Dr. Kyle Warren
Meghan Feir Walker
How is your immune system functioning when you have a chronic illness like Lyme, autoimmune conditions, and/or other issues? If you’re dealing with one or more chronic illnesses, you are also dealing with chronic immune dysfunction. One of the most important but often overlooked factors that must be checked in detail is how your immune system is working (or not working). More specifically, regulatory T cell levels and other immune markers should be measured. Observing different types of immune system dysfunction can help us understand how to help the immune system regulate itself.
This applies to every patient suffering from chronic Lyme, co-infections, autoimmune issues, and even patients who have lingering symptoms and an imbalanced immune system after infections have been eradicated.
Every patient is unique and has different types of immune dysfunction. When we tailor protocols to address their specific issues, we can be more successful in helping them heal, so let’s learn more about regulatory T cells.
| Key takeaways Regulatory T cells (Tregs) are specialized immune cells that help keep the body’s defense system balanced. They can calm overactive responses. Most Tregs are CD4⁺ cells that express FOXP3 and CD25, thereby limiting inflammation and maintaining immune harmony. Supporting Treg function may encourage recovery and resilience after immune challenges, such as the long-term effects of Lyme disease. Lingering symptoms after an infection is eradicated are due to inflammation caused by immune dysfunction. Only killing the bacteria in a Lyme protocol will cause far more side effects and complications. The immune system dysregulation must be addressed first. Nutrition, certain herbs, gut health, stress balance, and quality sleep can all help promote the body’s natural ability to maintain healthy immune regulation. |
What are regulatory T cells (Tregs)?
In the immune system, there are various types of immune cells, including neutrophils, monocytes, eosinophils, and lymphocytes.
Lymphocytes are important white blood cells that can identify, remember, and fight infections, viruses, and cancer. The main types of lymphocytes are B cells that help make antibodies, T cells that help kill infected cells and regulate the immune response, and natural killer (NK) cells that destroy infected cells.
T cells have many different subtypes.
T cell subtypes:
- T helper lymphocytes
- T cytotoxic lymphocytes
- T regulatory cell (Treg)
- Etc.
While everything has an important job, T regulatory cells (Tregs) are absolutely crucial lymphocytes, hence why I call them “the moms of the immune system.” They help maintain control and balance of the immune system and prevent excessive immune activation.
When someone has low levels of Tregs, we know the immune system is out of whack, often resulting in autoimmune conditions. The health of T regulatory cells is extremely important in preventing the immune system from losing control and attacking itself.
Unfortunately, many Lyme protocols only stress the importance of attacking the bacteria and don’t emphasize the importance of balancing the immune system.
While there are various things we can do to boost immune recruitment, thus helping the immune system attack intruders, we first want to regulate your immune system. We want the immune system to target and kill infections, viruses, and Lyme bacteria, but we don't want it to attack your body. Balancing T regulatory cells is absolutely key for maintaining that differentiation.
Why Tregs matter for wellness and immune support
Measuring T regulatory cells in the body points us in the right direction for helping the immune system.
Important ways Tregs regulate the immune system:
- Tregs have an immune-balancing effect.
- If you’re fighting something and your immune system is down, supporting Tregs can help boost the entire immune system.
- If your immune system is overactivated, Tregs can help calm down the immune system.
In our practice, many of our patients have inflammation and out-of-control immune systems, and adding support for Treg function can offer more immune control without having to suppress the entire system. This is key in helping people heal.
What is the difference between regulatory T cells and cytotoxic T cells?
T regulatory cells have different designations called cluster differentiations that are paired with a number (e.g., CD57). They are receptors located on the outside of the cell that help cells communicate with each other.
When we’re observing an immune panel for clues into how your immune system is functioning, we look at these cluster differentiation markers. One of the most common panels we use measures CD4, CD25, CD56, and CD57, all different types of immune cells.
The main difference between cytotoxic T cells and regulatory T cells is that cytotoxic T cells (e.g., CD8⁺) directly destroy infected or damaged cells, while regulatory T cells (e.g., CD4⁺) modulate and calm other immune cells.
Another unique aspect of Tregs is a special transcription factor called FoxP3, which is located in the nucleus (the interior) of the Treg cell. It’s a gene and protein that is a master regulator for Tregs.
