This is the first 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 second post will be posted this Wednesday.  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.

Those that suffer from autoimmune disease commonly experience symptoms that stem from imbalances within the functioning of their immune system. There are many factors that can influence this balance – stress, nutrition, vitamin and mineral deficiencies, gut flora, and allergies, among others. This way of looking at autoimmune disease is a growing trend in the alternative field, highlighted through the work of Datis Kharrazian.

In this series I hope to give readers a basic explanation of how the T-helper cells work within the immune system, as well as what factors can cause them to be more or less in balance.

What are Th1 and Th2?

T-helper cells (abbreviated as Th) are a vital part of the immune system. They are lymphocytes (types of white blood cells) that recognize foreign pathogens, or in the case of autoimmune disease, normal tissue. In response to this recognition, they produce cytokines, which are hormonal messenger proteins that are responsible for the biological effects of the immune system. They are divided into subgroups as follows:

Th1: Th1 cells are involved in what is called “cell-mediated” immunity, which usually deals with infections by viruses and certain bacteria. They are the body’s first line of defense against pathogens that get inside our cells. They tend to be pro-inflammatory and are involved in the development of organ-specific autoimmune disease.

Th2: Th2 cells are involved in what is called “humoral-mediated” immunity, which deals with bacteria, toxins, and allergens. They are responsible for stimulating the production of antibodies in response to extracellular pathogens (those found in blood or other body fluids). They tend not to be inflammatory and are involved in systemic autoimmune disease and other chronic conditions.

In a well-functioning immune system, both groups of these T helper cells work together to keep the system balanced. One side might become more active to eradicate a threat, then settling back to a balanced level.

How does this affect autoimmune disease?

In some people with autoimmune disease, patterns showing a dominance to either the Th1 or Th2 pathway have been shown. Although there are exceptions, the following table shows the conditions that are most commonly associated with a Th1 or Th2 dominant state:

TH1 dominant conditions:

Type I diabetes
Multiple sclerosis
Hashimoto’s Thyroiditis
Grave’s Disease
Crohn’s Disease
Psoriasis
Sjoren’s Syndrome
Celiac Disease
Lichen Planus
Rheumatoid Arthritis
Chronic viral infections

TH2 dominant conditions: 

Lupus
Allergic Dermatitis
Scleroderma
Atopic Eczema
Sinusitis
Inflammatory Bowel Disease
Asthma
Allergies
Cancer
Ulcerative Colitis
Multiple chemical sensitivity

When the th1 cells of the immune system are overactive, they can suppress the activity of th2 and vice versa. This can be problematic because these two components of the immune system function in a delicately balanced relationship. In the case of autoimmune disease, imbalance can further the attack on healthy tissue, thereby worsening symptoms.

Although research can lump those with certain conditions under the Th1/2 categories, in reality they can be all over the map. For instance, although most Hashimoto’s patients present a Th1 dominance, some can be Th2. It is also possible to have both Th1 and Th2 simultaneously overactive or under-active. Pregnancy can shift the immune system temporarily to Th2, which is why a lot of women find out they have Hashimoto’s after they give birth and their immune system returns to Th1 dominance.

How do I find out if I am Th1 or Th2 dominant?

There is a Th1/Th2 cytokine blood panel that your doctor can order to find out if your immune system is imbalanced. You can also do a challenge with certain nutritional compounds that stimulate either Th1 or Th2, although this can be tricky and is best done under the supervision of a practitioner.

In the next article, I will cover these nutritional compounds along with other strategies of balancing and modulating the immune system.

References: 

Why Do I Still Have Thyroid Symptoms? by Datis Kharrazian 

Immune Balancing for Hashimotos - Chris Kresser 

Research Review: Could Green Tea Actually Be Bad For You? – Dr. Bryan P. Walsh