Dietary nitrate (beetroot) vs Nattokinase
Two supplements aimed at blood pressure and blood flow. One has a mapped mechanism and a measurable effect; the other carries a bleeding risk.
Short answer
Both are supplements with some human trials behind them, so what separates dietary nitrate and nattokinase is the goal. For a reader focused on blood pressure, nitric oxide, blood flow and endurance, dietary nitrate is the relevant choice; nattokinase is marketed for circulation and clot support.
Dietary nitrate (beetroot)
Beet juice, beetroot powder
A well-mapped NOS-independent route to nitric oxide with a genuine ~4–5 mmHg systolic effect and a small endurance benefit in recreationally trained people — but nothing in elite athletes, no hard outcomes, and an effect antibacterial mouthwash can abolish.
Full Dietary nitrate (beetroot) evidence reviewNattokinase
Small human trials show modest blood-pressure and fibrinolytic-marker effects, but they're small/industry-linked with no hard outcomes — and there is a real bleeding risk, especially with anticoagulants.
Full Nattokinase evidence reviewDietary nitrate (beetroot) vs Nattokinase: head to head
- FDA status / approved use
Dietary nitrate (beetroot)
Sold as foods and dietary supplements; not FDA-approved for any conditionNattokinase
Sold as a supplement; products are unstandardized- Marketed for
Dietary nitrate (beetroot)
Blood pressure, nitric oxide / blood flow, enduranceNattokinase
Circulation, clot support- Outcome areas
Dietary nitrate (beetroot)
Cardiovascular; Exercise performance / enduranceNattokinase
Cardiovascular- Evidence grade
Dietary nitrate (beetroot)
Clinical dataNattokinase
Clinical data- How it works
Dietary nitrate (beetroot)
Mouth bacteria convert nitrate to nitrite, which the body turns into nitric oxideNattokinase
Enzyme that directly breaks down fibrin, the protein mesh of blood clots- Route and dosing
Dietary nitrate (beetroot)
Oral beet juice or nitrate shot, about 2–3 hours before exerciseNattokinase
Oral supplement, around 2,000 FU per day in trials- Headline human result
Dietary nitrate (beetroot)
Systolic blood pressure around 4–5 mmHg lower in a meta-analysis of short randomized trialsNattokinase
Systolic pressure fell 5.55 mmHg and diastolic 2.84 mmHg vs control over eight weeks in a 2008 RCT of 86 people- Strongest evidence
Dietary nitrate (beetroot)
Siervo 2013 meta-analysis, J NutrDietary nitrate (beetroot) evidence reviewPubMed 23596162Nattokinase
BP RCT, Hypertens Res 2008Nattokinase evidence reviewPubMed 18971533- Key safety signal
Dietary nitrate (beetroot)
Additive with blood-pressure medication; interacts with nitrates and PDE5 inhibitorsNattokinase
Bleeding risk, especially with anticoagulants or antiplatelets or before surgery- How it is obtained
Dietary nitrate (beetroot)
Over the counter as a dietary supplementNattokinase
Over the counter as a dietary supplement
| Dietary nitrate (beetroot) | Nattokinase | |
|---|---|---|
| FDA status / approved use | Sold as foods and dietary supplements; not FDA-approved for any condition | Sold as a supplement; products are unstandardized |
| Marketed for | Blood pressure, nitric oxide / blood flow, endurance | Circulation, clot support |
| Outcome areas | Cardiovascular; Exercise performance / endurance | Cardiovascular |
| Evidence grade | Clinical data | Clinical data |
| How it works | Mouth bacteria convert nitrate to nitrite, which the body turns into nitric oxide | Enzyme that directly breaks down fibrin, the protein mesh of blood clots |
| Route and dosing | Oral beet juice or nitrate shot, about 2–3 hours before exercise | Oral supplement, around 2,000 FU per day in trials |
| Headline human result | Systolic blood pressure around 4–5 mmHg lower in a meta-analysis of short randomized trials | Systolic pressure fell 5.55 mmHg and diastolic 2.84 mmHg vs control over eight weeks in a 2008 RCT of 86 people |
| Strongest evidence | Siervo 2013 meta-analysis, J NutrDietary nitrate (beetroot) evidence reviewPubMed 23596162 | BP RCT, Hypertens Res 2008Nattokinase evidence reviewPubMed 18971533 |
| Key safety signal | Additive with blood-pressure medication; interacts with nitrates and PDE5 inhibitors | Bleeding risk, especially with anticoagulants or antiplatelets or before surgery |
| How it is obtained | Over the counter as a dietary supplement | Over the counter as a dietary supplement |
marks a row where the two differ. “Not established” marks a cell the available evidence does not answer. Evidence grades come from our evidence matrix, which grades each molecule on the human data for the use it is marketed for.
