Is CoQ10 the same as nattokinase?

No — and the confusion is reasonable, because both sit in the same cardiovascular aisle.

CoQ10 is a fat-soluble molecule your body already makes, present in every cellular membrane [1]. Nattokinase is a 275-amino-acid enzyme [2] extracted from fermented soybeans.

Different molecules, different jobs, different evidence — and opposite effects on blood-thinning medication. That last difference matters far more than the naming.

Table of Contents

1. The Short Answer
2. What Nattokinase Actually Is
3. What CoQ10 Actually Is
4. Five Ways They Differ
5. The Blood Thinner Problem: Opposite Directions
6. Can You Take Both Together?
7. What to Look For in a Nattokinase Supplement
8. The Bottom Line
9. Frequently Asked Questions
10. Research References

1. The Short Answer

They share no chemical relationship. Nattokinase is a protein — a fibrinolytic enzyme of 275 amino acid residues [2] produced when Bacillus subtilis ferments soybeans into natto. CoQ10 is a small fat-soluble quinone that your cells synthesise continuously, concentrated most heavily in the heart, liver, kidney and brain [7].

The overlap is purely commercial. Both are marketed for cardiovascular support, so they appear beside each other on shelves and in search results. That proximity is where the confusion starts, not from any shared biology.

This mirrors a related mix-up. Vitamin K2 and nattokinase both come from natto and are also frequently confused — we cover that in detail in our guide to whether K2 and nattokinase are the same.

2. What Nattokinase Actually Is

Nattokinase is a serine protease with a molecular weight of approximately 27.7 kDa [2]. Its job is breaking down fibrin, the mesh protein that holds blood clots together.

It works through two routes. It cleaves fibrin directly, and — more significantly — it inactivates PAI-1 [6], the inhibitor that normally suppresses your body's own tPA. Freeing tPA lets your natural clot-clearing system run harder. The mechanism is explained fully in our breakdown of how nattokinase works.

The clinical evidence centres on blood pressure. A randomised, double-blind trial of 86 participants taking 2,000 FU daily for 8 weeks [8] recorded net reductions of 5.55 mmHg systolic and 2.84 mmHg diastolic against placebo. A separate crossover study found that even a single 2,000 FU dose measurably shifted coagulation and fibrinolysis markers [9] in healthy adults, with all changes staying inside the normal range.

3. What CoQ10 Actually Is

CoQ10, also called ubiquinone, is a vitamin-like molecule sitting in every cellular membrane in your body [1]. It shuttles electrons through the mitochondrial respiratory chain to produce ATP — the energy currency every cell runs on.

It has a second role as an antioxidant, reducing lipid peroxidation and helping preserve nitric oxide, which supports vascular function. Your body makes it, so it is not a dietary essential in the way vitamin C is.

Its strongest cardiovascular evidence comes from heart failure. The Q-SYMBIO trial [4] gave 420 patients 100 mg three times daily for two years; the primary endpoint occurred in 15% of the CoQ10 group versus 26% on placebo, with all-cause deaths at 21 versus 39. Even so, the NCCIH describes the overall heart failure evidence as inconclusive [10].

4. Five Ways They Differ

The practical distinctions matter more than the chemistry:

• Molecule class: Nattokinase is a 275-amino-acid protein enzyme [2]; CoQ10 is a small fat-soluble quinone.
• Source: Nattokinase comes from fermented soybeans; your body synthesises CoQ10 continuously, with a smaller additional contribution from food.
• Target: Nattokinase acts on fibrin in the bloodstream; CoQ10 acts inside mitochondria.
• Studied dose: 2,000 FU daily [8] for nattokinase; 100 mg three times daily [4] in the largest CoQ10 heart failure trial.
• Evidence base: Nattokinase's clearest signal is a 3.45 mmHg systolic reduction across 6 trials [3]; CoQ10's is heart failure outcomes plus contested statin-myopathy data.

That last point deserves honesty. CoQ10 is widely taken for statin-related muscle pain, and the research disagrees with itself. A meta-analysis of 12 trials and 575 patients [11] found CoQ10 improved muscle symptoms, while a Mayo Clinic Proceedings analysis [12] found no significant benefit. A 2025 review of 7 trials in 389 patients [13] reported an overall reduction in muscle pain, but found a significant effect in only four of the seven trials — the studies barely agree with one another.

5. The Blood Thinner Problem: Opposite Directions

This is the difference that carries real consequence, and it is the reason the question is worth asking at all.

