Guest Post by Mickey Trescott: How Do You Balance Th1 and Th2 in Autoimmune Disease?

January 16, 2013 in Categories: , , by

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mickeyphoto2This is the second of two guest posts written on the subject of Th1 versus Th2 dominance in the context of autoimmune disease by Mickey Trescott, blogger behind Autoimmune-Paleo (the first post is here).   But first, let me introduce you to Mickey.  Mickey is a personal chef and blogger from Seattle, WA who has both Hashimoto’s and Celiac disease. She writes about her struggles with autoimmunity, alternative treatments and protocols, and shares many AIP-friendly recipes on her blog. She is busy writing a cookbook for the autoimmune protocol that is coming out early this year (and yes, I will let you all know when it’s released!  how exciting!). You can also find Mickey on Facebook and Instagram.

In my last article I explained the basic roles of Th1 and Th2 in the immune system as well as how they can be imbalanced in those suffering from autoimmune disease. In this article, I am going to cover the nutritional compounds that can shift the balance between Th1 and Th2, as well as those that are known to modulate them.

How do I tell if my immune system is imbalanced?

 A Th1/Th2 Cytokine blood panel is the best way for a person to find out which side of their immune system is dominant. Alternatively, a person can also participate in a supplement challenge, where they take a nutritional supplement that stimulates Th1 for a few days and then switch to a supplement that stimulates Th2 for a few days, while noting the effect this has on their symptoms. (Update:  there are some newer tests that can establish Th 1 versus Th2 dominance, discussed in the comments on this post)

What is the protocol for balancing the immune system?

 Dr. Kharrazian is the practitioner who has developed the protocol for treating autoimmune disease by balancing Th1 and Th2. If Th1 is dominant, he will use Th2 stimulating compounds to raise the level of Th2, and vice versa. In addition, he uses other vitamins and compounds that are known to modulate the balance between Th1 and Th2. His view is that by balancing Th1 and Th2, the autoimmune attack is lessened and the body is able to function closer to normal. He also places his patients on an autoimmune gut-repair diet (which is very similar to the autoimmune protocol). Many people have been helped by using this protocol for the treatment of Hashimoto’s disease.

 That being said, balancing the immune system for those with autoimmune disease is still tricky business and baffles even the most skilled practitioners. There are many people who have had a negative experience using this type of treatment, most likely because it is easy to accidentally stimulate their dominant pathway, causing the autoimmune attack to worsen. The Th1/Th2 stimulating compounds are as follows:

TH1 stimulating compounds:



Medicinal Mushrooms (Maitake and Beta-Glucan are common)

Glycyrrhiza (found in licorice)

Melissa Oficinalis (Lemon balm)

Panax Ginseng


Grape Seed Extract

TH2 stimulating compounds:


Green Tea Extract

Pine Bark Extract

White Willow Bark

Lycopene (found in tomatoes and other red fruits excluding strawberries and cherries)

Resveratrol (found in grape skin, sprouted peanuts, and cocoa)

Pycnogenol (found in the extract of the French maritime pine bark and apples)

Curcumin (found in turmeric)

Genistin (found in soybeans)

Quercitin (a flavanoid found in many fruits and vegetables, such as onions, berries and kale)

Why is it important to know about these compounds?

 As you can see, many items on the list are common and are used by many people on a regular basis. Echinacea, for example, is a common herbal cold and flu remedy, but it can cause someone with a Th1 dominant condition to worsen. Likewise, a person with a Th2 dominant condition that is drinking a few cups of coffee everyday could be unintentionally stimulating the already dominant Th2 pathway. The opposite could be true – a Th1 dominant person may benefit from the consumption of caffeine, although this gets a little messy when you add a person’s adrenal status to the mix (caffeine may help them if they have low cortisol, but they could still be Th2 dominant and have worsening autoimmune symptoms from it).

 If you suffer from an autoimmune disease, chances are you are going to be sensitive to supplements that effect the immune system. Just knowing how powerful these compounds are is useful information even if you are not going to attempt to use them to balance your levels of Th1 and Th2.

Is there a safer way to balance Th1 and Th2?

 Playing with the balance of Th1 and Th2 is tricky and some people do not do well with it, even under the care of a practitioner. Using vitamins and nutrients that naturally modulate the balance between Th1 and Th2 or support T-regulatory cell function is much less risky than taking supplements that directly stimulate either one. The following compounds have been shown in studies to do this:

TH1 and TH2 modulating compounds:

Probiotics (found in fermented foods like kimchi, saurkraut, yogurt, kombucha, kefir as well as supplements)

Vitamin A (found in liver and cod liver oil as well as butter and eggs from pastured animals)

Vitamin E (found in red palm oil, pastured egg yolks, avocados, as well as nuts and seeds)

Colostrom (a mother’s first milk that is available in supplement form)

T-regulatory supporting compounds:

 Vitamin D (obtained by sunbathing, also found in liver, cod liver oil, sardines, raw dairy and pastured eggs)

EPA and DHA (found in fatty cold-water fish such as salmon, sardines and mackerel as well as in pastured meats and eggs in smaller quantities)

In conclusion, I believe that it is good for autoimmune patients to know which compounds stimulate Th1 and Th2 because of how they can better or worsen the progression of disease. Knowing one’s Th1 or Th2 dominance and treating with supplements to achieve balance can be helpful to some, but I don’t believe that is the best and safest approach for everyone. If you do decide to go this route, make sure to enlist the help of a practitioner who is skilled at using this treatment for autoimmune disease. A safer alternative is to focus on compounds that have been shown to modulate the immune system, in addition to implementing other strategies that have been shown to help autoimmune disease.



