Question about TH1/TH2 immune response in late stage Lyme and Buhner Protocol

[Lotus97]

I've avoided Astragulus like the plague after reading what Buhner said about it's effect in late stage Lyme. Astragulus stimulates a TH1 immune response and xrunner explains why Astragulus should be avoided.

The other thing to bear in mind is that Astragalus, one of the components of Oxy, will stimulate a TH1 immune response and this may not appropriate for autoimmune disorders and for certain infections that in the chronic stage will overstimulate the TH1 (some infections initially are TH2 dominant but with time they become chronic and shift the immune response to a TH1 dominance). One such is Borrelia (Lyme disease) which has typical viral symptoms and it's fairly difficult to diagnose. Astragalus in chronic Lyme will aggravate symptoms and the disease process.

Here's where the confusion comes in for me. In the past, Buhner recommended Sarsaparilla/Smilax for herx and mopping up toxins. In a recent quote he says he now prefers chlorella instead of Sarsaparilla. At this point I should mention that about 30% of the population has some sort of intolerance to chlorella and should use caution when taking it. Perhaps start out with half a capsule and work your way up. I don't have an intolerance to chlorella, but I just read that chlorella along with some other supplements I've been taking or have considered taking or have taken in the past also stimulate a TH1 response. I also just found out that some of the supplements I have been taking or are planning on taking initiate a TH2 response. There's an article about Dr. Cheney who believes that many people with CFS have a TH2 dominant response and need to shift it to a TH1 dominant response. It also says that Ampligen shifts from TH2 to TH1.
http://www.ei-resource.org/articles/chronic-fatigue-syndrome-articles/dr.-cheney:-balance-the-immune-system-(th1th2)-/
This is all rather confusing. How do I balance my TH1 and TH2? I don't think I'm going to have any luck convincing my doctor to have me tested. Is it possible to support both TH1 and TH2? I found this from Dr. Jeff

The difficulty with these sometimes is that they support different elements of either Th1 or Th2 production. It's possible to support both and have a beneficial effect. For instance, it may support overall Th1 dominance, while supporting aspects of Th2 that reduce runaway inflammation.

 

[heapsreal]

http://www.drkaslow.com/html/immune_restoration.html
an interesting read on th1 and th2 stuff.
is says some substances promote both th1 and th2 astragalus, echinacea and beta glucan. So posting this link as it mentions astragalus but also alot of other info

 

[heapsreal]

14. DHEA or AED (androstenediol) increases IL-2, IFN-gamma and decreases IL-6 and 10.DHEA or AED promotes Th1 and decreases Th2 cytokines.Research done in Mexico by Hernandez-Pando R et al in mice exposed to B. Tuberculosis (TB) found that either DHEA (Dehydroepiandrosterone) or AED (androstendiol) had antiglucocorticoid effects and promoted Th1 cytokines. They reported that immunity to TB requires a Th1 cytokine profile. Their findings suggest that adrenal exhaustion may promote a cytokine shift from Th1 to Th2.They report that AED was particularly protective, causing a “fall in bacterial counts and prolonged survival.”(Immunology 1998 Oct;95(2):234-41).Inserra (Proc Soc Exp Biol Med 1998 May;218(1):76-82) at the University of Arizona found DHEA significantly increased Th1 cytokines (IL-2 and IFN-gamma) and decreased Th2 cytokines (IL-6 and Il-10) in aged mice.

Above is from the link in previous post. I think its apart of many of our problems, adrenal fatigue because if these hormones are off it changes the th1 and 2 balance. There is a section in the link that says prednison/cortisol promotes th2 response but low doses promotes th1 response?? There are many substances that cfsers find helpful in that link that are th1 shifters LDN being one of them. I am suprised that immunovir or inosine arent mentioned.

Is it th2 that go after allergies?? if so then treating allergies with say an antihistamine could help with th1 response?? as its sorting the allergies out and a th2 response isnt required??? but just a thought.

 

[Lotus97]

This is all very confusing stuff. We really need more doctors working on this kind of stuff
That's interesting. Someone was just telling me about LDN.

 

[heapsreal]

This is all very confusing stuff. We really need more doctors working on this kind of stuff
That's interesting. Someone was just telling me about LDN.

agree, nothing is black and white just alot of grey.