Nattokinase adds to anticoagulation. Memorial Sloan Kettering notes it may increase bleeding risk alongside anticoagulant, antiplatelet and fibrinolytic drugs [6]. Full detail sits in our article on nattokinase as a natural blood thinner.

CoQ10 works the other way. It is described as a fat-soluble, vitamin K-like molecule [7], and the Mayo Clinic warns it might make warfarin work less well, raising clot risk [5]. The NCCIH flags warfarin among its interactions [10], alongside insulin and some cancer treatments. The structural resemblance to vitamin K is often offered as the explanation, though these sources document the interaction without settling the mechanism.

So one supplement pushes toward bleeding and the other toward clotting. Anyone on warfarin or a direct oral anticoagulant needs their prescriber's input before adding either — INR monitoring exists precisely for shifts like these. Related safety detail is in our guide to nattokinase side effects.

6. Can You Take Both Together?

For adults not taking anticoagulants, there is no documented direct interaction between the two supplements. They act on separate systems — fibrin in plasma versus electron transport in mitochondria — so the theoretical case for combining them is coherent.

Practical considerations differ, though. CoQ10 is fat-soluble and absorbs better with a meal containing fat. Nattokinase is typically taken as a single daily capsule on an empty stomach, which puts the two on opposite ends of a meal. Taking nattokinase first thing and CoQ10 with breakfast an hour or so later resolves the conflict.

The caveat holds for anyone on blood-thinning medication, with a bleeding disorder, or facing surgery. Given that the two interact with warfarin in opposing directions, stacking them without INR monitoring is not a reasonable experiment to run alone.

7. What to Look For in a Nattokinase Supplement

Two specifications separate a nattokinase product that matches the research from one that does not.

The first is potency stated in FU, not milligrams. Fibrinolytic Units measure enzyme activity; milligrams measure powder weight. The trials showing a 3.45 mmHg systolic reduction [3] used 2,000 FU daily, so that is the number worth checking on a label.

The second is whether the capsule survives stomach acid. Nattokinase is a protein, and proteins degrade in gastric acid before reaching the small intestine where absorption happens. Standard enteric coatings solve this but often introduce phthalates and plasticizers.

The BioAbsorb Nattokinase Enzyme was built around both points: 100 mg delivering 2,000 FU per capsule, in a DRcaps delayed-release veggie capsule that protects the enzyme without those plasticizers. It is manufactured in a Canadian GMP-certified facility, non-GMO, non-irradiated, and free of gluten, nuts, eggs, dairy, fish, shellfish and all animal products.

It is also deliberately free of vitamin K2 — relevant here, since raw natto is high in vitamin K2, which can interfere with warfarin [6]. Every batch is third-party tested for enzyme activity, heavy metals, gluten and microbial contaminants. Current pricing and pack sizes are listed on the product page. Dosing guidance is in our nattokinase dosage guide.

The Bottom Line

CoQ10 and nattokinase are unrelated compounds with different mechanisms, different evidence, and opposite effects on warfarin. If fibrinolytic support is what you are after, a 2,000 FU nattokinase supplement matches the dose used across the 6 trials in the published meta-analysis [3].

Frequently Asked Questions

Is nattokinase a form of CoQ10?

No. Nattokinase is a 275-amino-acid protein enzyme [2] from fermented soybeans, while CoQ10 is a small fat-soluble quinone your body produces. They belong to entirely different chemical classes and act on different systems.

Which one is better for blood pressure?

Nattokinase has the more direct evidence, with a pooled reduction of 3.45 mmHg systolic across 6 trials [3]. CoQ10 supports vascular function through antioxidant activity, but its strongest cardiovascular data concerns heart failure outcomes rather than blood pressure in healthy adults.

Can I take CoQ10 and nattokinase at the same time of day?

Timing them together is awkward rather than unsafe. CoQ10 absorbs better with dietary fat, while nattokinase is usually taken on an empty stomach, so spacing them an hour or so apart works better.

Does CoQ10 thin the blood like nattokinase does?

It does the reverse. CoQ10 is described as a vitamin K-like molecule [7] and may reduce warfarin's effectiveness [5], whereas nattokinase can add to anticoagulant effects [6]. Anyone on blood thinners should discuss either supplement with their prescriber.

Do statin users need CoQ10?

The evidence is split. A meta-analysis of 575 patients [11] found improvement in statin-associated muscle symptoms, while a Mayo Clinic Proceedings analysis [12] found no significant benefit — so it is worth discussing with the prescribing physician rather than assuming.

Is nattokinase found in the same foods as CoQ10?

No. Nattokinase occurs in natto, the fermented soybean dish. CoQ10 is concentrated in muscle meats, liver and oily fish, though most of the CoQ10 in your body is synthesised rather than eaten.

