Joe Manganiello is opening up about a devastating health crisis that he says changed nearly every part of his life. In his upcoming memoir Bloodlines, the actor details a seven-year battle with a mysterious, undiagnosed autoimmune illness that brought severe physical pain, multiple medical procedures, and a life-threatening emergency.
The 49-year-old actor also writes about how the illness affected his marriage to Sofía Vergara. His account offers new context around the years leading up to their 2023 split while also addressing public speculation about why their relationship ended.
Bloodlines, published by Avid Reader Press/Simon & Schuster, is scheduled for release on October 13, 2026.
Joe Manganiello’s autoimmune illness remained undiagnosed.
Manganiello says his health problems began shortly after his 2015 wedding to Vergara. According to excerpts from Bloodlines reported by PEOPLE, his symptoms included intense abdominal pain, fevers, rashes, fatigue, and rectal bleeding.
His condition became increasingly difficult to manage. He underwent repeated medical testing and procedures, but doctors were unable to provide a definitive diagnosis.
Manganiello describes the experience as a prolonged search for answers. The memoir presents his illness as autoimmune-related, but no specific autoimmune disease has been publicly identified as his diagnosis.
That distinction is important because autoimmune conditions can involve very different symptoms and treatments. In Manganiello’s case, the memoir focuses on his individual experience rather than providing a confirmed medical diagnosis.
A medical emergency changed everything.
The actor’s health crisis reached a critical point in 2016.
During an emergency hospitalization, doctors reportedly discovered severe infection in his large intestine and determined that immediate surgery was necessary. The procedure involved removing his large intestine and resulted in Manganiello needing an ostomy bag.
Entertainment Weekly reported that Manganiello recalled fearing he might die during the ordeal. The experience also became one of the defining moments of the health battle described in Bloodlines.
The physical consequences were only part of the struggle. Manganiello also writes about the emotional impact of living with an illness that doctors could not fully explain.
His illness also affected his marriage to Sofía Vergara.
Manganiello connects his prolonged health crisis with the deterioration of his marriage to Vergara.
In his memoir, he describes a relationship that became emotionally difficult while he was searching for answers about his health. He also discusses feeling unsupported during some of his darkest periods.
These are Manganiello’s recollections and allegations about a highly personal relationship. They should not be treated as independently established facts.
PEOPLE reported that Vergara’s representatives had not responded to the allegations at the time of its coverage.
Manganiello disputes the public narrative about their divorce.
The actor also uses Bloodlines to revisit the public discussion surrounding his divorce from Vergara.
The couple married in 2015 and announced their separation in 2023. Their different views about having children became a major part of the public conversation surrounding the breakup.
Vergara previously said that the marriage ended partly because Manganiello wanted children while she did not want to become an older mother. Manganiello disputed that characterization in a 2024 interview with Men’s Journal, saying the relationship ultimately ended because the couple had grown apart.
His memoir now provides additional context from his perspective. Manganiello says his serious health problems changed how he viewed the possibility of becoming a father.
He has explained that he did not want to risk leaving Vergara with a child if his illness caused him to die.
Bubbles became an important source of support.
During one of the lowest periods of his health battle, Manganiello adopted a small Chihuahua named Bubbles.
He has credited the dog with giving him a renewed sense of responsibility and purpose. According to PEOPLE, Manganiello has also spoken openly about experiencing suicidal thoughts during his illness and said caring for Bubbles helped shift his focus.
The story adds another dimension to his memoir. Bloodlines is not simply an account of medical procedures. It also explores the psychological effects of prolonged illness and the ways Manganiello tried to find meaning while dealing with uncertainty.
Manganiello says he is now in remission.
After years of medical treatment and searching for answers, Manganiello says his health has significantly improved.
He is now symptom-free and off medication, according to recent reporting about the memoir. His recovery story also includes unconventional approaches to healing and an exploration of family history and generational trauma.
The official publisher description similarly frames Bloodlines as a story about survival, illness, ancestry, and the emotional consequences of inherited trauma.
However, his personal explanation for recovery should not be confused with established medical evidence about autoimmune disease. His memoir describes his own experience and beliefs.
What is Joe Manganiello’s memoir Bloodlines about?
Bloodlines goes beyond Manganiello’s Hollywood career.
According to Simon & Schuster, the memoir explores his mysterious illness, near-death experiences, family history, and the search for answers beyond conventional medicine. It also examines themes of masculinity, faith, identity, and survival.
The book is scheduled to be published by Avid Reader Press/Simon & Schuster on October 13, 2026, and is listed at 320 pages.
Joe Manganiello is looking toward a new chapter.
Manganiello’s story has changed significantly since his divorce from Vergara.
He is now engaged to actress and host Caitlin O’Connor. The couple announced their engagement in October 2025 after Manganiello proposed in June of that year.
His health recovery has also changed his outlook. After years spent fearing that his illness could take his life, Manganiello now describes himself as able to look toward the future.
For the actor, Bloodlines appears to be an attempt to explain that journey in his own words—from a mysterious illness and major surgery to emotional turmoil, recovery, and a renewed sense of possibility.