Interesting that your warning about nattokinese is FOLLOWED immediately by an advertisement for.... nattokinase extracts!

Actually most nattokinase does not contain vitamin K2.  When nattokinase is extracted from natto, the K2 is separated and sold as another profitable byproduct.

Wait a minute though! Was there any indication that he needed a real blood thinner before his clot? Maybe he was just taking it like a daily aspirin to "thin the blood" not for therapeutic blood anticoagulation. His clot was unfortunate but probably could have occurred with a cardiologist sactioned baby aspirin.

Anon--

He was taking aspirin, as well.

However, aspirin does NOT prevent deep vein thromboses that lead to pulmonary emboli, regardless of dose. Aspirin is a platelet-inhibitor, not a true "blood thinner" that works by way of clotting proteins.

Was he using nattokinase as an excuse not to take his warfarin, or something like that? Otherwise it seems very unlikely that the nattokinase had anything to do with the clot. If anything, I'd worry about nattokinase causing bleeds, not clots.

Curious if you ever recommend pycnogenol in cases where there is a risk of DVT? I believe there is at least one study showing a reduced risk of DVT in those who took pycnogenol.

I'm not saying it's better than anti-coagulants, but it may be better than aspirin.

Real anti-coagulants?  Like the red clover extract coumadin?  Patients on coumadin even with careful control often suffer excessive bleeding or more clots and strokes.    
I guess the point is that clotting control is very difficult and that the number one drug is a natural medicine, herbal extract.

One time, I was at a local vitamin shop when I saw that the supplement I was thinking about buying contained nattokinase.  Having read your blog and knowing what you think of nattokinase, I put the product back on the shelf.  The proprietor of the shop asked me why I did not want that supplement, because in his opinon it was a very good product.  I said that I did not want to take anything with nattokinase in it, and he said, "What do you have against nattokinase?"  I didn't bother to explain myself to him, figuring that I would just be wasting my breath.

What is your opinion about doing higher dose mixed tocopherols, which do work on the clotting cascade. Or garlic and omegas which decrease platelet aggregation. What is your stand on normalizing your vitamin K content and then titrating your dosage of coumadin up to theraputic INR. As far as the nattokinase is concerned, do you like any of that style of enzyme? lumbokinase, serrapeptase. Although they don't have any effect on INR they should have an affect on FDPs

That title is misleading.  People have been known to have near death cardiac events while taking fish oil, vitamin D3, and high dose niacin too.

As well, on rare occasion, people have been known to have a recurrent DVT and/or PE while on warfarin therapy, even with an INR as high as 2.5.  Therefore, does that mean warfarin is an ineffective anticoagulant?  Of course not.

This whole blog is about how we as individuals need to take control of our own health.  That just because we're taking a therapeutic medication or supplement, it does not therefore absolve ourselves from further investing in a life style that is proven to lower risk factors that may cause catastrophic health events.  

I totally agree that some of the marketing claims made concerning nattokinase are inflated and frankly, unbelievable - particularly about its capabilities as a thrombolysis.  And I agree that if your doctor advices that you need heprin or warfarin therapy in order to prevent a catastrophic health event, you certainly need to heed that advice.

But, count me down as someone who has extensively studied this subject and is still open to the possibility that nattokinase may contain some attributes in the prevention of venus thrombosis from a novel approach that needs further clinical investigation.

Dr. Davis,

I wouldn't be so quick to blast nattokinase because of this isolated incident or lack of research.

Nattokinase is a "mild" blood thinner. Taking it once a day will not do more than relieve inflammation and slightly improve a person's circulation.

A person would have to take it every 4 times a day (800 IU) on an empty stomach for if he desires a therapeutic effect. I would be curious if this patient of yours even took 200 IU per day (because a lot of products don't even contain that much).

I have personally witnessed an improvement in circulation after taking nattokinase.

I would like to add one more thing...

I'm sure you have had experience with patients who took 400 IU of vitamin D in tablet form, and did not see any results after six months either. Was it because vitamin D is a worthless supplement, and should not be used?

Sorry, I was misspoke about the dosage. Nattokinase is measured in fibrinolysis units (FU), not IU, and the effective dose ranges anywhere from 2,000-8000 FU per day.

