TH1/TH2 & Autoimmunity: Symptoms and Testing

In a recent article I discussed two cells of the immune system: T Helper 1 (TH1) and T Helper 2 (TH2). In this article I will briefly discuss prevalence and symptoms of both, as well as current testing limitations.

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Prevalence:

In my experience, TH2 polarization (sometimes AKA “TH2 dominance”) is far more common than TH1 polarization. I believe this is due to several factors:

• Relative abundance of problematic yeast in the USA

• Relative abundance of viruses (they’re always everywhere!)

• Relative lack of parasites and soil-borne infections in the USA today (hygiene hypothesis)

• The abundance of and the effects of stress on the immune system (favors TH2 polarization)

• The over-use of steroids in the USA (favors TH2 polarization)

• The lack of breastfeeding in the USA (definitely alters the microbiome and immune system, unsure exactly how)

• The lack of nutrients in our diet that influence immunity (Zinc, Vitamin A, Vitamin D, Vitamin K)

• The prevalence of leaky gut syndrome and dysbiosis, which not only creates inflammation but sucks up all of your glutathione (which is needed for TH1 immunity)

Symptoms and Diseases of TH2 Polarization:

Here are some symptoms and diseases that are associated with TH2 polarization. Remember, TH2 cells command the allergic and anti-parasite side of the immune system.

• Eczema (Atopic Dermatitis)

• Asthma

• Allergies (both airborne and anaphylactic)

• Histamine intolerance

• IBS (particularly visceral hypersensitivity)

• Predilection toward ear and sinus infections

• Chronic viral infection(s)

  • Examples: Epstein Barr Virus (EBV), Cytomegalovirus (CMV), Herpes Simplex 1, 2, and 6, HIV, Parvovirus B19

• Mucous in stool

  • Note: This may mean you have a parasite that is driving the TH2 polarization, in which case suppressing TH2 is not recommended.

Symptoms and Diseases of TH1 Polarization:

If you google this, you will find much, much larger lists of “TH1 dominant diseases” on the internet. Please take these lists with a whopping grain of salt- most of what was blamed on TH1 cells was actually TH17 cells.

• Sudden, extreme autoimmune flares that seem to come out of nowhere. Often they will involve a lot of joint of muscle inflammation and pain.

  • Note: This is the best I can do to describe this. However, I have noted that every single one of my patients with Lupus/SLE and Fibromyalgia are TH2 polarized, not TH1. The same is true of the vast majority of my RA patients, if not all. A pattern like this that is truly due to TH1 cells is quite rare.

Testing Options:

There are only a few ways to test for TH1/TH2 balance, and all of them are somewhat lacking. You’re far better off determining this based on symptoms.

The Best we’ve got:

• At this time, we can’t measure TH1 or TH2 cells in blood samples. We can, however, test for some of their friends. On a standard CBC you can see Eosinophils and Basophils, which are both TH2 gang members. Other examples include Natural Killer cells (NK cells), B cells, Cytotoxic Ts, and a few others that can be ordered through Labcorp.

• You can see hints of TH17-mediated inflammation on routine blood work:

  • High C Reactive Protein (CRP)

  • Very low ferritin (with normal TIBC)

  • High ferritin (with normal TIBC and UIBC)

  • High Reverse T3

Not Recommended at this time:

• Cytokine tests such as this one from Diagnostic Solutions Labs, Labcorp, or Quest. There are times when I make an exception, but generally I do not recommend these tests for the following reasons:

  1. The amount of cytokines in the blood likely does not reflect the amount of cytokines in target tissues (ex: the lung or a lymph node). If the immune system made enough cytokines for them to show up in blood that would be tremendously wasteful and draining. Instead, cells make just enough to communicate with other local cells.

  2. At this time, I do not support the interpretation given by DSL for their Cytokine test. They currently list IL-6 as a TH2 cytokine, which is false (it is a TH17 cytokine). Less egregiously, they list TGF-beta as anti-inflammatory. While is is generally true, there are contexts where it can become very inflammatory or be made by inflammatory cells.

• “Poke it and see what happens” is what I jokingly call a test that was started by one of my favorite supplement companies, Apex Energetics. For this test, you are instructed to take some TH2 supportive herbs for 2 days (XFLM), then switch to TH1 supportive herbs (V-Viromin). If one makes you feel better, it is assumed that it’s because it helped balance your seesaw. I not only find this test to be of limited usefulness, but I now see that it is potentially very dangerous. If, for example, you give a virally infected person TH2 support, you will be giving the virus an advantage- the last thing that person needs. Sure, the person may feel a little better for the moment (because TH2 is inherently somewhat anti-inflammatory), but the down-stream consequences of this test may be disastrous.

Wishing you the best of health,