 

[Lotus97]

This new research on HERV seems interesting, but I don't understand any of it.

 

[Lotus97]

I was reading something Rich wrote about Lyme and methylation and he mentioned the Th1 response. I'm not sure how it fits in with all this.

It is known that the immune system is dysfunctional in CFS, and the GD-MCB hypothesis [6] suggests that this results from glutathione depletion and disruption of the folate metabolism. Glutathione is particularly important for the function of the T lymphocytes [20], and folate is needed in the synthesis of DNA and RNA, necessary for the proliferation of T cells [21]. Thus, the biochemical mechanism suggested in the GD-MCB hypothesis can be expected to have a deleterious effect on the cell-mediated (Th1) immune response, which is needed to counter intracellular pathogens. Bb has been found to be able to reside intracellularly [18], and it has been shown that Th1 types of responses are required for optimum eradication of Bb [22]. Therefore, this immune dysfunction may help Bb to continue to survive in the body of the host, which is relevant to chronic Lyme disease.

 

[Lotus97]

When I made a partial recovery last year I was taking supplements that were listed either as a TH1 or TH2 stimulant and they didn't cause any problems. Maybe they balanced each other out, but my guess that some of the lists I've looked at that simply list certain supplements as either a TH1 or a TH2 stimulant is an oversimplification. I have no idea who this Dr. Jeff is that I quoted, but his response was to someone asking if certain TH2 stimulating supplements were ok to take. I'll post the question and answer for better context as to why I quoted him earlier.

Dr. Jeff I am very confused about the th1 stimulating substances and th2 and what supplements I should take etc. I have read a lot of contradictions. Some say grapeseed extract is th1 and some say th2. I know if your th2 dominant which most people with candida are than you want to take food and supplements that switch your immune system over to th1 mostly. I know you talk a lot about probiotics and how taking them early in the plan can candida can cause them to have a th2 response which prolongs the fungal condition.

From what I understand after researching these are the the supplements I take that are said to be th2 stimulators or that are in question to me. I know there are many positive benefits to taking these substances but i don't want to screw up the plan and there are so many contradictory statements and opinions.

Curcumin
Resveratrol
Some say Grapeseed extract?
Green Tea
Coenzyme Q10
Some say cats claw
Certain Mushrooms (Maitake)

Can you give me a list of supplements I should avoid that would potentially cause my immune system to stay at th2 while doing the plan? Can you also tell me if taking or rotating the substance listed above is ok or i should avoid them because taking them would not allow the switch back to th1 necessary to rid the body of candida.

I think your list of supplements is fine, with the possible exception of Cat's Claw. Most of the info on that seems to support Th2. The difficulty with these sometimes is that they support different elements of either Th1 or Th2 production. It's possible to support both and have a beneficial effect. For instance, it may support overall Th1 dominance, while supporting aspects of Th2 that reduce runaway inflammation.

Something I just noticed is that the person mentions probiotics and I've been having a lot problems with probiotics recently. I thought it was just that the probiotics might be causing a herx. I didn't even realize they could initiate a Th2 response. The main symptom I've been experiencing is depression. I was reading that certain cytokines can induce depression. Both cytokines from Th1 and Th2 are involved. I'm planning creating a more general thread about supplements that affect the immune system that would apply to more people than just Lyme. I'm not sure if Buhner is right though about Th1 or Th2 in Lyme being different than the other people here.

 

[heapsreal]

its all about having the right balance, we still need th2 activity as well.

From what i read about astragalus it does both, so i dont think its one or the other, which is what it seems reading others doctors opinions on this.

I think if we narrow it down then we need to look for things that improve nk function and cd8 t cell function as these are things commonly found in cfs/me. If u can find anything on increasing nk bright cells then this is closer to the mark as this is what PHANU are looking into as a biomarker for cfs/me.

 

[taniaaust1]

Is it th2 that go after allergies?? if so then treating allergies with say an antihistamine could help with th1 response?? as its sorting the allergies out and a th2 response isnt required??? but just a thought.

