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Boluoke: Fibrin-dissolving enzyme from earthworms that protects from heart disease

The BEST oral enzyme for blood health

For many centuries, earthworm has been used in Far Eastern traditional medical practice for conditions associated with circulatory abnormalities.  It was recorded in the "Ben Cao Gang Mu," the traditional Eastern world's pharmacopoeia, as a potent medicine for "Liver Wind Uprising" and "Channel Blockage" conditions.

In order to elucidate the power of earthworms, Japanese scholars Dr. Hisashi Mihara and others succeeded in extracting a fibrin-dissolving enzyme from Lumbricus rubellus in the 1980s.  This enzyme was later found to consist of a few proteolytic sub-enzymes which are collectively named lumbrokinase.  Lumbrokinase is also referred to as earthworm fibrinolytic enzymes (EFE), earthworm powder enzymes (EPE), or e-PA.

Since then, many Chinese and Korean researchers have compiled extensive scientific and clinical data on lumbrokinase extracted from Lumbricus rubellus and Eisenia fetida.  In Japan and Korea, lumbrokinase has been the main ingredient in "Dragon Heart," a popular health supplement for supporting circulatory health.  In China, earthworm protein extracts and lumbrokinase have been studied thoroughly and have been used to support a healthier blood state.  As science and technology have advanced over the last century, so has the knowledge about the active constituents in traditional medicine.

First, there were the dried earthworms used in traditional Oriental medicine decoctions, and then there was ground-up earthworm powder.  Later came the granular crude extract of earthworms, and now there is Boluoke®, a nutraceutical product containing purified enzymes extracted from earthworms.  (Pronounced Boh-LUKE.)  Just like the Omega-3 molecules in fish oil, the polyphenols in green tea, and curcumin and turmeric, the group of enzymes called lumbrokinase shall in time be known as a valuable characteristic of earthworms.

Boluoke (lumbrokinase) is the only fully researched oral enzyme on the market supporting a healthier blood state, and it shows great promise in supporting a healthy balance of coagulation and fibrinolysis in the body. 

The coagulation system is a complicated and highly regulated system.  Modern lifestyles often tip the balance toward hypercoagulation, but rarely toward hypocoagulation.  For most people, Boluoke can support the body in keeping the system in a more balanced state.  Some practitioners are also recommending Boluoke for those who choose to be on hormone replacement therapy or birth control pills, or for those who cannot tolerate standard preventative pharmaceutical drugs.

Hypercoagulation and Why You Should Care

Hypercoagulation is a thickened blood state, and means that the body is producing fibrin strands faster than it can break them down.  When this happens, the fibrin may get deposited on the capillary walls, and this impedes the delivery of oxygen and nutrients from the blood into the tissues, and waste chemicals from the tissues out to the bloodstream.  If this situation is sustained for a prolonged period of time, the tissues of the body will gradually become hypoxic (lacking in oxygen) and malnourished.  The end result is often an acidic tissue environment, pain, lack of energy, and the decline or loss of organ functions.  Hypercoagulation also predisposes a person to clot formation (as in strokes or heart attacks) in blood vessels if atherosclerosis is already present.

Research has clearly shown that hypercoagulation is often present in patients with chronic illnesses.  If the hypercoagulation condition is not addressed in these patients, they often do not improve, or they relapse easily. 

Hypercoagulation is often present in the following conditions:

Cancer Angina
Diabetes Heart attack history
Fibromyalgia Transient ischemic attacks
Crohn’s Disease Ischemic stroke history
Lyme Disease On birth control pills
Multiple Sclerosis On Hormone Replacement Therapy
Meniere’s Disease Thrombocythemia
Chronic Fatigue Syndrome Deep venous thrombosis
Chronic infections Being on long air flights
Lupus Hip fracture
Gulf War Syndrome Ulcerative colitis
Excessive heavy metal burden Polycythemia
Elevated serum fibrinogen Vascular dementia
Elevated Serum CRP Autism
Elevated serum Lp(a) ADD/ADHD
Elevated homocysteine Habitual miscarriages

Of course, the cause of hypercoagulation must also be addressed in order to achieve a lasting improvement.  Some of the most common causes of hypercoagulation are infections, coagulation protein defects (inherited), and heavy metal or chemical toxicities.