Tregs help every other immune cell do its job in a more balanced way, making them of vital importance in how your immune system is able to function.
Regulatory T cells and long-term effects of Lyme disease
Immune imbalance after Lyme
Long-term immune activation often leads to lingering inflammation. Most of my patients are either fighting chronic Lyme disease (with an out-of-control immune system) or an autoimmune condition. Only about 15-20% of my patients are dealing with both Lyme and an autoimmune condition. This is one reason why people with chronic Lyme can respond so differently to protocols and present different symptoms.
Lyme, co-infections, and autoimmunity all involve chronic inflammation. When you dig deeper and measure the individual’s immune markers, you get a clearer picture of where their immune system is stuck.
For some patients, their immune system isn’t functioning properly because the Treg cells aren’t working as they should, but that’s not a universal pattern for everyone.
In some cases, Treg cell function is performing well, but other parts of the immune system are stuck in overdrive or underperforming.
While discovering which infections you’re fighting is direly important, you also need to know how each infection is altering different parts of your immune system.
Why immunosuppressants aren’t the answer for Lyme
There are many nutritional foods, supplements, herbs, and lifestyle choices that can raise parts of the immune system that are too low. However, it’s more difficult to balance an overactive immune system.
When you’re trying to calm down the immune system, anti-inflammatories and immunosuppressants may seem like good options. However, when someone is chronically sick, we want the immune system to be strong so they can heal. We want to regain balance and control of the immune system. We don't want to suppress the immune system forever.
That isn’t the solution to an overactive immune problem.
When you’re done fighting an infection, your body is supposed to calm down, stopping its creation of excess inflammation. This is known as immune resolution. But when your body is chronically inflamed, it’s clearly not resolving. It's getting stuck in its inflammatory pattern. We don't want to just suppress it. We want the immune system to move forward to immune resolution.
T regulatory cells can secrete a cytokine called Interleukin-10 (IL-10). IL-10 helps tell the immune system to calm down when necessary. Supporting Treg cells is a huge part of helping your immune system regain control and get to this healed, resolved state.
Tips for Lyme protocols
You don't want to boost an immune system that's out of control.
Treg cell function should be checked before you boost natural killer cells and use bacteria killers. If you’re just boosting natural killer cells, you might not only be killing bacteria but also boosting the destructive, inflammatory process of the body.
This is often why we focus on incorporating supplements and herbs that help regulate the immune system early in a protocol. Once that's established, you have a safety net for boosting natural killer cells, if necessary. The majority of the time, once you help the regulators, the rest of the immune system balances and is able to do its job much better.
Once the regulator cells are in place, the more aggressive parts of the protocol will go much more smoothly.
When Lyme is gone, but the inflammation remains
For some people, symptoms caused by inflammation remain even after the infection has been eradicated. This happens more prevalently with patients who have used many heavy antibiotics for long periods of time. However, this can still occasionally happen to patients who have gone the herbal route.
Why do symptoms remain after the infection is no longer active? Put simply, when the infection is gone, but patients are still inflamed, the immune system hasn’t calmed down.
This usually happens because most doctors solely focus on killing the infection and don’t pay attention to reestablishing immune system balance.
At Restorative Health Solutions, our number one goal is to reestablish immune balance for your body. The second goal is to kill the chronic Lyme bacteria. Since the first part of our protocols is focused on balancing the immune system before killing the bacteria, we usually see the inflammation resolve.
While some symptoms do come directly from the bacteria, many symptoms in autoimmunity, chronic Lyme disease, and other tick-borne infections come from the inflammation that is created.
You won’t feel better until your inflammation goes away, and your inflammation won’t go away until the T regulatory cells tell it to go away.
Examples of inflammation-caused symptoms:
- Brain fog
- Neuropathy
- Joint/muscle pain
- Low energy
- Sleep problems
- Depression, anxiety, and other mental health problems
- Etc.
Helping the immune system return to its normal state is a vital part of symptom relief.
How to support and encourage regulatory T cells
Gut health
The state of your microbiome cannot be overlooked. Gut health is important to address for almost every health issue, but especially when you’re trying to regulate an over- or under-performing immune system.