Research References

1. Coenzyme Q10 — StatPearls. National Institutes of Health, NCBI Bookshelf (updated 2024). Describes CoQ10 as a fat-soluble, vitamin-like molecule present in every cellular membrane and central to mitochondrial ATP production.
2. Purification and characterization of a strong fibrinolytic enzyme (nattokinase) in the vegetable cheese natto, a popular soybean fermented food in Japan. Biochemical and Biophysical Research Communications, Vol. 197, Issue 3 (1993), pp. 1340–1347. The original characterisation paper: established nattokinase as a serine protease of 275 amino acid residues with a molecular weight of 27,728 Da, showing high homology with the subtilisins.
3. Nattokinase Supplementation and Cardiovascular Risk Factors: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Reviews in Cardiovascular Medicine, Vol. 24, Issue 8 (2023), article 234. Pooled 6 trials and 546 participants, finding systolic blood pressure fell 3.45 mmHg and diastolic 2.32 mmHg versus placebo.
4. The Effect of Coenzyme Q10 on Morbidity and Mortality in Chronic Heart Failure: Results From Q-SYMBIO. JACC: Heart Failure, Vol. 2, Issue 6 (2014). Found the two-year primary endpoint occurred in 15% of CoQ10 patients versus 26% on placebo across 420 participants receiving 100 mg three times daily.
5. Coenzyme Q10. Mayo Clinic (2025). Notes that CoQ10 might make warfarin work less well, potentially raising the risk of a blood clot.
6. Nattokinase. Memorial Sloan Kettering Cancer Center, Integrative Medicine. Documents nattokinase's PAI-1 inactivation mechanism, its theoretical bleeding risk alongside anticoagulant, antiplatelet and fibrinolytic drugs, the high vitamin K content of raw natto, and a reported case of repeat valve replacement following self-substitution of nattokinase for warfarin.
7. Coenzyme Q10 — LiverTox. National Institutes of Health (2024). Identifies CoQ10 as a fat-soluble, vitamin K-like molecule found in highest concentrations in heart, liver, kidney and brain tissue.
8. Effects of nattokinase on blood pressure: a randomized, controlled trial. Hypertension Research, Vol. 31, Issue 8 (2008), pp. 1583–1588. Found net reductions of 5.55 mmHg systolic and 2.84 mmHg diastolic in 86 participants taking 2,000 FU daily for 8 weeks.
9. A single-dose of oral nattokinase potentiates thrombolysis and anti-coagulation profiles. Scientific Reports, Vol. 5, article 11601 (2015). Double-blind crossover study in 12 healthy males showing that a single 2,000 FU dose measurably shifted D-dimer, Factor VIII, antithrombin and aPTT, with all changes remaining within the normal range.
10. Coenzyme Q10. National Center for Complementary and Integrative Health. States that CoQ10 may interact with warfarin, insulin and some cancer treatments, and that heart failure research remains inconclusive.
11. Effects of Coenzyme Q10 on Statin-Induced Myopathy: An Updated Meta-Analysis of Randomized Controlled Trials. Journal of the American Heart Association, Vol. 7, Issue 19 (2018), e009835. Reported that CoQ10 improved statin-associated muscle pain, weakness and cramps across 12 trials and 575 patients.
12. Effects of Coenzyme Q10 on Statin-Induced Myopathy: A Meta-analysis of Randomized Controlled Trials. Mayo Clinic Proceedings, Vol. 90, Issue 1 (2015), pp. 24–34. Found no significant benefit of CoQ10 for statin-induced myopathy, providing the counterweight to the JAHA analysis.
13. Effects of coenzyme Q10 supplementation on myopathy in statin-treated patients: a systematic review and meta-analysis. Journal of Nutritional Science (2025) [journal volume not confirmed]. Seven RCTs with 389 patients; reported an overall significant reduction in muscle pain, with a significant effect in four trials and no significant change in three.

About the Author

David Kimbell is a health writer, digital entrepreneur and former aerospace engineer, based in Ottawa, Canada. He loves translating complex science into clear, actionable guidance for consumers seeking evidence-based solutions.

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Important Disclaimers

Medical Disclaimer: This article provides educational information only and is not intended as medical advice. Always consult with a qualified healthcare provider before starting any new supplement, especially if you have existing health conditions, take medications, or are pregnant or nursing.

FDA/Health Canada Statement: These statements have not been evaluated by the Food and Drug Administration or Health Canada. This product is not intended to diagnose, treat, cure, or prevent any disease.