What is the Immune System and Why is it so Important for Fertility?
The immune system is a network of cells, tissues and organs that work together to defend the body against attacks by ‘foreign’ invaders, known as antigens. Antigens are any substance which causes the body to produce an immune response against itself.
The immune system includes white blood cells or leukocytes which protect the body against disease and foreign invaders. Their main task is to distinguish between ‘self’ and ‘non-self’ substances. White blood cells target antigens for destruction but this can sometimes include the antigens of embryonic cells.
Have you Heard of Natural Killers?
Another part of the immune system is Lymphocytes. These are B and T cells. B cells are produced in the bone marrow and T cells in the thymus gland. They track and identify targets and keep records of invaders. T cells secrete cytokines, which are chemical messengers. Natural Killer cells or NK cells are a special type of white blood cell that is sent to attack targeted antigens.
You need Natural Killers in the body in order to protect the body against infections, especially as they provide a first response to harmful cells. Natural killers are raised in pregnancy to protect the foetus and a healthy number of Natural Killers is part of a healthy immune system. However, sometimes the body can over produce Natural Killers and T helper cells which can cause an over-reactive response.
What Happens in an Auto-Immune Response?
In the case of auto-immune disease, the white blood cells perceive a serious threat and the lymphocytes (B and T cells) deliver a specific immune response. There are two types of T helper cells, TH1 and TH2.
For example, in a TH1 response, cytokines are released and become overly aggressive. They can attack incorrect targets, such as an embryo, believing it to be a foreign body.
TH1 auto-immune responses include:
· MS, type 1 diabetes, lupus
· Vitiligo or psoriasis
· IBS or inflammatory bowel disease
· Connective tissue disorder/ myasthenia gravis
· Recurrent IVF failure or implantation failure
· Recurrent miscarriage
What can you do to naturally reduce TH1?
· Avoid lectins
· Probiotics
· DHA fish oil
· Turmeric
· Strawberries
· Black tea
· Black cumin seed oil
· Oliver leaf extract
· Myo-inositol
· Acupuncture
TH2
There is another type of T-helper cell, called TH2 cells. They act to restrain the TH1 cells.
TH1 cells are seen as aggressors. TH2 cells are seen as pacifiers.
TH2 cells generate cytokines and help to calm the actions of the TH1 cells. Therefore in acupuncture, if the TH1 response is dominant, we aim to raise TH2 in order to balance the response.
Healthy TH2 cells play a vital role at integrating pregnancy tissue into the body.
However, when TH2 are over-active and therefore over-suppress the TH1, the body can be vulnerable to infection.
When you attend acupuncture for your initial consultation, you will find that I ask you a lot of questions about the immune system to determine how to most effectively treat you with Chinese Medicine.
What is a TH2 Allergic Response?
Most allergies are classic TH2 dominant responses. For example, when IgE antibodies are produced in response to an allergen, histamine is released and attaches to the receptors on TH2 cells.
Some women have IgE antibodies to progesterone. Their bodies treat it as an allergen and release a TH2 immune response. This might cause hives in the luteal phase.
In this case, in Chinese Medicine we aim to raise TH1 in order to balance the immune response.
TH2 Reactions Include:
· Asthma, eczema or hayfever
· Allergies, food intolerances
· Sinusitis
· Cystitis
What can you do to naturally reduce TH2?
· Spend time in the sun
· Probiotics
· NAC
· Chinese herbs prescribed by a herbalist for your diagnosis
· Oxytocin
· Acupuncture
Inflammation
When it comes to the immune system, we can’t discuss it without thinking about inflammation as they are so closely related. We all need a healthy amount of inflammation in the body to be supportive of the immune system. However, we don’t want so much TH1 that all the body has is an over active inflammatory response and we don’t want so much TH2 that the inflammatory response is completely down regulated. Having the right amount is really important for implantation.
Here are some characteristics of excess inflammation:
Redness
Swelling
Heat
Pain
Loss of function
What Aspects of Fertility are Affected by an Over-Active Immune System?
Although we commonly think of an over active immune system as an implantation and miscarriage issue, it can affect other areas aswell.
For example, when NK cells are high, they circulate in the bloodstream looking for what they perceive as harmful cells and destroy them. But they also produce TNF - alpha, a chemical messenger which has a detrimental effect on the following stages of reproduction:
Egg quality
Implantation
Foetal growth
Foetal survival
How Does Acupuncture Help if you Have an Overactive Immune System?
In Chinese Medicine, raised Natural Killers means a diagnosis of Blood Stasis (where the blood flow is blocked), Spleen deficiency and Lung deficiency.
Spleen deficiency is predominant if your TH1 cells are raised and Lung deficiency is predominant if your TH2 cells are raised.
An acupuncturist will work out if your immune system may be overactive and which may be the predominant diagnosis. We would then move the blood and tonify the spleen and lung energy, using needles on these channels.
In order to reduce inflammation, acupuncture points can clear heat and remove damp which contribute to an over active inflammatory response.
NK Cell Testing:
If you have any of the following we may recommend that you get immunology testing.
· Any of the above auto-immune TH1 or allergen TH2 symptoms with the addition of:
· Thyroid condition
· PCOS
· Insulin resistance
· Family history of auto-immune disease
· Unexplained infertility
· History of STI
· History of depression, fibromyalgia or chronic fatigue
· Recurrent miscarriage
· Miscarriage with no known cause
· Miscarriage following birth of a child
· Problems in previous pregnancies, eg. Pre-eclampsia or pre-term labour
If your immune system is overactive, what is the medical treatment to support implantation and prevent miscarriage?
· Steroids (prednisolone)
· Intralipids
· Low dose aspirin
· Progesterone
· Endometrial scratch
· IVIg – Intravenous immunoglobulins
I hope this helps to determine whether or not you would benefit from acupuncture to balance the immune system, support egg quality and encourage implantation and whether you require additional immune system testing. Feel free to discuss this further with me at your next appointment.
Natalia
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