This article is Part 2 of a series on how Th1 and Th2 may affect immune function, including autoimmune disease. Part 1 focused on what Th1 and Th2 are, and how they can affect autoimmune disease. Click here to read that article. This article will focus on how to identify whether a person is Th1 or Th2 dominant followed by the basic treatment principals. For more specified approaches, I recommend seeing a local Naturopath.
As a reminder from my previous article, Th1 dominant responses often relate to organ specific autoimmune disease whereas Th2 dominant responses usually lead to systemic autoimmune disease and allergies . I want to emphasize these are theories, and the science isn’t cut and dry – but these principles can be used to start treatment of patients suffering from autoimmune disease .
How to Determine If You Are Th1 or Th2 Dominant
Before treating, we must try to determine if the person is Th1 or Th2 dominant. As we will discuss later, there are many foods, supplements and even lifestyle recommendations which could, in theory, aggravate a patient depending on whether they are Th1 or Th2 dominant.
Earlier we discussed Th1 dominance being associated with organ specific autoimmune disease, and Th2 dominance being associated with systemic autoimmune disease and allergies. I want to point out, there are exceptions – not every allergy case is due to Th2 dominance, and not every organ-specific autoimmune disease is Th1 dominant  – they are really determined by the cytokine profiles our body produces. For this reason, measuring cytokines may be helpful. Remember Th1 and Th2 subsets are built on cytokine patterns. Measuring the cytokines IL-10, IFN-gamma and TNF-alpha using ultra-sensitive enzyme linked immunosorbent assay systems would be an excellent place to start . Unfortunately, cytokine testing is difficult to do here in Ontario. Naturopaths are no longer able to requisition these tests for patient.
Going with Trends
Beyond cytokine profiles we can run with the hypotheses that Th1 dominance relates to organ specific autoimmune disease and Th2 dominance relates to systemic autoimmune disease, allergies and atopy . When I work with patients in this matter, we first eliminate potentially harmful foods (based on this hypothesis) and look for improvement. Once we gain some more insight into whether a person is Th1 dominant or Th2 dominant, we could add and remove more foods/supplements in trying to ease the symptoms.
We know certain diseases and conditions are classified according to Th1 or Th2 dominance. Please refer to Article 1 by clicking here.
We can also go based on symptoms in assessing whether a person is Th1 or Th2 dominant.
Th1 dominance is associated with:
- Delayed food sensitivities
- Fatigue after meals
- IF-gamma, IL-1b, TNF-alpha all part of Th1 cytokines and they all supress orexin, which in turn causes fatigue
- Low T3 syndrome 
- Thinness may be associated with Th1 dominance
- TNF-a and IL-1b are two Th1 related cytokines, both of which inhibit orexin (which inhibit appetite)
Th2 dominance is associated with:
- IgE skin allergies
- Nasal drip
- Hay fever
- Histamine intolerance
- Mercury exposure predisposes to Th2 dominance and auto-immunity
- Toxicity implicated in Multiple sclerosis, Parkinson’s disease, autism
- Mercury given to rats in toxic levels produce systemic autoimmune vasculitis
Remember the scale analogy from the other article:
This is what we want:
Immune dysfunction may look like this:
In experimental models in animals, a number of diseases can be prevented or improved by switching immune responses from Th1 to Th2 or from Th2 to Th1. The studies show the cytokines mentioned above can regulate the balance between proper immune function and immunopathology .
So if you’re Th1 dominant this is how we treat:
And if you’re TH2 dominant, this is what we do:
How we treat:
- we aim to balance the scale – bring the higher arm down, and raise the lower arm
- we bring one arm down by: avoiding the foods that stimulate that arm
- we bring the other arm up by: consuming foods that stimulate that arm
- The basics of treating Th1 and Th2 and these protocols are following Dr. Datis Kharrazian (DC)’s protocol. See his website here. In addition to the recommendations below, he also suggests using an Autoimmune/gut repair diet.
- It should be noted I don’t necessarily recommend every single item on the lists below – I just included everything for the sake of completeness
- Following these recommendations won’t cure disease, but I find some patients eat a lot of certain foods, some of which may be on the list of foods I would recommend avoiding. That’s a good place to start- remove the foods that you eat a lot of that oppose your condition.
Things to take/do if you are Th1 Dominant
- Fasting (intermittent fasting, or daily fasts) (reduces TH1, inflammatory cytokines)
- Vitamin A, Zinc (if deficient)  (human study, in deficient populations)
- Omega 3 (fish oils) (mouse study)
- Egg white (albumin) based protein supplements (mouse study)
- Soy based protein supplements (menopausal rat study)
- Evening Primrose Oil (Multiple Sclerosis, human study)
- Green Tea Extract
- Pine Bark Extract
- White Willow Bark
- Genistein (found in soybeans)
- Avoiding Lectins (Low Lectin Diet) 
- Fish (due to omega 3 sources) (reduces Th1 type cytokines, also small increase to TH2 (mouse study)
- Eggs(reduces Th1 type cytokines)  (mouse study)
- Soy(menopausal rat study)
- Hemp seeds (Multiple Sclerosis, human study)
- Pistachio (nuts, oil)  (rat study)
- Mustard seed (human study, Inflammatory Bowel Disease) 
- Gotu Kola
- 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)
- Turmeric for its Curcumin content
- Genistein (found in soybeans)
- Quercitin (a flavonoid found in many fruits and vegetables, such as onions, berries and kale)
- Progesterone 
- Likely contributes to natural suppression of cell-mediated immunity during pregnancy
In addition to the things above, if you are Th1 dominant, you could also try AVOIDING the things listed below (avoid the things to take if Th2 dominant).
Things to take/do if you are Th2 Dominant
- Medicinal Mushrooms (Maitake and Beta-Glucan are common) 
- Glycyrrhiza (found in licorice)
- Astragalus 
- Melissa Oficinalis (Lemon balm)
- Panax Ginseng
- Grape Seed Extract
- Melatonin (research went to 20mg/day; much higher than the typical 1-5 mg dosing for sleep) 
- DHEA 
- Selenium 
- Plant sterols, beta-sitosterol 
- NAC/Glutathione 
- Quercetin  (mouse study)
- Colostrum  (mouse study)
- Bilberry  (mouse study)
- Ginger (juice or root) 
In addition to the things above, if you are Th2 dominant, you could also try AVOIDING the things listed below (avoid the things to take if Th1 dominant).
One last note on probiotics: probiotics also have a role to play in balancing the Th1 and Th2 immune systems. It is the strains and combinations of those strains that will determine if a probiotic pushes Th1 or Th2. Talk to your naturopath about which products do what. Most research is done on individual strains, so they will need to tell you which products are suitable for you.
For a personalized, individual approach, and some help along the way, book in today to see what else can be done to help treat autoimmune disease.
About the Author
I'm Johann de Chickera, a Naturopathic Doctor, practicing in Ontario, Canada. My clinical practice relies on keeping up with the most up-to-date research and continued education. This blog serves as a way to provide others with a compilation of everything I've learned along the way. Please click here if you're local and want to see me in practice.