Treg activity can be boosted with beneficial metabolites like short-chain fatty acids. Butyrate and vitamin A can be excellent supporters for gut health.
Nutrition and nutrients
Focus on eating a healthy diet rich in vitamins, minerals, polyphenols, healthy fats, and protein.
Several nutrients are also useful for improving the function of Treg cells. Baseline nutrients like vitamin D, omega-3 fish oils, vitamin A, and glutathione are effective in supporting Treg cell function.
There are also herbs we use in our Lyme program that also improve Treg cell function, including Chinese skullcap and Japanese knotweed. These are also excellent choices for autoimmune/anti-inflammatory protocols because of their ability to boost Treg cell function. Other herbs have also been linked to improved Treg cell function, including turmeric and Reishi.
There are a number of nutrients and herbs that have been found to positively influence Tregs, and, depending on your symptoms and other factors, we can figure out which choices are the best for your specific case.
Lifestyle factors
Certain lifestyle choices can also increase Treg cells and their ability to function properly.
Lifestyle choices that support Treg cell function:
- Healthy sleep habits (getting enough sleep, going to bed at a regular, good time, etc.)
- Daily moderate exercise/movement
- Healthy, gut-friendly food
- Nutrient support (supplementing with things like vitamin D, vitamin A, butyrate, omega-3 fish oils, glutathione, and, in some cases, Chinese skullcap, Japanese knotweed, turmeric, and Reishi)
- Stress-management
- Practicing gratefulness
Movement is crucial for improving your immune system. You can’t regulate or balance your immune system without some form of regular movement or exercise.
In general, chronically inflamed people stop being active because they’re miserable, tired, and in pain, but once they stop moving, their mitochondria suffer. As you start feeling better, we begin incorporating movement back into your daily routine as quickly as possible.
While life is far from perfect, and it’s common to feel unhappy and full of fear when you’re constantly in pain, fatigued, and experiencing scary symptoms, try to focus on messages of encouragement and hope. Gratefulness has been shown to alter your nervous system and immune system to a state that promotes healing.
Emerging science on T regulatory cells
T regulatory cells have been in the news lately because the 2025 Nobel Prize in Physiology or Medicine was given to Mary E. Brunkow, Fred Ramsdell, and Shimon Sakaguchi for their discovery and research on Tregs. Their work focused on how Tregs impact the immune system and autoimmunity (when the immune system loses control and starts attacking itself).
I’ve spent much of my career trying to figure out ways to not just make protocols work, but to make protocols work safely with fewer issues. Thanks to ongoing research like theirs, we’ve been hearing about T regulatory cells and their role in immunity since 2010, and made it a point to measure and evaluate these cells in our practice.
Understanding how the immune system is reacting in a patient supports the healing process and adds safety and stability to a protocol.
Integrating Treg support into a functional wellness plan
You can get over chronic Lyme, co-infections, and help your immune system become more balanced with a comprehensive, functional approach. Your body can heal once the right pieces are identified and addressed.
Remember: We want the body to be able to defend you against infections, but we don't want your body to attack itself, and Treg cells are an imperative part of helping your immune system maintain control and proper targeting.
If you’re trying to come up with an action plan that supports Treg cells, focus on supporting gut function with healthy food, getting good sleep, moving every day, and taking supplements like butyrate, vitamin A, omega-3s, vitamin D, glutathione, and herbs like Chinese skullcap and Japanese knotweed. Turmeric and Reishi may be good choices in certain circumstances.
While this isn’t an exhaustive list, it’s a great starting point to help you regulate your immune function.
Uncover the root causes of chronic inflammation
At Restorative Health Solutions, we specialize in uncovering root causes and helping patients rebuild from the inside out.
If your symptoms don’t add up, it’s time to look deeper. If you don’t know whether they are caused by autoimmunity, chronic Lyme/PTLDS, and other tick-borne co-infections, or a combination of problems, we would love to help you in our clinic heal and live a healthy life.
Reach out to our clinic and set up your free consultation with one of our team members. They will go through your history, symptoms, and next steps with you.
Discovering what your body is fighting is the first step in recovering. You can get better from Lyme, co-infections, and autoimmunity.
To learn more about Lyme disease and co-infections, check out our Lyme page and blog.
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