Written by the Plenthera team (trained in orthomolecular nutrition). Scientifically reviewed in September 2026. Last updated: 18 September 2026.
Lumbrokinase is a complex of fibrinolytic enzymes from earthworms. The dried earthworm (Di Long) has been used for centuries in Traditional Chinese Medicine; the enzyme complex itself was isolated from Lumbricus rubellus by Japanese researchers in 1991 and subsequently standardised. Per milligram, lumbrokinase is the most active natural fibrinolytic enzyme available as a supplement. At Plenthera you will find Doctor's Best Lumbrokinase 20 mg in vegetarian capsules. Important: if you use blood thinners, before surgery or with clotting disorders, always seek medical advice first.
Lumbrokinase vs nattokinase — which suits you?
| Aspect | Lumbrokinase | Nattokinase |
|---|---|---|
| Source | Earthworms (Lumbricus rubellus) | Natto — soy fermented with Bacillus subtilis natto |
| Activity per mg | High — hence low doses (20-40 mg) | Lower — doses of 100-200 mg (2,000-4,000 FU) |
| Action | Breaks down fibrin directly and activates plasminogen | Breaks down fibrin directly |
| Vegan | No — of animal origin (the capsule is vegetarian) | Yes — plant-based |
| Research in humans | More limited, mainly Chinese studies | More extensive |
| Price | Higher | Lower |
If you are looking for a plant-based alternative, take a look at nattokinase.
What is lumbrokinase?
Lumbrokinase is the collective name for a group of fibrinolytic enzymes (serine proteases) from earthworms, mainly Lumbricus rubellus. The enzyme complex breaks down fibrin — the protein that gives blood clots their structure — and is therefore being researched in connection with blood circulation.
In Traditional Chinese Medicine, the dried earthworm has been used for centuries under the name Di Long ("earth dragon"). In 1991, Mihara and colleagues isolated from Lumbricus rubellus a group of six fibrinolytic enzymes (EFE, earthworm fibrinolytic enzymes), together called lumbrokinase. Earthworms probably developed this enzyme system to break down their food in the soil.
Lumbrokinase differs from nattokinase in having a dual mechanism: the enzyme breaks down fibrin directly (fibrinolytic) and converts plasminogen into plasmin, the body's own fibrin-degrading enzyme. As a result, activity per milligram is high and the usual doses are low: 20-40 mg per day, compared with 100-200 mg for nattokinase. Manufacturers express activity in units on fibrin plates or as a standardised extract in milligrams.
Because lumbrokinase affects fibrinolysis, the same caution applies as with nattokinase: with blood thinners (warfarin, acenocoumarol, DOACs), platelet aggregation inhibitors such as acetylsalicylic acid, before surgery or with clotting disorders, do not use without consulting a doctor.
What does science say about lumbrokinase?
Research into lumbrokinase focuses on fibrinolysis: in laboratory studies the enzyme complex breaks down fibrin and fibrinogen and activates plasminogen. Animal studies and a number of mainly Chinese clinical studies investigate lumbrokinase in connection with blood circulation and blood viscosity. These studies are relatively small and not all placebo-controlled; large, independent studies are still lacking. An overview of the state of research is given by Cooper & Balamurugan (2010).
A practical question is whether the enzyme survives the stomach. Research suggests that lumbrokinase is relatively stable at low pH and is partly absorbed intact; here too, the human evidence is limited. We therefore describe only the mechanism and the lines of research.
Lumbrokinase is a food supplement, not a medicine. If you take medication, before surgery or with a tendency to bleed: consult your doctor or pharmacist beforehand.
The lumbrokinase forms at Plenthera
Doctor's Best Lumbrokinase 20 mg — 60 vegetarian capsules (also 3×60 as a value pack)
Standardised lumbrokinase extract in 20 mg capsules, in a vegetarian capsule (the enzyme itself is of animal origin). Easy to dose: 1 capsule for the usual 20 mg, 2 capsules for 40 mg. Also available as a value pack of 3×60 capsules.
Other forms on the market
Lumbrokinase is also available as the Canadian brand Boluoke (standardised on enzyme activity) and in combination formulas with nattokinase or serrapeptase. These are not currently in our range; for plant-based fibrinolytic enzymes, see the category nattokinase and for serrapeptase the category serrapeptase.
How do you use lumbrokinase?
A simple basic approach for lumbrokinase:
- Start with 1 capsule of 20 mg per day; the usual range in supplements is 20-40 mg per day (1-2 capsules). Follow the label.
- Take lumbrokinase between meals, at least 30 minutes before or 2 hours after eating — so that the enzyme is not used for digesting protein from the meal.
