The nattokinase video clearly hit a nerve. Your comments were sharp, occasionally feisty, and worth a real answer. So this is the follow-up Q&A: natto the food versus nattokinase the isolated capsule, whether CIMT is a test I actually trust, the dosing argument a lot of you raised, and the supplement many of you asked about instead — lumbrokinase.

The back half is a proper walk through the one randomized trial testing lumbrokinase for secondary stroke prevention. I go through the design, the parts that gave me pause, and the plaque and IMT findings that genuinely caught my attention. My take, for what it's worth with the evidence we have: if you're going to hang your hat on an enzyme, lumbrokinase looks like the safer bet. Watch and decide for yourself.

⏱️ CHAPTERS
0:00 Why I'm answering your nattokinase comments
0:25 Natto the food vs. nattokinase the supplement
1:54 Is nattokinase the same as vitamin K2?
2:46 Do I trust CIMT? Plaque vs. IMT, explained
3:59 The "n=1" critique, Susan, and Dr. Brewer
6:01 The dosing fight: 2,000 vs. 10,800 FU
7:58 Lumbrokinase and serrapeptase: what they actually are
10:22 The 2013 lumbrokinase stroke trial: setup
13:09 Where the trial design gives me pause
15:46 Results: the patients and the open-label problem
17:26 Baseline data and the missing standard meds
20:20 Lab results: fibrinogen, CRP, D-dimer, tPA
22:29 The interesting part: plaque and IMT changes
24:57 Stroke scores, outcomes, and the low event count
27:52 How lumbrokinase differs from nattokinase (and why it's likely safer)
30:15 Bottom line: should you take it?

📚 STUDY DISCUSSED
Cao YJ, Zhang X, Wang WH, et al. Oral fibrinogen-depleting agent lumbrokinase for secondary ischemic stroke prevention: results from a multicenter, randomized, parallel-group and controlled clinical trial. Chin Med J (Engl). 2013;126(21):4060-4065. PMID: 24229674. https://pubmed.ncbi.nlm.nih.gov/24229674/

▶️ WATCH NEXT
"I Stopped Using Nattokinase. Here's Why.": https://youtu.be/vpenJQ3UJh0
The VitaK-CAC study: https://youtu.be/ArxAXtzsue4
Vit K Comments & Questions: https://youtu.be/uORGxMsedic

⚕️ DISCLAIMER
This channel is for education, not medical advice. I'm a board-certified vascular surgeon, but I'm not your surgeon, and nothing here replaces a conversation with your own physician. Supplements carry real risks, including bleeding. Talk to your doctor before starting, stopping, or changing anything — especially if you take blood thinners or antiplatelet medication.

💬 Found this useful? Subscribe, and drop your lumbrokinase questions in the comments. We'll get to as many as we can next time.

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🧬 About Dr. Lily Johnston

Dr. Johnston is a double board-certified vascular and general surgeon in San Diego, specializing in metabolic and cardiovascular prevention. She’s the founder of CorSight Health and a passionate advocate for reimagining how medicine approaches chronic disease.

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