You may want to start with A Functional Medicine Approach to Inflammation.
I see many patients whose immune expression is weighted towards, or dominant in what’s called a Th2 response. This means the conditions they suffer from are not likely to improve unless their Th2 dominance is treated. I cannot stress this enough. Here in this post, I dig into Th2 dominance – what it is and how to move out of it. It gets a bit technical but I try my best to simplify it….
T cell polarization 101
This refers to the ways that your baby (naive) T cells mature into different types of grown-up (effector) T cells that are restricted to certain tasks. There are four main types of effector T cells, shown here, and they all serve a useful purpose:
This chart is just to show you the four main types (in yellow) of effector T cells that come from the naive baby T cell (in blue). Ideally, your naive T cells can mature in all four directions as needed. The problem is when you get stuck, or dominant, in one direction – especially Th17 (autoimmune) or Th2. Here we focus on Th2.
What are Th2 cells?
These are a normal immune response needed to mount an immune response to allergies and extracellular pathogens. Your Th2 immune surveillance is high in areas your body has contact with outside invaders. These areas include your skin and your “hollow space” organs and cavities – lungs, nose, sinuses, gut, bladder, and vagina. Th2 cells respond to invaders by ramping up inflammation in these areas. This response is normal and necessary.
However, if you can’t stop making Th2 cells, you get stuck in a Th2 polarization that’s no longer serving you. You stay inflamed in these hollow space areas, and you’re prone to infections in there.
Why does this happen?
Th2 cells produce inflammatory messengers called cytokines, the predominant one being interleukin 4 (IL4). Ideally, you can mount a Th2 response temporarily when needed. The problem is that the presence of IL4 directs your naive T cells to keep maturing into Th2 cells, which easily creates a perpetual feedback loop that can make you stuck in a Th2 response. This is Th2 dominance.
How to know if you’re stuck in Th2 dominance
Chronic infections or inflammation in these hollow spaces signify Th2 dominance:
- Lungs: asthma, wheezing, pleuritis, bronchitis, frequent respiratory infections
- Nose and sinus: congestion, runny nose, allergies, frequent colds or sinus infections
- Gut: food intolerances, colitis, Crohn’s, frequent small bowel bacteria or fungal (as in candida) overgrowth, leaky gut, dysbiosis, amoebic parasites like Giardia
- Bladder: frequent infections, irritation, urge to urinate frequently, interstitial cystitis
- Vagina: irritation, frequent bacterial or yeast infections, vulvodynia
You can also test and look for:
- Histamine back up
- High eosinophil count (higher than 1% of your white blood cells)
- High basophil count (should be 0)
Things that push Th2 dominance
There are many factors that drive Th2 expression, including:
- Mold toxins
- Expanded viral load – think herpes, cold sores, shingles, Epstein Barr virus (EBV).
- Chronic infections like Lyme
- Stress chemistry
- Allergies & histamine
Th2 dominance blocks Th1
If you are primarily making Th2 cells then you can’t make Th1 cells. This is a BIG problem. One very important thing to wrap your mind around is that Th1 and Th2 are oppositional. You can’t express both at once. Th1 cells suppress Th2 cells and vice versa.
Why is a Th1 response important?
The next (future) post is about Th1, but in brief, you absolutely need to make Th1 cells in order to fight all microscopic infections – think all bacteria and viruses. In addition, Th1 cells can help suppress autoimmunity.
This means that another indicator of Th2 dominance is the inability to fight infections and pathogens. This means you may:
- Get colds and the flu often
- Not easily recover from colds, flu, or sinus infections
- Experience colds quickly turning into lung infections
- Have deeper chronic viral infections – shingles, herpes, EBV
- Not be able to clear small intestinal bacterial overgrowth, candida, or other microscopic gut infections
- Get frequent vaginal or bladder infections
Another reason to address Th2 dominance
If you are trying to combat generalized inflammation, or quell an autoimmune flare (directions how to do this) you must get yourself out of Th2 dominance first and foremost, else your anti-inflammatory protocol may not work.
Furthermore, if you take natural anti-inflammatories like turmeric, before shifting out of Th2 dominance, you run the risk of making your inflammation worse! Does curcumin or turmeric do nothing for your inflammation or even make it worse? This may be why.
Why doesn’t my doctor treat this?
Why haven’t you heard about Th2 dominance from your doctor? Staying up-to-date with current research in immunology is quite an endeavor, so unless your doctor is an immunologist who reads a lot of science, she or he may not be aware of things we’ve discovered in the last decade.
It’s relatively new to be aware of Th2 polarization and how widespread it is! Your doctor may not be trained to recognize this and treat it. Meanwhile, not addressing Th2 dominance may foil treatment of these conditions! This is the main problem with not treating Th2 dominance.
How to treat Th2 dominance
Evaluate the things that push Th2 cells, and mitigate them. This may mean managing stress, clearing toxic burdens, lowering your antigen load from pathogens or from the environment – get help with this!
Use natural things that down-regulate the Th2 response. These includes:
- The herbs Perilla and Astragalus
- The supplements NAC and quercetin
- This supplement called Th-2 Modulator
- The supplement Oxymatrine
Promote Th1 cells, which is especially desirable in cases of infections. This is the subject of the next (future) post. I always treat Th2 dominance when it exists. Need more help with this? I’d love to help you!
I welcome your input below,