Fascinating article. Thanks for sharing, Mickey. I guess this explains why Curcumin has been so helpful for me in controlling inflammation from Rheumatoid Arthritis. I never got tested, but when I researched supplements, I looked for studies specific to my diagnosis. Thanks for the education that supplements that work for one autoimmune disease, don’t necessarily help the others.

Eileen – That is awesome that curcumin is working to manage your inflammation! I would add also that your dominance can shift in the opposite direction if you supplement too aggressively, so not to worry you, but just be aware of it. I went through a phase where a high dose of curcumin was doing wonders for me, and then something shifted and it started to cause problems.

Curcumin seems to flare my autoimmune arthritis- ankylosing spondylitis. Frustrating since the supplement is one of the most recommended for AI arthritis, and was shown to work as well as Celebrex in one study i read about. Do you know if Spondylitis is a Th2 dominate condition? I’ve assumed it made me feel worse because it is starchy and starches supposedly exacerbate spondylitis. As usual, PaleoMom and her guest posts have some lightbulbs turning on in my head. If there’s any way to find out the Th status? There are quite a few supplements on those lists that have been recommended for my condition- especially the Th2 list.
Thanks for any insight, MaryCay

Hi Mary,
As I said in my first article, the list of associated conditions with either Th1/2 dominance are not set in stone. I don’t know enough about ankylosing spondylitis to know if it is most often a Th1 or Th2 dominant condition, but your experience with the stimulating supplements can be useful. There are blood tests, but they are very expensive and I don’t know how accurate they are. There is a possibility that both Th1 and Th2 can be overactive, meaning that you would need to avoid supplements with all of those ingredients. That is the situation I am in with my autoimmune conditions – both Th1 and Th2 stimulating compounds cause my symptoms to worsen. Instead I focus on the modulating and T-regulatory supporting compounds – probiotics, vitamins A, D, E, EPA and DHA, and colostrum.

I appreciate these thoughts Mickey. I didn’t hear about Th1 and Th2 compounds before. I try to be careful about how many eggs I eat on a regular basis, so the only other source of vitamin A that leaves is cod liver oil. What are the risks of eating too much cod liver oil if any? I force myself to have some (still getting accustomed to the taste) but not sure what the risks are (if any) when taken regularly. Thanks again for the post. This is clearly something I need to give more thought to as someone who has only been paleo a year.

I think I can answer this. 🙂 Cod liver oil also contains vitamin D which protect against vitamin A toxicity, so you can actually have quite a lot daily perfectly safely.

I was taking Bovine Colostrum and i dont know why it make me feel worse: out of space, slowly, sex drive, higher TSH…i dont know…I have hashimoto and i am TH1 dominant…I thought thas was die off but 12 days is too much…what do you think? thanks

Th1/Th2 balance is messy indeed when tinkering with immune-enhancing herbs and supplements. About 8 years ago (a couple of years after starting the Paleo diet), I became ill with the flu and my fever skyrocketed to 105. It was scary, I was miserable, and Tylenol and Ibuprofen weren’t bringing down the fever. Self-treatment with acupuncture was not helping ether. Fortunately, I had a large amount of raw astragalus root and raw reishi mushroom in my kitchen cupboard. I boiled them both in a stewing pot for about twenty minutes and then drank the resulting “tea.” It was a last resort, but it worked. About 30 minutes later, the fever came down. I still rely on a small dose of ginseng, astragalus, cordyceps, and several other Chinese Herbs to regulate my system and manage autoimmune symptoms, but I have problems with echinacea. Additionally, I seem to do fine with caffeine, but not so well with green tea. Does anyone have any incite into why this may be happening? This has been one of those things in which I go by what my body is saying versus anything I have read about Th1/Th2 balance.

Th balance is still not terribly well understood, and while it can be a good explanation for why some immune-stimulating compounds affect some people and not others, not everyone finds it to be true. It is definitely a case of listen to your body. – Christina, Sarah’s assistant

I realise I’m late to the game here, but Grapeseed Extract is quite a powerful Th2 stimulator, not Th1. There are a number of studies on that (message me if you want the references).

What about kombucha made with green tea if you’re th2 dominant, will that make it worse due to the green tea and is it better to stick to kombucha made with white or black tea?

I have Hashimoto’s and suspect I’m Th1 dominant. I’m also in stage 3 adrenal fatigue and don’t seem to tolerate the adaptogenic formulas which all seem to contain ginseng. Licorice is also often recommended for low cortisol but again it’s Th1 stimulating! Do you know of any other options to support the adrenals?

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