Autoimmune Patients, Have You Heard of Th1 and Th2 Dominance?

Autoimmune Patients, Have You Heard of Th1 and Th2 Dominance?

I remember the day I was reading the book Why Do I Still Have Thyroid Symptoms? When My Lab Tests Are Normal by Dr. Datis Kharrazian and came across the section on the importance of Th1 and Th2 dominance in Hashimoto’s Thyroiditis. I had never heard of this concept before and found it intriguing. I recently came across Mickey Trescott’s explanation of Th1 and Th2 dominance and felt it important to share with all of you.

This post was originally created for in two parts What is the Role of Th1 and Th2 in Autoimmune Disease? and How do You Balance Th1 and T2 in Autoimmune Disease  and re-posted together as one article here at Hypothyroid Mom with permission. Sarah Ballantyne, Ph.D. (a.k.a. The Paleo Mom) is author of a fabulous book called The Paleo Approach – Reverse Autoimmune Disease and Heal Your Body.

Written by Mickey Trescott, Autoimmune Paleo

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 article 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
Sjoren’s Syndrome
Celiac Disease
Lichen Planus
Rheumatoid Arthritis
Chronic viral infections

TH2 dominant conditions:

Allergic Dermatitis
Atopic Eczema
Inflammatory Bowel Disease
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.

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.

About Mickey Trescott

Mickey Trescott is the cook and blogger behind the website, which provides recipes and resources for the autoimmune protocol. 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 guiding people to better wellness through 1-on-1 customized nutritional therapy.

Mickey is the author of The Autoimmune Paleo Cookbook: An Allergen-Free Approach to Managing Chronic Illness, a guide and recipe book for the autoimmune protocol. She wrote the popular guest post How Autoimmune Paleo Change My Life at Hypothyroid Mom.


Why Do I Still Have Thyroid Symptoms? When My Lab Tests Are Normal – Datis Kharrazian

Basics of Immune Balancing for Hashimoto’s – Chris Kresser

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

Clinical Aspect in TH1 and TH2 Balance – Allergy Clinic Online

T helper cell – Wikipedia

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About Dana Trentini

Who knew that little butterfly-shaped thyroid gland at the base of my neck could affect my life so completely? I founded Hypothyroid Mom in memory of the unborn baby I lost to hypothyroidism. Winner of two 2014 WEGO Health Activist Awards: Health Activist Hero & Best In Show Twitter. *Hypothyroid Mom includes Affiliate links. Connect with me on Google+

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