What is the Role of Th1 and Th2 in Autoimmune Disease?

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This article was originally written as a guest post for The Paleo Mom

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

About Mickey Trescott

Mickey Trescott is a cook and one of the bloggers behind Autoimmune Paleo. After recovering from her own struggle with both Celiac and Hashimoto’s disease, adrenal fatigue, and multiple vitamin deficiencies, Mickey started to write about her experience to share with others and help them realize they are not alone in their struggles. She is a certified Nutritional Therapy Practitioner by the Nutritional Therapy Association, and is the author of The Autoimmune Paleo Cookbook, a guide and recipe book for the autoimmune protocol, and AIP Batch Cook, a video-based batch cooking program. You also can find her on Instagram.

36 comments

  • So thankful to have found your blog! I have type 1 diabetes (6 years) and have struggled with digestive issues for almost 16 years. I am starting the AIP this coming Monday and arming myself with all the resources I can find. Thank you for what you do!!

  • […] my last article I explained the basic roles of Th1 and Th2 in the immune system as well as how they can be […]

  • […] my last article I explained the basic roles of Th1 and Th2 in the immune system as well as how they can be […]

  • Nancy Todd says

    Where does ITP and microscopic colitis fall in the TH1 and TH2?

  • Saundra says

    I’m so glad to have found your blog. I’ve been busy reading this evening! Lots of good information! Which category would you put fibromygia, chronic fatigue, and Epstein Barr? Are they Th1 or Th2?

    • autoimmunepaleo says

      Hi Saundra,
      You can’t assume your TH dominance based on which condition you have, especially if you have more than one. Epstein-Barr is a virus and not autoimmune and tends to be a problem for those with weak immune systems. You will have to work with a practitioner or do your own challenge to find out dominance 🙂

  • Taff Suthar says

    Hi, can I assume that chronic conditions like chrom’s disease are treatable and manageable by diet control and that the autoimmune balance can be restored naturally rather than using steroids to suppress the immune system. I would be grateful for any advise and pointers that I could discuss with my medical practitioner.
    I ask on behalf of a 17 ye at old boy based in Toronto and the chrom’s disease has started to affect his organs such as Kidneys.
    Any help on diet or natural restoring of the autoimmune system would be gratefully received.
    I am the boy’s uncle and I am based in Cheshire in the Uk.
    Kind regards and thank you in advance or any help

    Mr.Taff Suthar

    • Mickey says

      Hi Taff,
      I can’t really say that all disease is able to be managed by diet, because that simply isn’t true. I do know that diet has a very powerful role in causing and determining the course of disease, and eating optimally can definitely help a person get healthier. This may not mean that they go into remission or are cured, but a lot of people have regained a large part of their life a big part thanks to the autoimmune protocol. I would suggest that he do an autoimmune protocol, strict for a month or two, then reintroduce foods to asses if any of them are contributing to his symptoms. Of course, work with his doctor to make sure this is OK, as I am not a medical professional.

      Hope it helps, and good luck.

      Mickey

  • Heidi says

    Inflammatory bowel disease is an umbrella term for two conditions named Ulcerative Colitis and Crohn’s Disease. It doesn’t make sense to mention both “Inflammatory Bowel Disease” AND “Ulcerative Colitis” as part of one category, nor does it make sense to put “Crohn’s Disease” into another category than “Inflammatory Bowel Disease”.

    • Mickey says

      Hi Heidi,
      Thanks for pointing that out – I did not do the research, the tables are from Dr. Kharrazian’s book. He makes the case that none of these diseases can be placed neatly in the categories of Th1/Th2 – but that these are the more common presentations, according to his research. It seems that UC and Crohn’s are in separate categories, and the IBD is a mistake (maybe it was in reference to UC patients? I don’t know).

      In any case, it isn’t super important which category the disease usually presents in, because it is up to each person individually to test and find out their dominance.

      Mickey

  • Brittany says

    Hi Mickey,

    I’m glad you posted this article. I’ve been trying to find out what is causing my severe eczema now for 5 years. I’m on the autoimmune protocol diet now (4 weeks in) and still not seeing any or barely any results. I’m going to get the T1/T2 cytokine blood panel done on tues. I’m hoping that I can get an answer I’ve been looking for to figure out what’s going on with me. So if I do have T2 cell dominance, would taking the T1 cell elevating supplements help my eczema quicker then doing the diet alone? Could taking the supplements and continuing the diet cure my eczema or only help it? For the past few years, I’ve only rarely had days where my inflammation is down a little bit but my eczema has never been gone which makes me believe with the help of discovering the autoimmune diet through a friend that my body is constantly under attack by something going on inside. Thanks in advance for your help!

    • Mickey says

      Hi Brittany,
      Sounds like you have a frustrating situation there. I don’t actually recommend trying to balance your immune system with supplements unless you are working with someone highly qualified to do so – you can definitely cause flare ups working that way. Have you had a comprehensive stool test, like the metametrix GI effects panel? I would recommend that over the cytokine blood panel, if you haven’t had it yet. I would bet that your eczema is more tied to some imbalance in your gut than an imbalance in your immune system (although it is plausible).

      Mickey

      • Brittany says

        I was definitely going to seek help to balance my immune system with supplements and not do it on my own because I’m sure I would screw something up! I will double check about the stool test because I know I had one for parasites and I think it tested other stuff. Either way, I’m still going to get it done since that was awhile ago. I’m just going to get both tests done plus I’m also going to get the Cyrex panels and NutraEval test done on tuesday. Any other test you think I should get done to figure out whats causing my eczema? I’m sure I have a leaky gut but want to see if anything else is going on. I need to get an answer soon as to what is going on because I’m sick of wasting time and money guessing and not fixing myself. This month is Eczema Awareness Month and I’m determined to find “my” eczema cause and how to cure it. It’s holding me back from life and having more kids.

