Quick Facts

Dr. Marty Ross, MD
Dr. Ross's Expert Review
Nattokinase is an enzyme made by the bacterium that ferments soybeans into natto, a traditional Japanese food. Like lumbrokinase, it works on fibrin, the protein the body uses for clotting, and I reach for it for the same two reasons: the theory of biofilms and sticky blood.
On biofilms: germs hunker down in slimy layers held together in part by fibrin protein. In theory, an enzyme that breaks down fibrin loosens that structure. No study proves this happens in tick-borne illness; that is theory plus my clinical observation.
On sticky blood: in some chronic health situations, small fibrin deposits can collect on blood vessel linings and slow flow through the smallest vessels. Nattokinase is studied in lab and human research for its fibrinolytic activity, meaning its effects on fibrin, and it is the more affordable enzyme option I keep in mind.
Two practical points. First, this one is made with NSK-SD, the patented nattokinase ingredient, and it is free of vitamin K2. That matters to me because K2 pushes clotting chemistry the other way, and I do not want it mixed into enzyme work. Second, it is a soy-derived product; the softgel carries soybean oil and lecithin, so it is not for anyone avoiding soy.
Work with your physician on where this fits in a full regimen.
How I Use It in My Practice
I use nattokinase as the gentler, lower-cost enzyme option when someone needs ongoing fibrin support. My usual approach is 1 softgel once or twice a day with a full glass of water, away from food, an hour apart from meals, supplements, and medicines on both sides. When someone needs more fibrin work than nattokinase delivers, I move to lumbrokinase instead of stacking doses. It does not belong in anyone with a bleeding condition, and anyone on anticoagulants needs their prescribing physician in the room on this decision.
The Research, in Dr. Ross's Words
The research on nattokinase centers on fibrin and clotting chemistry. The largest human study I have seen is a 2022 clinical study with 1,062 participants that looked at nattokinase in atherosclerosis and high lipids and reported changes in the progression markers it measured. A 2023 systematic review and meta-analysis of randomized controlled trials pooled the data on cardiovascular risk factors. A 2017 review made the case for nattokinase as an oral antithrombotic candidate, and a 2024 review rounds up the fibrinolytic, antithrombotic, anti-inflammatory, and antioxidant effects reported in the literature.
I read all of this the same way I read the lumbrokinase science: the fibrin mechanism is real and documented. What is not documented is nattokinase dissolving biofilms in a person with tick-borne illness. That is theory and my clinical observation. This is why I use it as one part of a broader regimen rather than a standalone fix, and why I give people the honest limits of the science when they ask.
References
Supplement Facts
| Amount Per Serving|%Daily Value | Amount | |
|---|---|---|
Nattokinase NSK-SD® (soy) 2000 FU | 100 mg | |
†Daily Value not established. | ||




