shifts on nattokinase, including stories that never get posted here.
Frequently asked questions
Is Nattokinase safe?
Has fibrinolytic activity and can interact with warfarin, aspirin, and other anticoagulants or antiplatelets. Stop before surgery. Avoid with bleeding disorders, and during pregnancy or breastfeeding. No notable adverse events in trials, but the interaction profile demands clinician involvement.
What is the right dose of Nattokinase?
Standard clinical dose is 100 mg (2,000 FU) per day. The European Food Safety Authority has reported no adverse effects at this dose in short-term studies.
Is Nattokinase worth taking?
We grade Nattokinase B- for worth-it at a typical cost of $10-20 per month. Derived from the October 2026 worth-it model: B- evidence at about $15 a month, targeted applicability, scored as evidence squared over the square root of cost.
Changelog
Last updated 2026-10-17
- 2026-10-16|New DRAFT entry, batch 4.
- 2026-10-17|Applicability assigned (targeted) for the worth-it leaderboard methodology update of 2026-10-17.
- 2026-10-17|Worth-it grade derived from the October 2026 worth-it model (same gated model as the leaderboard); applicability recorded for all records.