"Many researchers regard allergy as a Th2 weighted imbalance, and recently immunologists have been investigating ways to redirect allergic Th2 responses in favour of Th1 responses to try to reduce the incidence of atopy" http://www.bmj.com/content/321/7258/424.1 Interesting article , it talks of many things


"An additional strategy is being used to prevent the onset of disease; this involves the study of pregnancy and early postnatal life. Both of these states are chiefly viewed as Th2 phenomena (to reduce the risk of miscarriage, a strong Th2 response is necessary to modify the Th1 cellular response in utero). The fetus can switch on an immune response early in pregnancy, and because pregnancy is chiefly a Th2 situation, babies tend to be born with Th2 biased immune responses. These can be switched off rapidly postnatally under the influence of microbiological exposure or can be enhanced by early exposure to allergens.

It is also hypothesised that those who go on to develop full blown allergies may be those who are born with a generally weaker Th1 response, although it is now apparent that babies with allergies produce weak Th1 and Th2 responses"

Ive always suspected I was Th2 dominant all my life. I had hayfever as a child (something I dont really get issues with now).

 

[Symptomatic]

Another doc who has written about Th1/Th2 and Th17 (mostly in relation to autoimmune/thyroid, not CFS), and also Nitric Oxide is Datis Kharrazian. I bought his book specifically for the Th1/Th2 info, even though I don't currently have an official thyroid condition (do have high rT3 though). I do have immune/possible autoimmune issues, and my sister has Hashi's.

This is one of his blog entries:
http://thyroidbook.com/blog/page/3/

 

[adreno]

I suspect I'm TH2 dominant as well. Supps that stimulate TH2 generally make me worse; not so with astragalus.

 

[Lotus97]

"Many researchers regard allergy as a Th2 weighted imbalance, and recently immunologists have been investigating ways to redirect allergic Th2 responses in favour of Th1 responses to try to reduce the incidence of atopy" http://www.bmj.com/content/321/7258/424.1 Interesting article , it talks of many things


"An additional strategy is being used to prevent the onset of disease; this involves the study of pregnancy and early postnatal life. Both of these states are chiefly viewed as Th2 phenomena (to reduce the risk of miscarriage, a strong Th2 response is necessary to modify the Th1 cellular response in utero). The fetus can switch on an immune response early in pregnancy, and because pregnancy is chiefly a Th2 situation, babies tend to be born with Th2 biased immune responses. These can be switched off rapidly postnatally under the influence of microbiological exposure or can be enhanced by early exposure to allergens.

It is also hypothesised that those who go on to develop full blown allergies may be those who are born with a generally weaker Th1 response, although it is now apparent that babies with allergies produce weak Th1 and Th2 responses"

Ive always suspected I was Th2 dominant all my life. I had hayfever as a child (something I dont really get issues with now).

That's interesting about allergies being a Th2 response because quercetin is listed as a Th2 stimulant yet it helps a lot of people with allergies.

 

[Lotus97]

I found some recent quotes from Stephen Buhner about astragalus and chronic/late stage Lyme and it seems it doesn't always cause problems even though it's a Th1 stimulant and it's even helpful for some people.

Dear Stephen,
I have chronic lyme and stopped taking astragalus every day after reading Healing Lyme. In a few days I went into a tail spin! Tried to go without it for a week with continued deterioration. Back on it now – 500mg 2x day – and feel great! What weirdness do I have that makes me need this herb so badly in my chronic condition? Thank you!
Stephen’s response:
Astragalus does work for some people. Some people really don’t do well on it, for others it is very helpful. The information in the book is only intended to be a guideline for working with lyme. I feel it is very important for each person to modify the protocol for their specific situation.
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Dear Stephen,
My bartonella infection is a very late chronic stage one, and blood tests show a Th1 towards Th2 shift, which is the other way around than with lyme. You don’t recommend astragalus for late stage lyme as this is a Th1 condition which will be increased by this herb and should be avoided. But in my case, apparently I am in a Th2 dominant situation with a late stage bartonella infection, so what do you think in this case to use astragalus?​

Stephen’s response:
I would try it.​

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Dear Stephen,
I have been bitten a number of times over the last ten years. What usually happens, is I use your protocol and it helps very much, but then I get bitten again and I have to up the dosage and start again. So, I probably have chronic lyme. I’m certainly not new to it. Anyway, you recommend astragalus for prevention. I’d love to take something for prevention, but you say not to take it if one has chronic lyme. Is this still true? And if so, why? What does it do that’s negative? Thanks so very, very much for your protocol, such a big help, Don’t know what I’d do without it.

