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Finch et al, 2016)

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In an uncontrolled clinical trial in 45 subjects with a range of health statuses, 2,000 fibrinolytic units (FUs) of nattokinase daily for two months was shown to decrease levels of fibrinogen, factor VII, and factor VIII

For patients seeking weight loss who request B12 injections, GPs should: Assess for genuine deficiency through appropriate blood tests rather than empirical treatment Provide education about the lack of evidence supporting B12 for weight loss in non-deficient individuals Explore underlying concerns about weight and energy levels, addressing these through appropriate channels Signpost to evidence-based resources such as NHS weight management services according to local pathways Patients should contact their GP if they experience unexplained fatigue, neurological symptoms (numbness, tingling, balance problems), or signs of anaemia (pallor, breathlessness, palpitations), as these may indicate B12 deficiency requiring investigation