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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