This article is Part 2 of a series on how Th1 and Th2 may affect immune function, chronic urticaria. Part 1 focused on what Th1 and Th2 are, and how they work in health and 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 specific approaches, click the links above, but I also recommend seeing a local Naturopath. Testing and treatments really do vary based on your personal medical history.
A Quick Review
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 any immune 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 determind 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 patients.
Going with Trends
Beyond cytokine profiles we can run with the hypothesies 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 the accompanying article found 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 autoimmunity
- Toxicity implicated in Multiple sclerosis, Parkinson’s disease, autism
- Mercury given to rats in toxic levels produce systemic autoimmune vasculitis
The basics in treating immune disease is to regain balance.
In experimental models in animals, several 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 immune disease .
In general, if you’re Th1 dominant, we want to reduce Th1 and increase Th2. If you’re Th2 dominant, we aim to reduce Th2 and increase Th1. The goal is to always reach a state of balance.
How we Treat Th1 and Th2 Dominance
- Food: certain foods can stimulate the immune system. You’ll see some foods are helpful and some may be detrimental, depending on if you’re Th1 or Th2 dominant.
- Supplements: certain nutrients, vitamins and herbs can also stimulate the immune system. We must consider which ones help and which ones may harm, again, things depend on whether you’re Th1 or Th2 dominant.
- Activity/Lifestyle: again, certain lifestyle interventions such as exercise, hydrotherapy and acupuncture have been shown to modulate the immune system.
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.
Now that you’re familiar with the basis of Th1 and Th2 management, click the links below if you’re Th1 or Th2 dominant for more specific treatments with examples of foods, nutrients and lifestyle interventions.
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.
If you'd like to see me in practice, please click here, or the Book an Appointment tab at the top of this page.