PANDAS/PANS

PANDAS (Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections) and PANS (Pediatric Acute-onset Neuropsychiatric Syndrome) are conditions in which infection and the inflammatory effects of infection disrupt normal brain and immune function.

While these syndromes are often associated with a sudden and dramatic onset of symptoms—making them easier to recognize—the underlying drivers are frequently more complex. Infection may not behave like a typical short-lived illness. Instead, certain infections can persist, evade immune clearance, and create widespread immune dysregulation.

Although labeled as pediatric conditions, PANDAS and PANS can also occur in adolescents and adults.

Naturopathic Approach To PANDAs/PANS

Comprehensive Intake and Assessment

A detailed and compassionate intake is essential, particularly given the sudden and often distressing nature of symptoms. Assessment focuses on identifying triggers, patterns, and system involvement, including:

Timeline of symptom onset and progression
History of streptococcal infections or recurrent infections
Sudden onset of neuropsychiatric symptoms such as:
- Obsessions and/or compulsions
- Food restriction
- Tics or involuntary movements
- Emotional dysregulation, irritability, anxiety, depression, or separation anxiety
- Aggressive or oppositional behavior
- Cognitive regression, loss of academic skills, handwriting changes, or motor coordination difficulties
- Seizures or choreiform finger movements
- Urinary frequency or enuresis
- Increased sensory sensitivities
- Sleep disturbances

Evaluation also includes immune health, digestive function, inflammatory burden, and neurological regulation.

Comprehensive Functional Testing

Functional testing helps identify infectious triggers and immune system patterns contributing to symptoms. Testing may include:

Streptococcal testing when indicated
Evaluation for other infectious triggers associated with PANS, including:
- Mycoplasma pneumoniae
- Influenza viruses
- Epstein-Barr virus
- Borrelia burgdorferi (Lyme disease)
- Herpes simplex and Varicella viruses
Immune and inflammatory markers
Nutrient testing, with particular attention to carnitine and vitamin A, which are commonly depleted in chronic infection
Digestive health testing, including constipation patterns that may allow infections to persist
Assessment for biofilm activity where pathogens may evade treatment

This information allows care to be precise, measured, and supportive rather than overwhelming.

Individualized Treatment Plan

Treatment of PANDAS and PANS follows a step-by-step biomedical approach, focusing on restoring immune stability and neurological function. Treatment plans are individualized and may include:

Addressing chronic or ongoing infections, one layer at a time
Biofilm-disrupting strategies to expose hidden pathogens
Digestive support to reduce chronic infection reservoirs
Anti-inflammatory and immune-modulating therapies to calm immune overactivation
Nutrient repletion, particularly carnitine and vitamin A:
- Carnitine depletion may prevent treatments from reaching target tissues
- Vitamin A deficiency can impair immune clearance and immune regulation
Nervous system and brain inflammation support
Sleep optimization and sensory regulation strategies

Biomedical treatment is not a quick fix. It is an ongoing and adaptive process that evolves with the patient’s symptoms, resilience, and response to care. With individualized and comprehensive treatment, many patients experience meaningful improvements in emotional regulation, cognitive function, behavior, and overall quality of life.

PANDAS and PANS are medical conditions with treatment options. Supporting the body’s systems allows the immune system to regain clarity and stability, creating the foundation for healing.

PANDAS/PANS

Naturopathic Approach To PANDAs/PANS

Comprehensive Intake and Assessment

Comprehensive Functional Testing

Individualized Treatment Plan

Conditions

Testings

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