Stephen’s response:
If you are not currently sick, you can certainly take astragalus. The reason for not recommending it is that astragalus raises the parts of the immune system that are overactivated in chronic lyme. Those parts of the immune system are highly effective against lyme early on and help prevent or reduce the disease but if they are low to begin with and you are infected the infection can spread more easily. After awhile the immune system does ratchet up those parts to attack the lyme bacteria but by then the spirochete has altered itself and is no longer very affected by them, those parts of the immune system then begin to cause some of the lyme symptoms people have making the disease a kind of autoimmune problem. My book Healing Lyme goes into this in a great amount of detail.
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Dear Stephen,
I’m interested in adding astragalus to my protocol. HoweverHealing Lyme says it is contraindicated. I have “chronic lyme” plus many coinfections, including ehrlichia, babesia, and herpes simplex (for possibly 20+ years). The description in your book seems to cover many of my complaints including chronic fatigue, ehrlichia, chest pains, neuroborreliosis and more. Is it never indicated in late stage?

Stephen’s response:
You can try it and see how it works for you; none of this is written in stone. If you end up feeling worse, discontinue it.
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Dear Stephen,
You advise against astragalus for late-stage infection and up to now I have not taken it. At what point after treatment for late-stage is it okay to take it? I’ve been on your protocol as well as antibiotics for almost a year and have been pretty much symptom free for a month. Would astragalus be okay/advisable at this point?

Stephen’s response:
Six months after you are well, you can take it regularly.​

 

[Lotus97]

Someone just started a thread saying curcumin caused a herx with them. One person suggested in that thread suggested that it was because curcumin was a Th2 stimulant and many people here are Th2 dominant.

I also spoke with someone about Th1/Th2 response in Lyme and this is what she told me (although I'm just noticing now she didn't mention whether they were all chronic/late stage or not, but I think she was)

As far as Lyme and Th1 and Th2, I can only share what I know from other patients. I am in touch with many patients who have both Lyme and ME and they are all overbalanced toward Th2. So my doc hopes to switch us to Th1.

 

[heapsreal]

i used curcumin for quite awhile, cant say i noticed a great deal but there is enough science behind it, its suppose to be a good antioxidant etc I think alot of these substances dont actually have a feelable affect but that doesnt mean its not working. i think antioxidants go along way in preventing alot of damage and long term issues. worth persuing. I dropped the curcumin as i am on alot of antioxidants as it is, more a cost saving thing. I think its important to take a variety of antioxidants. my main antioxidants are vit e and c, nac, lipoic acid, q10, acetyl carnitine. I think lipoic acid and nac have gone along way in protecting my liver from medications and antivirals i have used over the years, liver and kidney function has always been good which i put down to them.

 

[Lotus97]

Those are pretty much the ones I'm taking except I'm taking fumarate because acetyl seems to make me too wired although fumarate can do that too to a certain extent. I actually am taking more than just those though since my health has taken a turn for the worse recently. I don't really know how much they're helping though. Without a good night's sleep and adequate rest during the day I think supplements are just band-aids. At least for myself. I can't speak for other people. I was talking to someone about recoveries and she was saying that for people with ME, Lyme, or some other type of virus or infection a recovery is likely to be only temporary unless the root cause of the illness is treated. I've only made one recovery so far, but that seems to be the case for me. I don't know if everyone diagnosed with CFS or fibromyalgia actually does have an underlying infection or virus as the cause. Someone said his wife with CFS was competing in a triathlon after only 6 months of being on Freddd's methylation protocol. My health actually got worse after trying methylation.

Curcumin has gotten a fair amount of positive customer reviews, but not everyone responds the same. About what I said earlier on curcumin, a quick Google search shows that curcumin possesses antibacterial, antifungal, antimicrobial, and antiviral properties so that person might have just been experiencing die off. Also, I'm not sure if these lists about Th1/Th2 stimulants mean that they all active the same way. While curcumin is listed as a Th2 stimulant it also is supposed to inhibit cytokines (I'm not sure if that includes Th2 cytokines) which might be why it helps some people with pain if it's from inflammatory cytokines.