Frequently Asked Questions About Boluoke

Does Boluoke have any side effects?

The earthworm has been used in Traditional Chinese Medicine for thousands of years and it is considered to be one of the safest ingredients in the traditional pharmacopoeias.  The studies on Boluoke have shown that when taken at high dosage, some people might experience nausea, diarrhea, bloating, skin rashes, or itching, but these resolve when the product is stopped. 

In one of the largest clinical studies of Boluoke involving 16 hospitals and 1560 patients in China, the overall adverse reaction rate was 1.92% (30 cases).  Of these 30 cases, 9 (0.58%) had skin itching, 3 (0.19%) had skin rash, and 18 (1.15%) had nausea or diarrhea.  No bleeding or major side effect was reported.

How long before surgery should a patient stop taking Boluoke?

The conservative approach would be to stop Boluoke one week prior to surgery.  The patient may resume taking Boluoke 15 days after surgery if there are no complications, or earlier if the physician deems it appropriate.

Can Boluoke be safely taken if a patient is on blood-thinning agents?

Boluoke does not significantly affect blood tests such as prothrombin time (PT) or activated partial thromboplastin time (aPTT), and thus it does not affect INR.  However, patients should always consult their physicians before taking Boluoke while on any prescriptions.

How does Boluoke compare to Nattokinase?

The fibrinolytic strength of Boluoke is unmatched by any other enzyme on the market.  Research has shown that 2 capsules of Boluoke, containing a total of 40mg lumbrokinase, is much more potent than 20 capsules of nattokinase, containing a total of 720mg nattokinase.  This is a potency difference of more than 18-fold.  To view these research results, click here for Page 1 and here for Page 2.

Can the content of Boluoke capsules be emptied out and taken without the capsules?

The capsules used for Boluoke are enteric-coated.  They are designed to resist stomach acid and dissolve in the small intestines, because lumbrokinase may be inactivated by stomach acid.  Preliminary in-house tests using a Sonoclot® machine (manufactured by Sienco, Inc.) indicate that Boluoke is still effective when taken without the capsules on an empty stomach.  However, it is highly recommended that the patients take Boluoke in its original encapsulated format whenever possible.

Are there any contraindications for taking Boluoke?

Contraindications for Boluoke are:  allergy to lumbrokinase or earthworm;  recent surgery;  pre-surgery;  lumbar puncture or arterial puncture;  trauma;  active internal bleeding or GI ulceration;  any other bleeding disorders or tendencies.  Patients should always consult their physicians before taking Boluoke.  Being on a strong anti-platelet medication like Plavix or Ticlid is a relative contraindication for taking Boluoke.

Can I take Boluoke if I am currently on other prescription medications?

Boluoke has been safely used by many patients with various medical conditions, and to date there are no known interactions between Boluoke and any prescription medicines.  However, patients should always consult with their physician before taking Boluoke.

Can Boluoke be taken with other enzyme products?

There is a theoretical possibility that Boluoke may be cleaved and rendered ineffective by other enzymes, so we currently do not recommend taking Boluoke at the same time as another enzyme product.  If you must take other enzyme products while on Boluoke, try to space more time between the dosing of the two enzyme products (i.e. at least 2 hours).

How is Boluoke different from other products that contain lumbrokinase?

Boluoke is the only lumbrokinase that has been thoroughly researched and its enzymatic strength standardized.  Other lumbrokinase products currently on the market may cite Boluoke’s credentials and research, but are not disclosing the enzymatic strength of their lumbrokinase.  On the raw material market, the price of lumbrokinase can vary by up to 15-fold, and the enzymatic strengths of various forms of lumbrokinase also differ greatly.

