Aspirin vs Nattokinase for Clogged Arteries (Which One Wins?)

Summary

Dr. Ford Brewer compares nattokinase and aspirin, emphasizing that they affect clotting differently and should not be treated as interchangeable. He argues that choices should be based on a person’s artery disease, bleeding risk, and medical circumstances—not on supplement headlines alone.

How They Work

• Nattokinase is an enzyme derived from natto, fermented soybeans. Brewer says it can break down parts of an existing clot, support the body’s clot-dissolving processes, and reduce some clot-forming material.
• Aspirin reduces the platelet signals that help a clot form. Its effect lasts for the life of the affected platelets—about a week to 10 days.
• Both can increase bleeding risk.

What the Evidence Shows, According to Brewer

• Brewer discusses one roughly six-month nattokinase study that reported reduced carotid plaque and a longer, double-blind trial that found no meaningful changes. He notes that the latter used a lower dose, so the evidence remains uncertain.
• He says aspirin has much stronger evidence for reducing heart attacks and strokes in some groups, particularly people who have already had a cardiovascular event. For people without known disease, he stresses that the benefit may be small and can be offset by bleeding risk.
• He argues that evidence of plaque on imaging changes the risk discussion. He mentions coronary calcium scans and carotid intima-media thickness (CIMT) ultrasound as ways to assess arteries, while noting that each measures different features.

Risks and Precautions

• Brewer warns against combining nattokinase with aspirin or prescription blood thinners such as Xarelto, Eliquis, or clopidogrel without a clear discussion with a clinician. He cites case reports of serious bleeding and says supplement dosing and manufacturing are less standardized.
• In his view, low-dose aspirin may be an option for people with plaque who have no major contraindications, under a doctor’s supervision. He describes nattokinase as a possible alternative for people who cannot tolerate aspirin, while acknowledging its weaker evidence.
• This is the presenter’s interpretation, not individualized medical advice. Do not start, stop, or combine these medicines or supplements without consulting a qualified healthcare professional.

Broader Prevention Strategies

Brewer emphasizes addressing possible underlying metabolic risks, including prediabetes, diabetes, and insulin resistance. He recommends reducing refined or high-glycemic carbohydrates, exercising vigorously, and addressing sleep problems and stress.

He encourages assessing risk rather than guessing, mentioning an oral glucose tolerance test, insulin response, artery imaging, and cholesterol fractions as possible parts of that assessment.

Brewer’s Personal Account

Brewer says he takes neither aspirin nor nattokinase. After developing atrial fibrillation, he switched to a prescription anticoagulant; he says he currently takes Xarelto and does not combine it with nattokinase or aspirin.

He advocates shared decision-making: clinicians should explain benefits, risks, and uncertainties, and patients should participate in choices about their care.

Presenters and Sources

• Presenter: Dr. Ford Brewer
• Sources mentioned: U.S. Preventive Services Task Force; Framingham Study; nattokinase and aspirin studies described in the video (not individually named).