Why Do I Feel So Good (Or Bad) During Pregnancy?

Pregnancy and Autoimmunity

Many women with autoimmune diseases experience a lessening of symptoms during their pregnancy, only to relapse after the baby is born. Or, the opposite may happen, where autoimmune disease symptoms worsen during pregnancy. Maybe you have heard of this phenomenon or even experienced it yourself. As we continue to celebrate Mothers’ Day, let’s dive into the ways pregnancy can affect an autoimmune disease.

One of the most amazing things about pregnancy is how a woman’s body doesn’t reject a fetus, which is basically foreign tissue because it shares DNA with the father. Very frequently during organ transplants, the body attacks foreign tissue because it thinks it is a threat. How do female bodies know not to attack a fetus?

The Tea on T Cells

Research has found that different types of T cells lead to either a tolerant immune response (the fetus lives), or an active immune response against the foreign tissue (miscarriage). The main two types of cells that make this decision are known as “Th1” and “Th2”. Th1 cells will reject a fetus, while Th2 cells are responsible for a successful pregnancy by creating baby-protecting antibodies.

Th1 and Th2 cells work dynamically creating balance, but are each linked to autoimmune diseases. So during pregnancy, when Th2 cell counts are higher, this can cause Th1-type autoimmune diseases to go into remission. This is why women with rheumatoid arthritis (RA), Graves’ disease, and multiple sclerosis (MS) usually feel much better while they are pregnant.

On the other hand, Th2-type autoimmune diseases such as systemic lupus erythematosus (SLE), generally known as just “lupus”, can get much worse during pregnancy while there are more Th2 cells trying to protect the fetus. Lupus flares can cause pregnancy complications such as preeclampsia (blood pressure problems).

Then, once the baby is born, the balance between those two types of T cells switches and causes the opposite effect: Th1-type diseases such as MS get worse, and Th2-type diseases such as lupus get better.

But is there just one simple answer to our question about why some women with autoimmune disease feel better during pregnancy? Our bodies are more complicated than that, of course. We know that Th1 can end a pregnancy while Th2 protects against miscarriages, but what decides which type of T cell is produced? 

Maybe the better question is, “What system can we influence that will regulate both in harmony?” If we could influence said system, wouldn’t we be less likely to experience these swings and problems during and after the pregnancy? After 13 years work with chronic autoimmune conditions, I can say there is an unequivocal “YES” to that question! T-regulatory cells influence Th17, the immune cells that control Th1/Th2 balance. Nutrients such as vitamins A, D, and K, as well as fiber, probiotics, alpha lipoic acid, green tea, and essential fatty acids are all potent stimulators for T-reg cell creation and ultimately help our immune system find balance! Are you getting enough of these in your diet or through supplementation? (Check out the bottom of this blog for one supplement that contains all of these nutrients!)

Hormones Have a Hand

Hormones are also tied strongly to autoimmune diseases, which often begin or change around pregnancy and menopause when a woman’s hormones are fluctuating. This is one of the reasons why most autoimmune diseases are much more common in women. For example, women are 3 times more likely to have rheumatoid arthritis than men are. This is even stronger for thyroid conditions like Hashimoto’s hypothyroidism.  

Androgens and estrogens, groups of sex hormones, are able to regulate Th1/Th2 balance. Androgens are generally male hormones and are responsible for pubic/underarm hair growth and help to build muscle. Estrogens help regulate menstrual cycles in females and fertility in males. Androgens such as testosterone promote Th1-type autoimmune diseases like RA, while estrogens promote Th2-type diseases such as SLE. Women with higher androgen levels (ex. polycystic ovarian syndrome, or PCOS) are therefore more likely to experience miscarriages because androgens promote Th1 cells. As we covered above, Th1 cells attack fetuses as if they are a foreign invader. 

Don’t forget that Th1 and Th2 basically work against each other. So when Th2-promoting estrogen is high during pregnancy, Th1-type diseases are suppressed and Th2-type diseases are fueled. When the baby is born, a woman’s estrogen levels decrease, allowing Th1-type diseases to flare up again.

