Nattokinase has strong fibrinolytic activity and vitamin E has mild antiplatelet effects; combined bleeding risk is increased.
Nattokinase dissolves fibrin while vitamin E inhibits platelet aggregation.
At normal vitamin E doses (400 IU or less) the added risk is modest. Inform your doctor before surgery.
Reference values for safe daily intake of these supplements.
Applies to synthetic forms (dl-alpha-tocopherol). Risk of bleeding at high doses.