- If you use blood thinners or platelet aggregation inhibitors: consult a doctor beforehand, even at low doses.
- Before surgery or a dental procedure: stop at least 2 weeks beforehand and inform the practitioner.
- Do not use during pregnancy or breastfeeding or with a known tendency to bleed.
- Enzymes are not medicines: with heart or blood vessel complaints, regular medical care remains the basis.
Myths and misconceptions about lumbrokinase
Myth 1: "Lumbrokinase is a natural blood thinner that can replace medication."
Incorrect and risky. Lumbrokinase breaks down fibrin; blood thinners such as warfarin inhibit the production of clotting factors and acetylsalicylic acid inhibits the platelets. These are different mechanisms with different doses and monitoring. Never stop prescribed medication in favour of a supplement.
Myth 2: "More milligrams of lumbrokinase work better."
Lumbrokinase is so active per milligram that low doses (20-40 mg) are common. Higher doses are not better substantiated and mainly increase the risk of bleeding.
Myth 3: "Lumbrokinase and nattokinase are the same."
Both are fibrinolytic enzymes, but they differ in source (earthworm versus fermented soy), mechanism (lumbrokinase also activates plasminogen) and dosage. Nattokinase is plant-based and more extensively researched; lumbrokinase is more active per milligram.
Myth 4: "Because it is a natural product, anyone can use it safely."
Incorrect. With blood thinners, before surgery, during pregnancy or with clotting disorders, lumbrokinase is not suitable without medical consultation.
Combining lumbrokinase with other supplements
Lumbrokinase is often combined within the heart and blood vessels theme. Popular combinations:
- Omega 3: EPA and DHA contribute to the normal function of the heart (with a daily intake of 250 mg EPA and DHA).
- Q10: a coenzyme that plays a role in cellular energy metabolism; being researched in connection with the heart and blood vessels.
- Magnesium: magnesium contributes to normal muscle function and to normal energy-yielding metabolism.
- Turmeric: curcumin is being researched for its antioxidant properties; note that curcumin can affect the platelets — only combine with lumbrokinase after consultation.
- Vitamin K2: vitamin K contributes to normal blood clotting and therefore works in a different direction from lumbrokinase. Combining is possible, but coordinate this with a doctor, especially if you take medication.
- Nattokinase: sometimes used together with lumbrokinase; stacking two fibrinolytics increases the risk of bleeding — only under supervision.
Frequently asked questions
What is lumbrokinase?
A complex of fibrinolytic enzymes from earthworms (mainly Lumbricus rubellus), known in TCM as Di Long and scientifically isolated in 1991.
How does lumbrokinase work?
It breaks down fibrin directly and activates plasminogen, the body's own fibrin-degrading system. Researched in connection with blood circulation; human data are limited.
How much lumbrokinase per day?
Common is 20-40 mg per day: 1-2 Doctor's Best capsules of 20 mg. Follow the label.
When should you take lumbrokinase?
Between meals, at least 30 minutes before or 2 hours after eating.
Can lumbrokinase be taken with blood thinners?
Not without medical consultation — the risk of bleeding may increase with warfarin, acenocoumarol, DOACs and acetylsalicylic acid.
What is the difference from nattokinase?
Lumbrokinase is of animal origin, more active per milligram and also activates plasminogen; nattokinase is plant-based, more extensively researched and dosed higher.
Is lumbrokinase vegan?
No. The enzyme comes from earthworms. The Doctor's Best capsule is vegetarian, but the contents are of animal origin. Plant-based alternative: nattokinase.
Does lumbrokinase have side effects?
Generally well tolerated at the usual dose. Possible: an increased tendency to bleed, especially in combination with other agents that affect clotting, and occasional mild stomach complaints.
Should I stop before surgery?
Yes, at least 2 weeks beforehand, and inform the treating doctor or dentist.
How do I recognise good-quality lumbrokinase?
A standardised extract with a stated amount per capsule, a reliable manufacturer and a clear statement of the source (Lumbricus rubellus).
Sources
- Mihara H. et al., "A novel fibrinolytic enzyme extracted from the earthworm, Lumbricus rubellus", Jpn J Physiol (1991).
- Cooper E.L. & Balamurugan M., "Unearthing a source of medicinal molecules", Drug Discov Today (2010).
- Regulation (EU) 432/2012 — authorised health claims (EPA/DHA, magnesium, vitamin K).
Disclaimer: This text is for informational purposes only and does not replace medical advice. Lumbrokinase is a food supplement, not a medicine. If in doubt or if you take medication, we recommend consulting a doctor or orthomolecular therapist first.