All in all, hormones from pregnancy influence T cells, which influence autoimmune disease. Critical nutrients from diet and supplementation can help stimulate the regulation of the immune system and thereby smooth the transition.

Yours in Health,

Dr. Ian Hollaman

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Can Olive Oil Help Multiple Sclerosis Patients?

T-Regulatory Cells

T-regulatory (Treg) cells are the police force of our immune system. As their name suggests, Treg cells regulate our body’s immune response by suppressing it when it isn’t needed. They are extremely important in preventing autoimmunity, which occurs when the immune system attacks the body’s own cells.

FOXP3 is a protein of the FOX protein family. It plays a role in the differentiation of Tregs during their production. Some Tregs use other protein markers, but FOXP3+ Tregs are the most studied, so these are the ones we will be referring to in these blogs when we say “Tregs.”

We know that the body deploys Tregs to deal with inflammation and disease, but we are increasingly learning the importance of “tissue-resident Tregs” for maintaining overall balance, even if there is no immediate need for an immune response. Tissue-resident Tregs live in our tissues and keep those environments stable. We are still learning about the mechanisms these resident Tregs use, but there is a strong possibility that specific types of fat play a vital role.

What does oil have to do with it?

All Treg cells require fatty acids to be produced and function effectively. The process they use is called ‘fatty acid β-oxidation–driven (FAO-driven) oxidative phosphorylation (OXPHOS)’. The important part to remember is that FAO (fatty acids and oxygen) are needed. Fatty acids = lipids = fats = oils. Recent data shows that the types of fatty acids Tregs use for this process greatly impact their suppressive function.

Our tissues have a lot of fat cells mixed into them, so Tregs that live in tissue have easy access to lipids. A recent study published in the Journal of Clinical Investigation compared the concentrations of different types of fatty acids in healthy tissue versus tissue from a person with Multiple Sclerosis (MS). 

MS is an autoimmune disease that results when someone’s Tregs are not policing the immune system correctly, causing them to attack the myelin sheaths surrounding nerves. You can visualize the myelin sheath if you think about the coating surrounding a wire. Imagine your own Treg cells eating away at that protective coating, exposing the nerve (or wire) to damage.


Because of the nerve damage, MS patients can experience a gradual loss of feeling and function in their limbs, pain, weakness/fatigue, muscle spasms and eventually serious problems with inner organ function.

In the study, researchers found that tissue from healthy individuals contained much higher concentrations of oleic acid than tissue from MS patients. Oleic acid promotes the Treg FAO-driven metabolic process and consequently increases FOXP3 production, which of course promotes more Treg production. This positive feedback loop is responsible for maintaining balance.

While healthy tissue had a lot of oleic acids, tissue affected by MS had much higher concentrations of proinflammatory arachidonic acid. The Tregs in MS tissue used primarily arachidonic acid, instead of oleic acid, for their FAO-driven metabolism. These Tregs had defects in their suppressive function (ability to suppress the immune system when it is overreacting).

The most interesting thing is, when researchers exposed the defected Tregs to oleic acid, their suppressive function was partially restored. This same trend proved true when the oleic acid exposure treatment was applied to patients with MS.

Sources of oleic acid:

While walnuts and fish count as sources for oleic acid, at Dr. Autoimmune, we make sure everyone is getting a good dose through high-quality olive oil. The oil we provide our patients with is organic extra virgin olive oil from Spain pressed from Picual olives. When Picual olives are out of season, we switch to an organic Italian oil of equal quality. Dr. Autoimmune has done his due diligence and chosen the absolute best oil at the best price for you.

If you are looking for help getting your MS symptoms under control, contact us using the form below. Dr. Autoimmune’s team is eager to empower you with the tools and support you need in order to tackle your health goals. Mention this blog and receive 15% off our premium olive oil!