 

[Lotus97]

I found the passage from Stephen Buhner's Healing Lyme book
http://www.amazon.com/Healing-Lyme-Prevention-Borreliosis-Coinfections/dp/0970869630
I hope it's ok to post this. It seems like a very good book from what I've read so far. I first heard about Buhner's protocol from customer reviews on iHerb where people were commenting that they were herxing on his protocol so I guess that means it works (?)

Buhner is saying that late-stage Lyme, unlike other chronic illnesses, is a Th1 illness and that astragalus will agravate the Lyme symptoms. I haven't read through the book, but I think some of the herbs in his protocol stimulate certain aspects of the Th1 immune system without causing it to become overactive as astragalus can sometimes do. Although astragalus is contraindicated for late-stage/chronic Lyme, Buhner recommends astragalus for early stage Lyme and also Lyme prevention (if you live in a Lyme infested area or have a partner with Lyme for example). Based on some of those Q&As I posted above, it seems that Buhner is also saying that astragalus might be good if you have Lyme in remission, but I'm not 100% sure about that.

 

[heapsreal]

I found the passage from Stephen Buhner's Healing Lyme book
http://www.amazon.com/Healing-Lyme-Prevention-Borreliosis-Coinfections/dp/0970869630
I hope it's ok to post this. It seems like a very good book from what I've read so far. I first heard about Buhner's protocol from customer reviews on iHerb where people were commenting that they were herxing on his protocol so I guess that means it works (?)

Buhner is saying that late-stage Lyme, unlike other chronic illnesses, is a Th1 illness and that astragalus will agravate the Lyme symptoms. I haven't read through the book, but I think some of the herbs in his protocol stimulate certain aspects of the Th1 immune system without causing it to become overactive as astragalus can sometimes do. Although astragalus is contraindicated for late-stage/chronic Lyme, Buhner recommends astragalus for early stage Lyme and also Lyme prevention (if you live in a Lyme infested area or have a partner with Lyme for example). Based on some of those Q&As I posted above, it seems that Buhner is also saying that astragalus might be good if you have Lyme in remission, but I'm not 100% sure about that.
View attachment 4924

might be also why herpes viruses then reactivate in lyme. Herpes viruses can lower interferon production as this is how it avoids our immune system, lower interferon lowers our nk function. so either or can make the other worse, double whammy

 

[Lotus97]

I mentioned earlier that someone told me they had heard of people with Lyme being Th2 dominant and yet Buhner says Lyme is Th1 illness. What if they're both right? Maybe Lyme suppresses certain aspects of Th1 and also causes a shift towards Th2 as many chronic illnesses seem to do, but at the same time Lyme causes other aspects of Th1 to overactive. However, the overactive Th1 doesn't do much good because certain parts are still supressed. Rich talked about how glutathione depletion can cause natural killer cells and CD8 cytoxic T lymphocytes to be unable to function properly. People with Lyme and other chronic illnesses are most likely to be glutathione depleted.
http://forums.phoenixrising.me/inde...lls-perforin-and-glutathione-depletion.17603/
Natural killer cells normally kill cells that are infected with viruses. They do this by secreting a substance called perforin, which makes a hole in the cell membrane, and then injecting granzymes, which induce the cell to undergo apoptosis (programmed cell death). The CD8 cytotoxic T cells operate in the same way in terms of their killing mechanism.

Some years ago, Dr. Kevin Maher, who was in Dr. Nancy Klimas's group, reported that the natural killer cells in PWMEs are low in perforin. It was also found that the CD8 cytoxic T lymphocytes were also low in perforin. This would, of course, inhibit their cytotoxic activity.

I suggest that this new result is consistent with the mechanism I have proposed for low perforin in ME/CFS. It indicates that the NK cells and CD8 cells are "trying hard" to produce perforin by boosting the transcription of the PRF1 gene to messenger RNA, but the protein synthesis process is at least partially blocked and cannot respond. If glutathione is somewhat depleted in the NK cells and CD8 cells, the protein synthesis process would indeed be partially blocked.

I continue to propose, as I did in 2007, that other features of the observed immune dysfunction in ME/CFS can also be explained by the GD-MCB hypothesis. These include the shift to Th2 immune response, the elevated RNase-L and formation of the low-molecular-weight RNase-L, the elevated inflammation, the failure of lymphocytes to proliferate when stimulated with mitogens, the reactivation of viruses and intracellular bacteria, and the accumulation of pathogens over time.

Best regards,

Rich