Nattokinase (pronounced nat-oh-KY-nase) is an enzyme extracted and purified from a Japanese food called Natto. Natto is a food made from fermented soybeans that has been eaten in Japan for many years. Natto is produced by fermentation by adding the bacterium Bacillus natto, a beneficial bacteria, to boiled soybeans. The resulting nattokinase enzyme is produced when the bacterium acts on the soybeans. While other soy foods contain enzymes, it is only the natto preparation that contains the specific nattokinase enzyme.

Nattokinase is a clot-buster and blood thinner.^[1] Nattokinase (nk) produces a prolonged action (unlike antithrombin drugs that wear off shortly after IV treatment is discontinued) in two ways: it prevents coagulation of blood and it dissolves existing thrombus. Both the efficacy and the prolonged action of NK can be determined by measuring levels of EFA (euglobulin fibrinolytic activity) and FDP (fibrin degradation products), which both become elevated as fibrin is being dissolved. By measuring EFA & FDP levels, activity of NK has been determined to last from 8 to 12 hours. An additional parameter for confirming the action of NK following oral administration is a rise in blood levels of TPA antigen(tissue plasminogen activator), which indicates a release of TPA from the endothelial cells and/or the liver.^[2] There is also evidence of nattokinase being effective in catabolism of toxic amyloid fibrils associated with Alzheimer's Disease.^[3]

The mechanism for this enzyme to potentiate fibrinolysis is not fully understood. Subtilisin Nattokinase (NAT) is reported not to possess plasminogen activator activity but appears to directly digest fibrin by limited proteolysis. However, this direct cleavage of fibrin does not seem to account for all of the enhancement of the fibrinolytic activity that has been observed without affecting the fibrinolytic cascade.^[4]

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