Also, here's actual scientific research (albeit small), not marketing hype, on nattokinase.

http://www.ncbi.nlm.nih.gov/pubmed/19358933

http://www.ncbi.nlm.nih.gov/pubmed/18971533

I've like the taste of natto from the moment I tried it. I am, however, a bit weird. ;)

Dr. Davis -- my question here is, could the nattokinase cause the blood clot (doesn't seem the be the case)?  Are you saying that it didn't matter that he was taking nattokinese because it doesn't reach the bloodstream to clear clots (so he would of had the clot anyway)

Secondly, if he was taking nattokinese that had vitamin K2 <--- is it possible that increases in K2 might cause abnormal blood cloting?

Vitamin K2 does not cause blood clotting any more than topping up your gas tank makes your car go faster.

Whether nattokinase has other effects is not my point. My concern is that people frequently ask if they should treat their DVT or pulmonary embolus with nattokinase. This is a death sentence. It should NOT be used for a such a purpose unless there were a large treatment trial proving equivalence or superiority to existing therapies.

Eric,

High dose mixed tocopherols use the same mechanisms as Wafarin/Coumadin.  They block the reabsorption of vitamin-K in the liver.  Vitamin-K is necessary for the liver to synthesize and release clotting proteins in the blood.  Warfarin/Coumadin is much, much more consistent than tocopherols in maintaining vitamin-K malabsorption and a safely prescribed INR range.  

Titrating a Warfarin/Coumadin dosage never made sense to me. It is not toxic other than causing vitamin-K deficiency. What difference does it make if the dosage is 20 mg or 20 mcg to maintain a therapeutic INR?  Your liver will need to be equally deficient in vitamin-K no matter how you caused the deficiency.

Garlic, ginger, ginkgo, curcumin, n-3, aspirin, N-acetylcysteine, Plavix, and yes tocopherols too all are anti-platelet agents.   They are effective at preventing arterial thrombosis, where anticoagulants have little effect. Conversely, anticoagulants are effective at preventing venous thrombosis, where anti-platelet agents (unfortunately) have little effect.

I'm giving my son nattokinase, one tablet daily and he also takes Vitamin K2. He has not been prescribed blood thinners, only aspirin which I stopped many months ago.
Are you warning of not replacing prescribed blood thinners with natural therapies?
If blood thinners have not been prescribed, is it of benefit to supplement with nattokinase?

Hi Dr. Davis

I was wondering if you could help me with something.

I've been monitoring my blood glucose recently with a basic monitor, and my readings would suggest that I am on the verge of impaired glucose tolerance, but not quite there yet.

I was reading about continuous glucose monitoring systems. I would love to have on if these to more thoroughly monitor my blood glucose, but every model out there requires a prescription to obtain one. I don't understand this, because they are not dangerous in any way.

Do you know of any way a non diabetic can purchase one of these?

Any information you can give me would be greatly appreciated. Thank you.

Rob

Dr. Davis, i am a 45 year old female who recently started taking Lovasa for high triglycerides , i am also on garlic tabs and one baby asprin per day . Is is safe to replace the garlic and asprin with one tab of Natto- K per day and is it safe to take with Lovasa? I am about 20 lbs overweight do not drink or smoke and swim and or walk 3 days per week. i am genetically predisposed to high triglycerides but never had a problem until i gained the weight. Until i get the weight off i am trying a more natural approach. Help!

[...] why you need to think for yourself and question studies. See, “Near-death experience with nattokinase | Track Your Plaque Blog, “Nattokinase supplement medical uses, safety, benefit, side effects,” and “Fight [...]

Acta Haematol. 2010;124(4):218-24. doi: 10.1159/000321518. Epub 2010 Nov 13.

In vivo evaluation method of the effect of nattokinase on carrageenan-induced tail thrombosis in a rat model.
Kamiya S, Hagimori M, Ogasawara M, Arakawa M.
Source
Nagasaki International University, Sasebo, Japan. kamiya@niu.ac.jp

Abstract
Thrombosis is characterized by congenital and acquired procatarxis. Nattokinase inhibits thrombus formation in vitro. However, in vivo evaluation of the therapeutic efficacy of nattokinase against thrombosis remains to be conducted. Subcutaneous nattokinase injections of 1 or 2 mg/ml were administered to the tails of rats. Subsequently, κ-carrageenan was intravenously administered to the tails at 12 h after nattokinase injections. The mean length of the infarcted regions in the tails of rats was significantly shorter in rats administered 2 mg/ml of nattokinase than those in control rats. Nattokinase exhibited significant prophylactic antithrombotic effects. Previously, the in vitro efficacy of nattokinase against thrombosis had been reported; now our study has revealed the in vivo efficacy of nattokinase against thrombosis.