In addition, lumbrokinase is a preparation containing multiple enzyme fractions, and the extraction and purification methods would determine the final compositions of the various enzyme fractions.  Therefore, different products would have different lumbrokinase compositions and cannot be considered the same.  This is also the reason why Boluoke does not significantly affect blood tests like prothrombin time (PT) or activated partial thromboplastin time (aPTT), while other lumbrokinase products may affect the test results.

What is the suggested protocol for taking Boluoke?

For most patients, Boluoke should be taken at the dose of 1 capsule one to three times daily 30 minutes before meals.  However, for people with severe hypercoagulation, physicians may suggest a dose of 2 capsules three times daily for 3 to 6 weeks or longer.


Boluoke (Lumbrokinase) References

Fan Q, Wu C, et al.  Some features of intestinal absorption of intact fibrinolytic enzyme III-1 from Lumbricus rubellus.  Biochem Biophys Acta, 2001; 1526(3): 286-92.

Gao Y, Qin MZ.  Lumbrokinase in treatment of patients with hyperfibrinogenemia of coronary atherogenesis disease.  Journal of Capital University of Medical Sciences, 1999; 4(20).

Gong B, Wu XY.  Observation of using Baiao lumbrokinase capsules to treat ischemic cerebrovascular accident with hyperlipidemia.  Capital Medicine, 2000; 7(12): 39.

Guo ZF, Liu XX.  Observation of treating ischemic cerebrovascular accident with Baiao lumbrokinase capsules.  Capital Medicine, 2000; 7(11): 45.

Huang ZD, Li ZW, Zhang WX.  Lumbrokinase in treating cerebral infarction.  Chinese Journal of New Drugs and Clinical Remedies, 2000; 6(19): 453-455.

Jie WH.  Clinical observation of treating unstable angina in seniors with lumbrokinase.  Capital Medicine, 2000; 7(10): 37.

Jin L, Jin H, Zhang G, Xu G.  Changes in coagulation and tissue plasminogen activator after the treatment of cerebral infarction with lumbrokinase.  Chinese Journal of Microcirculation, 2000; 23: 213-218.

Jing LR, Xu GZ.  Dynamics of fibrinolysis and hemostasis in ischemic stroke patients, and the effects of lumbrokinase on those dynamics.  Chinses Journal of New Drugs and Clinical Remedies, 1999; 18(1): 48-49.

Liao RH.  Analytical report of treating 30 patients of ischemic cerebrovascular disease with Panford lumbrokinase and nimodipine.  Strait Pharmaceutical Journal, 1997; 9(3): 25-26.

Liu J, Zhou LM, Ren Y.  Lumbrokinase capsule vs Salvia miltiorrhiza tablet in treating coronary disease with angina pectoris.  Chinese Journal of New Drugs and Clinical Remedies, 1999; 1(18): 17-19.

Mihara H, Sumi H, Mizumotoh, et el.  Oral administration of earthworm powder as a possible thrombolytic therapy, ed in Tamkak, Recent advance in thrombosis and fibrinolysis.  Hapan Academic Press, 1996, 287.

Mihara H, Sumi H, Yoneta T, Mizumoto H, et al.  A novel fibrinolytic enzyme extracted from the earthworm, Lumbricus rubellus.  Jpn J Physiol, 1991; 41: 461-72.

Mihara H.  A possibility of Earthworm powder as therapeutic agent for thrombosis.  Thromb Haemost, 1988; 50: 258.

Pan SY.  Treating Blood-Stagnation type angina with Baiao lumbrokinase.  Capital Medicine, 1998; 9(5): 40-41.

Pang SQ, Ding MC, Xie SP, et al.  A clinical study of therapeutic effectiveness in treating ischemic cerebrovascular disease with Lumbrokinase (Boluoke).  Chinese Journal of Neurology and Psychiatry, 1993; 26(4):  229.OOOOOPark S, Kye KC, Sumi H, et al.  Fibrinolytic activity of the earthworm extract.  Thromb Haemost, 1989; 62: 545.

