Question 256 of 433
What about nattokinase and niacin for the heart?
The short answer
Nattokinase is interesting and unproven. Niacin I no longer recommend.
Nattokinase is an enzyme from fermented soybeans. One large Chinese study reported that a high dose reduced plaque in the neck arteries over a year. It was not a randomized trial, and it has not been repeated. Nattokinase thins the blood mildly and should not be combined with anticoagulants without advice.
Niacin raises HDL and lowers Lp(a) on paper, which is why many of us once prescribed it. Large trials then showed it did not prevent heart attacks and caused harm, and newer research suggests a breakdown product of excess niacin may inflame arteries. I have changed my practice accordingly.
“This book is for education. It is not medical advice, and reading it does not make you my patient or create a doctor-patient relationship.” From the book’s medical disclaimer. Full disclaimer
LIMITED for nattokinase plaque claims; ROBUST negative outcome trials for routine add-on niacin in contemporary lipid care.Evidence grade (draft mapping)BLimited or small human studiesPart 17, Q256 · Part sources
From Longevity Unmasked by Afshine Ash Emrani, MD, FACC. Medical disclaimer. This book is for education. It is not medical advice, and reading it does not make you my patient or create a doctor-patient relationship. Nothing here is meant to diagnose, treat, cure, or prevent any disease. Medicine is personal: a test, drug, supplement, or exercise plan that helps one person can harm another. Do not start, stop, or change any medication or treatment because of something you read in these pages. Talk with a licensed clinician who knows your history first. If you think you are having a medical emergency, call 911. The author disclaims responsibility for any loss or harm arising from use of the information in this book.