Joe Manganiello Reveals 7-Year Battle with Mysterious Autoimmune Disease That He Says Nearly Killed Him (Exclusive)

Joe Manganiello is opening up to PEOPLE about his secret health battle that he says nearly killed him

The True Blood star says he's now symptom-free and engaged to Caitlin O'Connor after the 7-year-long ordeal

Manganiello's new memoir Bloodlines will be available everywhere on Oct. 13

Joe Manganiello 's long hair is tied up in a top knot, his beard is perfectly groomed, and his skin boasts glowing tan. He looks healthy because, finally, he is.

For seven of the last 10 years, the actor was secretly fighting a mysterious autoimmune illness so virulent it nearly killed him. In his new memoir Bloodlines (out Oct. 13), Manganiello, 49, opens up about recovering from a health battle that led to "major organ amputation" and contributed to the end of his seven-year marriage to actress Sofía Vergara , 54: "I can't believe I'm alive," he says. "I feel like I was reborn."

Manganiello first skyrocketed to fame in 2010 on True Blood as sexy werewolf Alcide Herveaux and then as a bare-chested stud in 2012's Magic Mike . In 2015, he married Modern Family star Vergara. Life was good—until Manganiello's health began to deteriorate shortly after their wedding.

It started with excruciating abdominal pain that left him unable to walk as his digestive tract ulcerated, along with fevers, blistering rashes, headaches and fatigue. He even began bleeding from his rectum while still a newlywed. "I was getting sicker and sicker," he says.

Over the course of seven years, Manganiello lost 60 lbs., underwent countless colonoscopies, and in one emergency surgery in 2016, had part of his intestines removed, leaving him unable to go to the bathroom normally and relying on an ostomy bag.

"It happened to me, and it's the truth, and I have all the scars to prove it," Manganiello says of the ordeal, for which he never received a conclusive diagnosis. "[Autoimmune] conditions are a dumping ground for things [doctors] don't understand. They start running you through this gauntlet of drugs."

Manganiello was prescribed meds for nerve pain as well as drugs used to treat Crohn's and colitis. "None of them worked on me," he says. Forced to turn to hydrocodone pills, fentanyl patches and marijuana to ease his agony, Manganiello wrestled with his hard-won 13 years of sobriety. "I didn't feel like I deserved to say that I was sober," he recalls, "[but] I had to put the pain and the condition first."

As Manganiello cycled through hospitals searching for answers, his illness took a toll on his marriage, which he writes had "become devoid of any emotionality whatsoever." He claims in the book that Vergara refused to hug him even when he begged and that she ridiculed him for his 5-lb. chihuahua Bubbles, a then-sickly pup Manganiello had adopted in 2019 when he was considering suicide. "I had to give my gun away because I kept thinking about it, and then the dog came. I went from being the patient to the caretaker," he says.

The couple's dream of having a child together had also been dashed. Vergara would later tell a Spanish newspaper that their marriage "broke up because my husband was younger; he wanted to have kids, and I didn't want to be an old mom." But Manganiello says he gave up the idea because of his illness. After failed IVF attempts led to them considering egg donors, he says he didn't want to die and leave Vergara with a child "who wasn't biologically hers."

Writing this book was his way of correcting the record: "There were things said and printed about me that were false," he says.

His marriage crumbling and his body failing, Manganiello looked beyond traditional medicine for answers. At one point his desperate search brought him to Cuba where a medicine man had him lick the pituitary gland in a goat's skull, but Manganiello believes he eventually found healing through a Santa Monica shaman, who told him generational trauma was to blame.

Manganiello's great-grandmother lost nine of her children to genocide in Armenia, and his grandmother battled lupus. He says he unburdened himself of his family's torment by confronting it: "Whatever chains there were to the past suffering of my ancestors, they were completely broken. There's not an ounce of fear in me about moving forward with my life."

Now the actor, who underwent follow-up surgery to reconnect his digestive tract, says he's off medication and symptom-free.

"Autoimmune diseases can go into remission," says Dr. Dawn Beaulieu, a Vanderbilt University Medical Center gastroenterologist and functional medicine provider who hasn't treated Manganiello. "From a medical standpoint, all we know is that he's better. This was his journey."

By his side on that journey today is Manganiello's fiancée Caitlin O'Connor , 37, whom he met after he filed for divorce in 2023. "Caitlin came into my life at this point where it was obvious to me that [she] was the direction to go," he says.

Together the couple are navigating a future—possibly one with children. "If that's meant for me," Manganiello says of potential fatherhood. "For seven years I thought I was going to be dead the next week. The world has opened back up to me."