        Also, I would like to do another parasite cleanse with homeopathics but I think they have some ingredients that are not ok for the AIP protocol. Do I not do it then? What do you recommend?

        Thanks for your help!

  • DJ says

    CAN HASHIMOTO’S MIMICK RA. LATELY I’VE BEEN WONDERING IF FOR THE PAST 28YRS I’VE HAD HASHIMOTO’S INSTEAD OF RA EVER SINCE I WAS DIAGNOSED WITH HYPOTHROIDISM

    • Mickey says

      DJ,
      The symptoms can be similar, but really it comes down to antibodies. A lot of people with Hashimoto’s have joint pain and a lot of people with RA have Hashimoto’s. I hope you find out some answers – wishing you luck.

      Mickey

  • […] This article has moved to a location on my new website (autoimmune-paleo.com), click here to read it! […]

  • Great article. Good ol Dr Datis to the rescue. Since I started practicing functional medicine his methods get the best labs test results I have seen over other philosophies. When I found out I had hashimotos a few years back I remember how much brain damage there was to find the dominate side. Its not as easy as just supporting the th1 and th2 imbalance because 17 is the centerpiece that holds it all together. My best suggestion is Do Not try to do it without supervision of a very skilled dr. I see hundreds of women a year falling apart from AI and its hard to get them back together from years of wrong treatment. It costs s small fortune and isnt roses daises butterflies and cupcakes if you guess wrong. Good article and good health

  • Elsa says

    Hi Mickey
    Trying to help my husband feel better I came across your blog. He is forever tired, gets up after a night of bad sleep and wants to go back to bed, his short term memory is going fast, his joints and muscles are painful, he feels depressed and has unusual headaches. Sounds like CFS to me. Can you suggest a path to recovery?
    Thank you so much,
    Elsa

    • Mickey says

      Elsa,
      I’m so sorry to hear about your husband. I can’t really suggest a specific path without a full history, but I do know that some do well switching over to a nutrient-dense, Paleo style diet who suffer from inflammatory conditions. I would try and find a functional medicine practitioner, or someone who uses ancestral diet in their practice (primal docs and paleo physicians network are both great resources).

      Good luck!

      Mickey

  • Hi Mickey,

    Great explanation. I have been going through your autoimmune cookbook too. I would love to interview you when I get back in the US and have you on our blog talk radio show. You really have so much valuable information. I have been trying to keep up with your website. 🙂

    • Mickey says

      Thank you Sterling! I appreciate the support. I would love to be on your show, keep in touch! mickeytrescott at gmail.com.

      Mickey

  • Sven says

    http://worldcocoafoundation.org/wp-content/files_mf/perezberezo2009.pdf

    Cacao seems to Down-regulates Th2 Respons in rats. If thats true to humans as well it’s good news for me and every other Th2-dominant paleo cacao loving people.

    Thanks for a good article by the way!

  • loula says

    Hello,
    I was diagnosed with hashimoto’s, hypoglycemia and insulin resistance last week. Since I am a boxer and a body builder I felt devastated. The first signs I saw was fat on my belly which shouldn’t have happened because I eat super healthy and train daily. Training has become really hard for me lately and I barely could keep up with my trainer. Boxing is becoming a struggle… my periods are messed up too…
    Can you please tell me if there are any further blood tests or any type of tests that I can do in order for me to prepare my meals. I really have to save my muscles if I want to save my career. I am lost and overwhelmed. I am switching to an autoimmune paleo diet but I will need to fine tune it so as to help me rebuild the muscles I lost…
    Please I do need to save my career and stay healthy… where do I start? What do I do?
    Thank you…

    • Mickey says

      Loula,
      I’m sorry to hear of your struggles. I hate to say that intense exercise is not conducive to healing Hashimoto’s–you may need to give your body some rest in order to heal. A lot of people find improvement after undergoing the elimination diet, but there is no way to tell for sure. I recommend working with a functional medicine doctor who can help do some lab work to see if anything needs to be tweaked according to your needs.

      Wishing you luck,

      Mickey

  • onduru julius says

    i am very impressed with very exhaustive information you you in this web site. thank you so much and may you keep the good work

  • […] immune system. In a healthy body, our immune cells work in harmony. In an autoimmune body, one type of immune cell becomes dominant over the others, and our bodies’ defenses end up attacking us. Many herbs (including herbal antibiotics), […]

  • jason says

    any suggestions on how to treat lichen planus?

    • Mickey Trescott says

      Hi Jason, since we aren’t medical practitioners we can’t advise on treating medical conditions, however many people with LS (including our good friend Sarah Ballantyne) have had good results after trying the elimination diet!

  • Heidi says

    What company(s) do the Th1/Th2 cytokine blood panel? Thank you!

    • Mickey Trescott says

      Hi Heidi!
      This test is no longer recommended because the results were not clinically significant. Most folks find that self-experimentation using “challenge” packs or the ingredients listed above helps them figure out their dominance. Hope it helps!

  • […] it is best to evaluate how the immune system is reacting. The two main systems to evaluate are the TH1 and TH2 response. In autoimmune diseases one system tends to be dominant.  It is important to identify which system […]

  • […] immune system. In a healthy body, our immune cells work in harmony. In an autoimmune body, one type of immune cell becomes dominant over the others, and our bodies’ defenses end up attacking us. Many herbs (including herbal antibiotics), […]

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