Park Y, Ryu E, Kim H, Jeong J, et al.  Characterization of antithrombotic activity of lumbrokinase-immobilized polyurethane valves in the total artificial heart.  Artif Organs,1999; 23: 210-4.

Qi W, Yu XB, et al.  Effects of lumbrokinase on blood rheology of seniors with coronary arterial diseases.  Chinese Journal of Microcirculation, 2000; 1(10): 55.

Ryu GH, Park S, Kim M, et al.  Antighrombogenicity of lumbrokinase-immobilized polyurethane.  J Biomed Mater Res, 1994; 28: 1069-77.

Tang Y, Liang D, et al.  Crystal structure of earthworm fibrinolytic enzyme component a:  revealing the structural determinants of its dual fibrinolytic activity.  J Mol Biol, 2002; 32(1): 57-68.

Wang LH, Yao W.  Vermis kinase (Boluoke) therapeutic evaluation to cerebral infarction and influence to blood rheology.  Journal of Practical Medical Technology, 1998; 5(2).

Wang R, Chen Q, Fang XQ, et al.  Effects of Fleroxacin combined with urokinase or earthworm kinase on bacterial biofilm.  Acta Pharmaceutica Sinica, 1999; 9(34): 662-665.

Wang XL, Yan DC.  Clinical observation of using Baiao lumbrokinase capsules to treat patients with coronary artery disease secondary to diabetes mellitus.  Capital Medicine, 2000; 7(8): 38.

Wu XQ, Wu C, et al.  Immobilized earthworm fibrinolytic enzyme III-1 with carbonyldiimidazole activated agarose.  Protein and Peptide Letters, 2002:  9(1): 75-80.

Yang GR.  Treating unstable angina with Baiao lumbrokinase capsules.  Capital Medicine.  1999; 3(6): 30.

Zhang GP, Jin HM, Zhang M, et al.  Anticoagulative and fibrinolytic effects of lumbrokinase and their relation to tissue plasminogen activator.  Chinese Journal of Geriatrics, 1998; 6(17): 366-368.

Zhang GP, Qian RZ, et al.  Experimental observation of the inhibitory effects of lumbrokinase on platelets.  National Medical Journal of China, 1998; 5(78): 394-95

Zhang HY.  Clinical evaluation of treating acute ischemic cerebrovascular disease with lumbrokinase.  Capital Medicine, 2000; 7(3): 45-46.

Zhang JQ, Jing CH.  Clinical evaluation of using Baiao lumbrokinase in the treatment of central retinal vein occlusion.  Capital Medicine, 1999; 6(2): 51.

Zhang LP, et al.  Preventative effects of lumbrokinase on experimentally induced emboli.  Chinese Journal of Hemorheology, 1995, 11(10): 679-680.

Zhang NH.  Blood rheological changes of coronary artery disease patients prior and after lumbrokinase treatment.  Chinese Journal of Hemorheology, 1999; 1(9): 63.

Zheng HJ, Xu JM, Huang ZH.  Lumbrkinase capsule vs ticlopidine in treating coronary artery disease with angina pectoris.  Chinses Journal of New Drugs and Clinical Remedies, 2000; 5(19): 406-408.

Zheng Z, Lin JN, et al.  Observation of 20 unstable angina patients treated with Baiao lumbrokinase capsules.  Capital Medicine, 2000; 7(6): 38.

Zhao J, Fan R, et al.  Assay of lumbrokinase with a chromophoric substrate.  Protein and Peptide Letters, 1997; 4(6): 409-14.

Zhou M, Wang FQ.  The effects of lumbrokinase on blood rheology in patients with sudden hearing loss.  Journal of Chinese Microcirculation, 2000; 3(4): 177-178.

Zhou XD, Zhao RX, Zheng XR, Zhang H.  Observation of Boluoke (lumbrokinase) treatment in the recovery of motor function after cerebral infarction.  Chinese Journal of Western and Chinese Medicine Cooperation, 1997; 12 (17).

For further reading, visit the manufacturer's website here.


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