PMID: 21071931

Thanks for subjecting yourself to these experiments!  Very interesting.  I have a friend who reacts poorly to wheat but tolerates spelt.

Wheat is eaten everywhere in the world. I'd hope GM crop scientists design a variety which can solve this problem.

If I am not mistaken, corn is also the result of the domestication of wild grasses existing some 8,000 years ago. Fooling with mother nature put us on a collision course with consequences.

My concern is that the body could be reacting without symptoms. Could  these ancient grains cause inflammation even though there is no obvious reaction? I have lived 7 years without gluten and have no desire to add it back to my diet. Before I eliminated gluten I was very ill. It is not worth the risk to me.

Dr. Davis,

In your experience, in terms of small LDL and the like, what's better: a high peak of 150 that's brought down relatively quickly or a lower peak, but extended over a longer duration?

Thanks,
David

Anne--

Please don't interpret these casual observations to mean that we should eat einkorn.

My goal with this little experience is to gain an understanding of where along the way of wheat's 10,000+ year human consumption history did things go wrong.

It seems to me that humans could have gotten away with eating einkorn much more freely, with fewer health problems than with modern wheat. I still would like to know where the extreme adverse effects were acquired, however. I suspect this occured in the 1960s and 1970s with the hybridization experiments conducted in Mexico. more on that later.

Anon--

No data. I suspect that the high peak is worse, but that is based on no formal data.

FODMAPs comprise a monosaccharide (fructose), a disaccharide (lactose), oligosaccharides (fructans and galactans), and polyols.

In one study, as obese people lose weight, the balance between the Firmicutes and the Bacteroidetes changes - the latter increasing in abundance as an overweight person gets slimmer.

Fructans, found in wheat, are fermented by bacteria in the large intestine into short chain fatty acids.


Besides human metabolism, the digestion of wheat is also affected by how it is metabolized by the particular intestinal flora inhabiting a person.


Sources:

Evidence-based dietary management of functional gastrointestinal symptoms: The FODMAP approach

An obesity-associated gut microbiome with increased capacity for energy harvest


Food tables: fructose



Fructose in the diet appears to be even more dangerous in the presence of trans-fats.


Source:

High Levels of Fructose, Trans Fats Lead to Significant Liver Disease, Says Study

"The investigators found that mice fed the normal calorie chow diet remained lean and did not have fatty liver disease. Mice fed high calorie diets (trans-fat alone or a combination of trans-fat and high fructose) became obese and had fatty liver disease.

"Interestingly, it was only the group fed the combination of trans-fat and high fructose which developed the advanced fatty liver disease which had fibrosis," says Dr. Kohli. "This same group also had increased oxidative stress in the liver, increased inflammatory cells, and increased levels of plasma oxidative stress markers.""

Your experience with einkorn and emmer is interesting. They do not seem to cause you the problems that wheat does, and that evidence supports the theory that they are less harmful than wheat.  But the same evidence makes another theory equally plausible: that foods such as wheat harm you through pathways that form only through repeated exposure.  Under this theory, einkorn and emmer could be just as harmful as wheat but, being novel to your diet, haven't had enough time for their pathways to form.

It would be interesting, then, to learn what happens if you were to incorporate einkorn or emmer into your diet more regularly.

This abstract would seem to support your view that it may be a modern phenomenon.

Journal of Medicinal Food
Effects of Short-Term Consumption of Bread Obtained by an Old Italian Grain Variety on Lipid, Inflammatory, and Hemorheological Variables: An Intervention Study

http://www.liebertonline.com/doi/abs/10.1089/jmf.2009.0092

Michael

Naturopath David Getoff recently did a podcast on this subject, it is worth listening to: http://naturopath4you.com/mp3s/Gluten%202010%20Final.MP3

Just wondering if you have experimented with fermenting the wheat or sprouting wheat and then drying it to make bread. I've read  that making bread through this method helps celiac problems and wondered if there is a connection  since soaking and/or sprouting neutralizes the phytic acid and supposedly aids in digestion and keeps blood sugars from rising as much.

Wondering if there is a difference in European wheat types verses American. I have illness, vomiting and nausea when I consume wheat here in the US. But when I tried it in France, Germany and Switzerland, I did not have any problems. I thought it might be the way US wheat is processed, but it might be the wheat type, as well.

Thank you,
Janet Creamer