- Clinical data:
- Tested in humans — but investigational, discontinued, or proven only on a surrogate marker (not the marketed outcome).
Our verdict
Dietary nitrate is the better-characterized of the two: a well-mapped NOS-independent route to nitric oxide with a genuine ~4-5 mmHg systolic effect and a small endurance benefit in recreationally trained people — though nothing in elite athletes, no hard outcomes, and an effect antibacterial mouthwash can abolish. Nattokinase's small human trials show modest blood-pressure and fibrinolytic-marker effects, but they are small, often industry-linked and without hard outcomes, and it carries a real bleeding risk, especially alongside anticoagulants. Neither has an outcome trial, and they have not been compared.
Dietary nitrate (beetroot) fits if
Blood pressure and exercise performance are the target, and you want the option with a clearer mechanism and no bleeding signal.
Nattokinase fits if
The fibrinolytic angle is what interests you, you take no anticoagulant, and you have cleared it with a clinician first.
Dietary nitrate (beetroot) vs Nattokinase: common questions
- Is either dietary nitrate or nattokinase FDA-approved?
- No. Dietary nitrate is sold as foods and dietary supplements; not FDA-approved for any condition. Nattokinase is sold as a supplement; products are unstandardized.
- Which has stronger human evidence, dietary nitrate or nattokinase?
- Neither clearly. Both have human clinical data. The key source for dietary nitrate is Siervo 2013 meta-analysis, J Nutr; for nattokinase, it is BP RCT, Hypertens Res 2008.
- What are the main safety concerns with dietary nitrate and nattokinase?
- Dietary nitrate is additive with blood-pressure medication; interacts with nitrates and PDE5 inhibitors. For nattokinase, watch for bleeding risk, especially with anticoagulants or antiplatelets or before surgery.
Key studies behind each
Dietary nitrate (beetroot)
- Lundberg JO, Weitzberg E, Gladwin MT. (2008). The nitrate-nitrite-nitric oxide pathway in physiology and therapeutics. Nat Rev Drug Discov. PubMed 18167491
- Govoni M, Jansson EÅ, Weitzberg E, Lundberg JO. (2008). The increase in plasma nitrite after a dietary nitrate load is markedly attenuated by an antibacterial mouthwash. Nitric Oxide. PubMed 18793740
- Kapil V, Haydar SM, Pearl V, Lundberg JO, et al. (2013). Physiological role for nitrate-reducing oral bacteria in blood pressure control. Free Radic Biol Med. PubMed 23183324
- Burleigh MC, Liddle L, Monaghan C, Muggeridge DJ, et al. (2018). Salivary nitrite production is elevated in individuals with a higher abundance of oral nitrate-reducing bacteria. Free Radic Biol Med. PubMed 29550328
Nattokinase
- Sumi H, Hamada H, Tsushima H, et al. (1987). A novel fibrinolytic enzyme (nattokinase) in the vegetable cheese Natto; a typical and popular soybean food in the Japanese diet. Experientia. PubMed 3478223
- Kurosawa Y, Nirengi S, Homma T, et al. (2015). A single-dose of oral nattokinase potentiates thrombolysis and anti-coagulation profiles. Sci Rep. PubMed 26109079
- Kim JY, Gum SN, Paik JK, et al. (2008). Effects of nattokinase on blood pressure: a randomized, controlled trial. Hypertens Res. PubMed 18971533
- Ren NN, Chen HJ, Li Y, et al. (2017). [A clinical study on the effect of nattokinase on carotid artery atherosclerosis and hyperlipidaemia]. Zhonghua Yi Xue Za Zhi. PubMed 28763875
The full evidence reviews
- Beetroot supplements and dietary nitrate: what the evidence actually supports
The nitrate→nitrite→nitric oxide pathway is real, and so are the blood-pressure and endurance effects — but they're modest, they vanish in elite athletes, product labels hide the dose, and antibacterial mouthwash can abolish the whole thing.
Updated August 2026
- Nattokinase: a real clot-dissolving enzyme on a thin, cautious evidence base
The fibrinolytic enzyme from natto genuinely cleaves fibrin and shifts human clotting markers, and small trials hint at modest blood-pressure, plaque, and lipid benefits — but the data are thin, often industry-linked, hard outcomes are absent, and bleeding risk is real.
Updated August 2026