Natto supplementation and decreased platelet count in a case with rheumatoid arthritis

How to cite this article:
Chaiyasit K, Wiwanitkit V. Natto supplementation and decreased platelet count in a case with rheumatoid arthritis. Ann Trop Med Public Health 2013;6:387


How to cite this URL:
Chaiyasit K, Wiwanitkit V. Natto supplementation and decreased platelet count in a case with rheumatoid arthritis. Ann Trop Med Public Health [serial online] 2013 [cited 2020 Aug 14];6:387. Available from:

Dear Sir,

The effect of natto on the platelet is the interesting topic. In general, natto is mentioned as a good functional food that is good for the human cardiovascular system. [1] Natto is reported to have protective effect against coronary atherosclerosis by attenuating platelet activity. [2] Therefore, the natto supplementation is widely used in neutraceutical medicine at present. However, to conclude for the benefit of natto intake, the clinical evidence is required. [3] Here, the authors would like to share an experience on using natto yeast supplementation in a case of rheumatoid arthritis who has the problem of thrombocytosis. The case is a female with known rheumatoid arthritis for more than 10 years and under control by standard medication therapy. The problem of thrombocytosis (with persistent platelet count >500,000/mm 3 ) was observed in this case. This case was consulted to the nutritional clinic for a possible role of neutraceutical medicine in managing of the thrombocytosis problem. At the starting point, the erythrocyte sedimentation rate (ESR) of the patient is about 100 mm/h. In this case, natto yeast supplementation was used. After 1 month, the interesting finding is the dramatically reducing of the platelet count to the normal range (150,000/mm 3 ). Of interest, this reducing of platelet count is not concordant with the persistent high ESR value. In this case, the natto might be a factor relating to the decreased platelet count in this case. An important component in natto is the nattokinase. It is reported that “thrombolytic activity of nattokinase is stronger than that of plasmin or elastase in vivo.” [4] As a diet supplementation, it is also reported that “natto extracts, because of their thrombolytic activity, suppress intimal thickening after vascular injury as a result of the inhibition of mural thrombi formation.” [5] Based on this case, the natto supplementation might be an additional alternative for management of the problem of thrombocytosis.



1. Rajaram S. The effect of vegetarian diet, plant foods, and phytochemicals on hemostasis and thrombosis. Am J Clin Nutr 2003;78:552S-8.
2. Borgwardt K, Bonifatius S, Gardemann A. Acidic peptides enhanced genistein-dependent inhibition of human platelet aggregation: Potential protective effect of digestible peptides plus genistein against atherosclerosis. Nutr Res 2008;28:523-31.
3. Ask the doctor. I have read good news about nattokinase and would like to use it to keep my blood thin. Is it a good substitute for aspirin? Heart Advis 2007;10:8.
4. Fujita M, Hong K, Ito Y, Fujii R, Kariya K, Nishimuro S. Thrombolytic effect of nattokinase on a chemically induced thrombosis model in rat. Biol Pharm Bull 1995;18:1387-91.
5. Suzuki Y, Kondo K, Ichise H, Tsukamoto Y, Urano T, Umemura K. Dietary supplementation with fermented soybeans suppresses intimal thickening. Nutrition 2003;19:261-4.

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/1755-6783.121022

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