What is NRF2 and should I use it?

As always, when some new product (or new use for an older product) hits the market, I am overwhelmed with questions from my equine clients about it.  Over the last 6 months I’ve been hit with the NRF2 question — Do you think the new NRF2 supplement will fix my horse? How does it work?

First, just a quick review of NRF2   — (researchers will have a stoke at my attempt to simplify this but I’m not teaching a course.)

NRF2 (or NFE2L2) is a protein, naturally found within the body.  It’s job is to help regulate the work of antioxidant proteins that can help protect against oxidative damage.  This oxidative damage can be triggered by injury and inflammation and involves the production of free radicals. The NRF2 pathway is part of a large system the body has in place to protect itself from damage.

Oxidation is a normal process in the body and free oxygen radicals are normal (and necessary) in the correct numbers.  Problems occur when there are too many free radicals.  Oxidative stress is an imbalance of free oxygen radicals and antioxidants in the body. Many chronic issues (arthritis, tendon and ligament issues, gastric issues, respiratory issues, etc) can be intensified by excess free oxygen radicals.

Second, oxidative stress (excess free radicals) can be due to many factors.  Supplements for use as antioxidants — Vitamin E, fish oil, Vitamin C, turmeric, cinnamon, green tea, sweet potato, etc — can all help but the body is set up to maintain free radicals itself.  Overwork, lack of rest, overfeeding, excess sugars, lack of free exercise, lack of sleep — these are just a few of the management factors that keep the body from being able to maintain itself.

Third, the supplements I’m being asked about are NOT NRF2, they are mainly herbals.  They are supposed to help with the NRF2 pathway activation.  One product I’ve been asked a lot about has 5 different herbs mixed together.  Each of these herbs has been used for specific individual conditions:

Milk thistle (Silybum marianum) — Dr. Kathy used this product for years as part of her treatment protocol in dogs with liver disease.  Studies have linked it to decreasing oxidative stress and improving immune function.

Bacopa (Bacopa monnieri) — Used in humans for Alzheimer’s.  One proposed mechanism for the cause of Alzheimer’s is oxidative stress.  Also used for anxiety and depression.

Ashwagandha (Withania somnifera) — Used in humans for anxiety.

Green tea (Camellia sinensis)– Used as an antioxidant and stimulant.

Turmeric (Curcuma longa)– Used as antioxidant and anti-inflammatory in arthritis.

There has been no scientific proof (that I can find and no information through the FDA) that these herbals work on the NRF2 pathway.

Fourth, many times herbals are sold under a marketing plan that includes treating by a new mechanism of action or offers 100% cure rate.  THIS IS MARKETING.  I have no idea if the combination in question actually works on the NRF2 pathway but that does not mean the herbal combination does not work in some way in specific cases.

Fifth, should you try these herbs?  I am certified in Chinese Herbal medicine.  I KNOW herbs can work because I’ve used them for years, so I am a firm believer in trying herbals for any condition.  The goal is for you and your horse to be as healthy as possible and to be pain free.  If using a supplement helps achieve that goal then it is up to researchers to argue about how it actually works.

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